Download A Colour Handbook of Gastroenterology by Ralph Boulton, Sanjeev Gupta, Claire Cousins, Humphrey PDF

By Ralph Boulton, Sanjeev Gupta, Claire Cousins, Humphrey Hodgson

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Aetiology, epidemiology, and pathophysiology Pharyngeal pouches are uncommon and affect the elderly. The diverticula arise in the midline, posteriorly between the inferior constrictor and the cricopharyngeus muscles. They enlarge as thin-walled sacs, typically deviating to the left side of the neck. The aetiology may be failure of relaxation during swallowing, due to primary cricopharyngeal dysfunction, sometimes referred to as cricopharyngeal achalasia. There is an association with hiatus hernia.

In developed countries, the prevalence is low in children, but rises with increasing age, paralleling the agerelated prevalence of chronic gastritis (20% of 20-year-olds and 60% of 60-year-olds). In poorer communities, the prevalence is high in all age groups. TYPES OF H. PYLORI INFECTION Acute H. pylori infection Little is known about the acute phase of H. pylori infection. A short-lived illness with epigastric pain, nausea, and vomiting associated with hypochlorhydria has been reported following ingestion of H.

This is replaced by columnar epithelium as an adaptive response, and thus the squamocolumnar junction migrates up 51A 51 Two images of uncomplicated Barrett’s oesophagus. Physical examination There are no physical signs. Laboratory and special examinations The diagnosis is suspected at endoscopy. Normally, the demarcation between pink–grey squamous epithelium and salmon-red columnar epithelium forms an irregular ring at the cardia. This is called the ora serrata or ‘Z’ line. In columnar-lined oesophagus, this migrates proximally as a cylinder, with islands of pink squamous mucosa or long irregular tongues of columnar mucosa rising into the oesophagus from the cardia (51).

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