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

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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.

Pylori, or what determines the outcome of acute infection. The consequences of chronic H. pylori infection are more important in clinical practice. Chronic H. pylori infection H. pylori colonizes the epithelium of the gastric antrum in chronic infection (65). The organism lies adjacent to the gastric epithelial cells, and in the gastric pits beneath the mucous layer. Active, chronic gastritis develops predominantly in the antrum. Degenerative changes occur in the epithelium, and chronic inflammatory cells consisting of polymorphs, plasma cells, and 65 H.

At endoscopy, a number of appearances have been described, none of which are specific. Mucosal changes include furrows, corrugations, and vertical lines (37). The lumen may have a small calibre (38). Management Any GORD should be treated. Endoscopic dilatation should be considered for smallcalibre oesophagus, but is associated with a higher rate of oesophageal perforation than peptic disease. Bolus obstruction can be managed endoscopically. There is no routine medical therapy, but topical steroids (fluticasone) and the leukotriene receptor antagonist montelukast have been used.

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