Dse of the Esophagus Flashcards
What are the disease seen in esophagus?
- Gastroesophageal Reflux (GERD)
- Esophageal Cancer
- Schatzki ring
- Plummer-Vinson or Paterson-Kelly syndrome
- Hiatal Hernia
- Achalasia
- Corrosive esophagitis
- Mallory-weiss tear
- Esophageal varices
What are the symptoms of Esophageal Dse?
- Heartburn (pyrosis)
- Regurgitation
- Chest pain
- Esophageal dysphagia
- Odynophagia
- Globus sensation (globus pharyngeus)
It is the most common esophageal symptom, a discomfort or burning sensation behind the sternum that arises from the epigastrium and may radiate toward the neck
- Heartburn (pyrosis)
SYMPTOMS OF ESOPHAGEAL DISEASE:
effortless return of food or fluid into the pharynx without nausea or retching
- Regurgitation
SYMPTOMS OF ESOPHAGEAL DISEASE:
Characteristics similar to cardiac pain a pressure type sensation in the mid chest, radiating to the mid back, arms, or jaws.
- Chest pain
SYMPTOMS OF ESOPHAGEAL DISEASE:
Feeling of food “sticking” or even lodging in the chest.
- Esophageal dysphagia
SYMPTOMS OF ESOPHAGEAL DISEASE:
- Pain either caused by or exacerbated by swallowing
- more common with pill or infectious esophagitis
- Odynophagia
SYMPTOMS OF ESOPHAGEAL DISEASE:
Preception of a lump or fullness in the throat that is felt irrespective of swallowing. Often occurs in the settling of anxiety or obssessive-compulsive disorders
- Globus sensation
what are the 3 dominant mechanisms of esophagogastric junction icompetence?
- Transient LES relaxations
- LES hypotension
- Anatomic distortion of the esophagogastric junction inclusive of hiatal hernia
What is the typical manifestation of GERD?
- Heartburn and Regurgitation
Less typical or common symptoms of GERD?
- Dysphagia & chest pain
What are the esophageal syndromes associated with GERD>
- Chronic cough
- Laryngitis
- Asthma
- Dental erosion
What is the hallmark for endoscopic examination of GERD
- Erosive esophagitis at the esophagogastric junction
why does esophagitis occurs in GERD patient?
- Esophagitis occurs when refluxed gastric acid and pepsin induce inflammation of the esophageal mucosa that leads to microscopic injury and macroscopic erosion and ulcers
At what pH level is an indication of recent acid reflux?
- pH <4
How does Reflux testing is done?
- ambulatory 24-94 h esophageal pH monitoring using wireless pH sensitive transmitter
what are refluxogenic foods?
- Fatty foods
- Alcohol
- Spearmint
- Peppermint
- Possibly coffee and tea
What are the 3 category of foods to avoid to prevent GERD?
- Refluxogenic food
- Acidic foods (citrus fruits and tomato based foods)
- Also minimize reflux or heartburn by avoiding stress
It is a treatment of GERD wherein the proximal stomach is wrapped around the distal esophagus to create an antireflux barrier - this is usually done with severe however it is rarely done
Laparoscopic Nissen Fundoplication
What are prevention of GERD in progressing to Barret’s syndrome?
- High-dose proton pump inhibitor therapy
- PPI + Aspirin
- Delay all cause mortality or the development of esophageal adenocarcinoma or progression to high-grade dysplasia
What is the typical presentation of Esophageal Cancer
- Progressive solid food dysphagia and weight loss
What are the associated symptoms of esophageal cancer
- odynophagia
- Iron deficiency
- Cough from tracheoesophageal fistula
- Hoarseness from left recurrent laryngeal nerve injury
What is the diameter of the lumen seen with Schatzki rings
- <13 mm
Schatzki ring is associated with? other than narrowing of lumen
- episodic solid food dysphagia
It is one of the most common causes of intermittent food impaction also known as “ steakhouse syndrome”
Schatzki rings
it is constriction of the esophagus seen higher in the esophagus can be of congenital or inflammatory in origin
Web-like constriction
A narrowing syndrome characterize with combination of symptomatic proximal esophageal webs and iron-deficiency anemia in middle-aged woman
- Plummer vinson or paterson-kelly syndrome
