Dysphagia and GERD Flashcards
Dysphagia with normal gastropscopy often due to
Achalasia - NO decrease in lower esophageal sphincter pressure, less peristalsis in body
causes of dysphagia
- achalasia
- cancer of esophagus
- scleroderma -
how does scleroderma cause dysphagia
- decreased esophageal sphincter pressure - no peristalsis
schatzki’s ring causes what type of dysphagia
Intermittent dysphagia
If dysphagia happens with both solids and liquids it is often a
neuromuscular disorder
If dysphagia is problematic with solids and liquids and is progressive
- chronic heart burn/ scleroderma
If dysphagia is problematic with solids and liquids and is progressive with resp Sx
achalasia
If dysphagia happens only with solids
mechanical obstruction
If mechanical obstruction is intermittent
- Lower esophageal ring
If mechanical obstruction is progressive with chronic heart burn
- peptic stricture
if > 40, cancer
The most common cause of true dysphagia is
Peptic stricture
when do you suspect eosinophilic esophagitis
- young, allergies, pain, mucosal rings, many eosinophils
Pathogenesis of reflux in most cases is
transient relaxation of lower esophageal sphincter
what are 2 reliable indicators of reflux
- heart burn
- acid regurgitation
Diagnosis of reflux is established by
NOT gastroscopy
- 24 hr esophageal pH monitor
Reflux can be
NERD vs Esophagitis
what is the metaplasia in barretts esophagus
squamous to columnar
what are the risks of barrett’s
High relative risk of adenocarcinoma
Low absolute risk
Treatment of reflux is
PPIs
weight loww
elevate head at night
