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
