Esophageal Diseases Flashcards
oropharyngeal dysphagia
difficulty initiating a swallow, and/or associated coughing, choking, or nasal regurgitation
esophageal dysphagia
sensation of food getting stuck in esophagus, typically a few seconds after initiating a swallow
achalasia
Failure of LES to relax because of loss/degeneration of Auerbach’s (myenteric) plexus
-> Loss of postganglionic inhibitory neurons (normally release nitric oxide, VIP) which would relax the sphincter muscles
scleroderma esophagus
Autoimmune condition associated with alteration in microvasculature and immune system leading to fibrosis
-> Esophageal dysmotility: esophageal smooth muscle atrophy which results in decrease in LES pressure and dysmotility
eosinophilic esophagitis
Chronic, immune/antigen-mediated disease, leads to solid food dysphagia, food impaction, heartburn; (associated with asthma, food allergies)
Gastroesophageal Reflux Disease (GERD)
Pathologic regurgitation of gastric contents into the esophagus
- may by symptomatic (burning, chest pain, dysphagia, regurgitation) or asymptomatic with complications
Barrett’s Esophagus
metaplastic transformation of esophageal lining (normal stratified squamous -> intestinal columnar with goblet cells)
HSV Esophagitis
punched out lesions, see the 3 Ms on histology (molding, multi-nucleated, margination)
CMV Esophagitis
large solitary ulcers or erosions
Candida Esophagitis
white mucosal plaque-like lesions
Squamous Cell Carcinoma of Esophagus
most common worldwide
risk factors = older male, Black, rural, ETOH/tobacco, vitamin/mineral deficiencies, h/o achalasia, esophagitis, celiac
Adenocarcinoma of Esophagus
rising incidence in US
risk factors = GERD, Barrett’s, obesity, diet low in fruits/veg
protective factors = NSAIDs, aspirin, H. Pylori
Para-esophageal Hernia
Stomach herniated above diaphragmatic pinch
Schatzki’s Ring
fibrous band of tissue that develops in and constricts the lower esophagus, possibly due to long-term GERD.
