Esophageal Disorders

Question 1

What is the difference between a modified barium swallow and a regular barium swallow?

Answer 1

The Regular Barium swallow looks at the entire esophagus, “esophageal sweep”

The Modified Barium Swallow looks just at the oropharynx. (What we do!)

Question 2

GERD vs. LPR

Answer 2

Gastroesophageal Reflux Disorder: reflux that goes above the LES but not above the UES.

Laryngopharyngeal Reflux: reflux that can go past the UES and can spill onto the vocal folds causing contact ulcers on the posterior parts of the VFs.

Question 3

What is Achalasia?

Answer 3

Tightening/failure to relax of the LES, making food passage into the stomach a challenge and painful.

Question 4

What are some symptoms of achalasia?

Answer 4

Dysphagia for solid & liquid
Regurgitation
Chest pain
Feeling like there is something stuck in your throat.

Question 5

Is the peristalsis affected in achalasia?

Answer 5

Not normally. It will be diminished.

Question 6

Describe diffuse esophageal spasm (DES)

Answer 6

LES fails to relax to allow passage of bolus from the esophagus to stomach.
Repetitive, high amplitude contractions of smooth muscle portion of the esophagus. Peristalsis is affected.
corkscrew motion

Question 7

Describe nutcracker esophagus.

Answer 7

Similar to DES (Diffuse esophageal spasm) marked by very high amplitude contractions in the distal esophagus. More severe corkscrew.

Question 8

What are strictures?

Answer 8

Defined as any loss of lumen area within the esophagus, narrowing of the esophagus.

Question 9

What does the biological term “lumen” refer to?

Answer 9

the inside space of a tubular structure.

Question 10

About how big is the diameter of a normal esophagus?

Answer 10

about 20 mm in diameter

Question 11

What is the predominant clinical symptom of strictures?

Answer 11

The predominant clinical symptom of strictures is dysphagia, which is usually when the lumenal diameter is less than 15 mm. (Normal is 20 mm)

Question 12

What is a Schatzki ring?

Answer 12

A varient of strictures. (The narrowing is layered)

Narrowing of the lower part of theesophagus.

The narrowing is caused by a ring ofmucosal/muscular tissue.

Question 13

List some symptoms of GERD.

Answer 13

Classic symptom is frequent and persistent heartburn. Persistent sore throat, hoarseness, chronic cough, asthma, heart-like chest pain, and a feeling of a lump in the throat.

Question 14

How can you identify LPR?

Answer 14

pH Monitoring. Monitoring the pH levels in the pharynx for 24 hours.

Question 15

Any kind of a diverticulum is a…

Answer 15

pouch

Question 16

What is the most common location for esopheal diverticulum?

Answer 16

Killian’s triangle: Exists between the cricopharyngeal sphincter and the inferior pharyngeal constrictor muscle.

Question 17

What is an esophageal diverticula?

Answer 17

When a pouch or sac protrudes from the esophageal wall and contains portions of the bolus.

Question 18

What are esophageal diverticulums assocatated with/symptoms?

Answer 18

Cough
Bad Breath
Regurgitation of undigested food
May see a bulge in the throat
May have repeated Pneumonia.

Question 19

What is the most common type of esophageal diverticula?

Answer 19

Zenker’s Diverticulum, which occurs near Killian’s Triangle.

Question 20

How do you treate esophageal diverticula?

Answer 20

Surgery.

Question 21

What is scleroderma?

Answer 21

Connective tissue disorder that weakens LES thus associated with increased GERD

Affect predominantly the smooth muscle region - (lower 2/3)of the esophagus.

Causes hypermotility.