Esophagus + gastric Flashcards
Gastroparesis
cause? dx? tx?
MCC is IDIOPATHIC, may also be DM or Neuropathy
==> chronic NV, early satiety +/- ab pain
dx: Gastric Emptying Study
tx: prokinetic agents(metoclopromide), small meals, avoid opiates
Hpylori Ulcer description
tx? dx?
single ulcer!
TX: 1. Amox+Clarithromycin + PPI 2. Metro + tetra+ bismuth +H2
DX: w/breath test & confirm eradication w/stool antigen
NSAIDs Ulcer
description? tx? dx?
multiple shallow ulcers, tx w/PPI + stop drug
-> sulcrafate, misoprostal, H2
Malignancy Ulcer
description? tx? dx?
necrotic base w/heaped margins, resect lesion + PPI
Curlings Ulcer
description? tx? dx?
ulcer seen in burn patients, tx w/PPI
Cushings Ulcers
description? tx? dx?
ulcers seen in patients with increased ICP or ventillated patients, tx w/PPI
Gastrinoma Ulcer
description? tx? dx?
multiple refractory ulcers + diarrhea, tx w/resection of the tumor
Tx of barretts esophagus
HD PPI + annual EGD, once stable EGDq3
GERD tx
LD PPI for 6weeks then lifestyle(avoid LES dialators: alcohol, smoking, pepermint, chocolate)
Achalasia
dx?tx?
loss of myenteric plexus causing LES not relaxing
dx: biopsy > EGD
tx: dilation
Scleroderma
tx?
anti-centromer, anti-SCL70(topoI), autoimmune depo of collagen causing LES not able to contract = relentless GERD
tx: PPI for gerd, methotrexate, NSAIDs
Esophageal Spasm
dx? tx?
looks like MI + relieved by nitrates
dx: mamometry showing spasm
tx: NO, CCB
Schatzki Ring
dx? tx?
Fibrous Ring & LES causing EPISOIC dysphagia usually w/big meals
dx: biopsy, EGD
tx: dilate
tx of eosinophilic esophagitis
1st: PPI
2nd line: aerosolized steroids
tx of caustic esophagitis
low severity: liquid diet 24-48h
high severity: stridor + wheezing NPO 72hrs & can do NG lavage
**NEVER vomit, NEVER neutralize
