Esophagus GI issues Flashcards
What is esophagitis?
Inflammation of the esophagus primarily affecting the mucosa. Associated with GERD or other not infectious causes.
What is dysphagia?
Difficulty in swallowing caused by a number of underlying causes: stroke, local trauma, muscle dysfunction, tumor or swelling that obstructs the passage of food
List some neuromuscular causes of oropharyngeal dysphagia
CVA MS Thyroid dysfunction CP Head trauma Bells palsy
List some structural disorders that cause oropharyngeal dysphagia
Oropharyngeal tumors Zenker's diverticulum Thyroidomegaly Prior surgery/radiation Prox. esophageal webs Cleft palate
List some neuromuscular causes of esophageal dysphagia?
achalasia
diffused esophageal spasm
nutcracker esophagus
scleroderms
List some structural disorders that cause esophageal dysphagia?
peptic stricture esophageal rings and webs diverticula carcinoma foreign bodies mucosal injuries ---> infections or GERD
List dysphagia red flags
weight loss odynophagia vomiting early satiety GI bleeding Iron deficiency ---> carcinoma
When does oropharyngeal dysphagia begin?
begins within 2 seconds of swallowing
When does esophageal dysphagia begin?
begins several seconds after swallowing and often in a feeling of food being stuck in lower sternal area
What is the best test for esophageal dysphagia?
Esophagogastroduodenoscopy (EGD)
What is achalasia?
Motliltiy disorder of the esophagus characterized by incomplete relaxation of the lower esophageal sphincter and peristalsis of esophagus smooth muscle.
—-> failure to relax
Short term symptom relief of achalasia?
CCB and Nitrates
What is esophageal spasm?
increase number of uncoordinated peristaltic waves
What is esophageal stricture?
narrowing of the esophagus usually due to gastric reflux can be d/t toxic liquids or solids
What is an esophageal ring (schatzki ring)
narrowing of the diameter of the esophageal lumen usually at the level of the lower esophageal sphincter. This mucosal ring is a thin annual web-like tissue usually at the level of the squamocolumnar junction
What is esophageal web?
a thin membrane that may develop across the lumen of the esophagus usually at the level of the cricoid cartilage
What is esophageal web associated with?
iron def. anemia.
What is Zenker’s Diverticulum?
obstruction of the esophageal introitus that results from mucosal herniation posteriorly between the cricopharyngeus muscle and the inferior pharyngeal constrictor muscle.
S/Sx of Zenker’s Diverticulum?
dysphagia to solids and liquids (MC)
regurgitation
sensation of lump/fullness
cough
halitosis
aspiration pneumonia
weight loss
voice changes
sialorrhea
What is the test of choice to diagnose Zenker’s diverticulum?
Barium swallow
What is a hiatal hernia?
protrusion of intra-abdominal contents through an enlarged esophageal hiatus of the diaphragm
Barrett’s esophagus is predisposed to develop what?
esophageal adenocarcinoma
Clinical sxs and findings of Barretts esophagus?
chronic hearburn
dysphagia w/ solid foods
epigastric TTP
Etiology of Barretts esophagus?
metaplasia is thought to result from re-epithelialization of esophageal tissue injured as a result of chronic GERD
