Esophgeal issues

Question 1

baretts

Answer 1

dude with hiastus hernia/obesity/heartburn controlled on PPis comes in with hemetemesis. this is an alarm symptom. Ix: do endoscopy - see baretts. Biopsy to confirm. if they get cancer, then think of two types : adenocarcinoma vs SCC

Question 2

what is the gerd- cancer spectrum?

Answer 2

1) GERD
2) baretts - squamous to columnar change. Les than 2% lifetime risk of getting cancer
3) low grade dysplasia- 4% develop cancer in 5 yrs
4) high grade dysplasia- 50% will get cancer in 5 yrs
5) cancer

Question 3

how often do we do surveillance endoscopy?

Answer 3

just know that baretts is less, and high grade dysplasia is more often surivellance

Question 4

questions to ask about dysphagia

Answer 4

solid vs liquid? Oropharngyeal ( cant get food past their throat = neuro problem like stroke). Cervico-thoracis (I hget food stuck) = an esophgeal problem. you always order EGD to check