GASTROESOPHAGEAL REFLUX DISEASE part 2 Flashcards
What is the goal of Achalasia treatment?
To reduce LES pressure
Describe a common endoscopic technique for treating Achalasia.
Pneumatic dilation, an endoscopic technique using a balloon dilator across the LES.
Are pharmacological therapies effective for treating Achalasia?
Relatively ineffective.
Name two types of pharmacological therapies used for Achalasia, though relatively ineffective.
Nitrates or calcium channel blockers administered before eating.
What is the mechanism of action of Botulinum toxin in Achalasia?
It inhibits acetylcholine release from nerve endings.
What does pneumatic dilation provide in Achalasia treatment?
Transient symptom relief.
What surgical procedure might be considered in difficult cases of Achalasia
Surgical myotomy.
What type of testing might be used, along with drugs, to induce symptoms and manometric findings?
Provocative testing.
What drug is mentioned for provocative testing in Achalasia?
Edrophonium.
cholinesterase inhibitor
Name two secondary motility disorders discussed.
Scleroderma (SD) and Chagas’ disease
What pathological process occurs in Scleroderma that affects esophageal motility?
Collagen deposition and fibrosis of the smooth muscle.
What type of organism causes Chagas’ disease?
Parasitic protozoa Trypanosoma cruzi.
What condition does the esophageal dysfunction in Chagas’ disease resemble?
Achalasia.
What is a Mallory-Weiss tear?
A mucosal tear at the gastroesophageal junction.
With what condition is a Mallory-Weiss tear associated?
Repeated vomiting.
What is the primary symptom of a Mallory-Weiss tear?
Hematemesis (vomiting blood).
endoscopy for diagnosis
What interventions are used if bleeding from a Mallory-Weiss tear does not stop spontaneously?
Bipolar electrocautery or injection of epinephrine.
What are the two main histological types of Esophageal Cancer?
Squamous cell carcinoma and adenocarcinoma
List four etiological factors believed to be associated with Esophageal Cancer.
Excess alcohol consumption (whiskey); cigarette smoking; ingestion of nitrites, smoked opiates, and fungal toxins in pickled vegetables; mucosal damages from physical agents.
Give two examples of mucosal damages from physical agents that can be associated with Esophageal Cancer.
Hot tea, lye ingestion, radiation-induced strictures, chronic achalasia.
What esophageal condition associated with iron deficiency is a risk factor for Esophageal Cancer?
Plummer-Vinson Syndrome.
What congenital condition involving hyperkeratosis and pitting of the palms and soles is a risk factor for Esophageal Cancer?
Tylosis palmaris and plantaris.
What dietary deficiencies are associated with an increased risk of Esophageal Cancer?
Molybdenum, selenium, and vitamin A.
What chronic condition associated with gastric reflux is a risk factor for adenocarcinoma of the esophagus?
Barrett’s Esophagus.
