GI - 3 Esophagus pt 2 Flashcards
What is Esophageal Manometry? What does it test?
A small, pressure sensitive tube is passed into the stomach and then the patient is asked to swallow. It tests peristaltic function of the esophagus.
What test is good for diagnosing Achalasia?
Esophageal Manometry
Esophageal Manometry is mainly used to diagnose what?
Achalasia
What test? Wireless or catheter based, pH probe is passed transnasally or via endoscopy, and pH is recorded for 24-48 hours. Provides info on amount of reflux and can correlate with temporal symptoms
Esophageal pH Recording
20% of adults report weekly heartburn and 10% daily: What is it called?
Gastroesophageal Reflux Disease
5 causes of GERD
Incompetent LES, Hiatal hernia, Effects of refluxate, Abnormal esophageal clearance, Delayed gastric emptying
4 Typical manifestations of GERD
Heartburn, Regurgitation, Sour taste, Dysphagia
4 Atypical manifestations of GERD
Asthma, cough, laryngitis, noncardiac chest pain
What is the 2 best tests to diagnose GERD? Why?
EGD. It can determine type and extent of tissue damage Barium Esophagram (helpful for new, unfamiliar patients)
If a patient comes in with heartburn, do what test?
EGD
4 Medications for GERD. Which is the best?
Antacids, H2 blockers, PPI (the best, most effectdive, last 24 hours), Promotility agents (if patients are still symptomatic after lifestyle changes and taking PPI)
What is surgical fundoplication?
Fundus of the stomach is gathered, wrapped, and sutured around LES. Increases pressure at lower end of esophagus and reduces acid reflux.
Fundus of the stomach is gathered, wrapped, and sutured around LES. Increases pressure at lower end of esophagus and reduces acid reflux.
Surgical fundoplication. Don’t do this.
A common complication of GERD is:
Barrett’s Esophagus
What is Barrett’s Esophagus? What else must patients also have to have this?
Squamous epithelium is replaced by metaplastic columnar epithelium with goblet/columnar cells. Patients must have specialized intestinal metaplasia.
