Oesophageal Disorders Flashcards
What are the causes of dysphagia?
Benign stricture
Malignant stricture
Motility disorders
Eosinophilic oesophagitis
How do motility disorders (achalasia) present?
Progressive dysphagia for solids and liquids
Weight loss
Chest pain
Regurgitation and chect infection
How does GORD present?
Heartburn
Cough
Waterbrash (sour taste in mouth)
Sleep disturbance
How does Oesophageal cancer present?
Progressive dysphagia (90%)
Anorexia and weight loss (75%)
Odynophagia (pain when swallowing)
Chest pain
Cough
Pneumonia
What is the pathology of motility disorders?
Hypomotility - associated with connective tissue disease, diabetes or neuropathic origin
- Failure of LOS mechanism causes heartburn and reflux symptoms
What is the pathology of GORD?
GORD symptoms as a result of exposure of the lower oesophagus to acid and bile from the stomach
GORD aetiology:
Relaxation of LOS
Delayed gastric emptying
Hiatus Hernia
What is the pathology of Barrett’s Oesophagus?
Epithelium of Oesophagus changes from stratified squamous (healthy oesophagus) to columnar epithelium (gastric type cells that are better at withstanding acid)
What is the pathology of Oesophageal cancer?
Barrett’s Oesophagus is usually a precursor to oesophageal adenocarcinoma
What is the treatment of dysphagia?
Endoscopic baloon dilatation
PPI’s
What is the treatment of GORD?
Drugs - PPI’s (omeprazole), Histamine antagonists (Ranitidine), antacids
Lifestyle - Weight loss, stop smoking, raise head of the bead, small & regular meals
Surgery - Only if symptoms are severe
What is the treatment for oesophageal cancer?
Surgical oesophagectomy
