Oesophageal Disorders Flashcards
What are some causes of dysphagia?
benign stricture
- malignant stricture (oesophageal cancer) - motility disorders (eg achalasia, presbyoesophagus) - eosinophilic oesophagitis - extrinsic compression (eg in lung cancer)
What is hypermotility of the oesophagus and what is its appearance on a barium swallow?
Oesophageal spasm
Presents as corkscrew on barium swallow
How does oesophageal hypermotility present and how is it treated?
Severe episodic chest pain and dysphagia
Smooth muscle relaxants
What is the cause of achalasia?
Functional loss of myenteric plexus ganglion cells in distal oesophagus and LOS, failure of LOS to relax
In what syndrome is achalasia often present?
Allgrove syndrome
What are the symptoms of achalasia?
Dysphagia Retrosternal pain Heartburn Regurgitation Weight loss Chest infection
What are the treatments for achalasia?
Pharmacological - Nitrates, Calcium Channel blockers
Endoscopic - Botulinum Toxin
Pneumatic balloon dilation
Radiological - Pneumatic balloon dilation
Surgical - Myotomy
What are risk factors for GORD?
Pregnancy, obesity, drugs lowering LOS pressure, smoking, alcoholism, hypomotility
What are symptoms of GORD?
heartburn, cough, water brash, sleep disturbance
What are two types of oesophageal hiatus hernia?
Sliding and Para-oesophageal
What is Barrett’s oesophagus?
Intestinal metaplasia related to prolonged acid exposure in distal oesophagus
Change from squamous to mucin-secreting columnar (ie gastric type) epithelial cells in lower oesophagus
Risk of adenocarcinoma
What is the treatment for Barrett’s oesophagus?
Endoscopic Mucosal Resection (EMR)
Radio-Frequency Ablation (RFA)
Oesophagectomy rarely
