Oesophageal Disorders Flashcards
What is heartburn?
Retrosternal discomfort or burning sensation
What other symptoms are often associated with heartbun?
Waterbrash (a sudden flow of saliva)
Cough
What causes heartburn?
USually a consequence of reflux of gastric contents into oesophagus.
Can be induced by certain drugs and foods which reduce pressure in the LOS such as alcohol, nicotine and dietary xanthines.
Define dysphagia and odynophagia?
Dys - Diffculty swallowing
Odyno - Pain on swallowing
What questions should be asked about dysphagia?
- Solids or liquids
- Progressive or intermittent
- Location? (oropharyngeal or oesophageal
- Associated features such as weight loss, regurgitation of cough
What can cause dysphagia?
A benign stricture Malignant stricture Motility disorder (E.g. Achalasia) Eosinophilic Oesophagitis Extrinsic compression (e.g. lung cancer)
What type of endoscopy is there for oesophageal disorders?
OGD - Oesophago-Gastro-Duodenoscopy
Also called Upper GI Endoscopy (UGIE)
What investigative tests can be done for oesophageal disorders?
Endoscopy (UGIE) Contrast Radiology (barium swallow) Oesophageal pH & Manometry
When is a barium swallow used?
When an UGIE isnt possible, particularly when investigation dysphagia
How is OEsophageal pH and manometry performed?
A probe with pressure and pH sensors is inserted through a naso-gastric catheter,
It measures muscle contraction and pH as you swallow
What is the use of a oesophageal pH and manometry?
- Tells us about dysphagia and motility disorders
- Assesses sphincter tonicity
- pH helps investigate refractory (stubborn) heart burn
Give an example of a hypermotility disorder?
Diffuse Oesophageal spasm
- Severe episodic chest pain (easily confused with angina)
- +/- dysphagia
How would oesophageal spasm appear on tests?
Corkscrew barium swallow
Manometry shows exaggerated, uncoordinated, hypertonic contractions
How do we treat oesophageal spasms?
Smooth muscle relaxants and wait for it end
What conditions are related to hypomobility of the oesophagus?
- connective tissue disorders
- Diabetes
- Neuropathies
They cause the LOS to fail leading gastro-oesophageal reflux disease