PAIN ORIGINATING FROM ESOPHAGUS

Question 1

Achalasia

Answer 1

Achalasia is a primary esophageal motility disorder characterized by the absence of esophageal peristalsis and impaired LES relaxation

Question 2

Causes of esophageal pain

Answer 2

Hiatus hernia
Achalasia
GERD
Esophageal candidiasis
Esophageal tumors
Spasm of esophageal muscle in response to obstruction

Question 3

Symptoms of seen in esophageal pain

Answer 3

Retrosternal chest pain
Regurgitation
Difficulty swallowing

Question 4

Dysphagia to water suggests ….

Answer 4

Achalasia

Question 5

Dysphagia to solid suggests …..

Answer 5

Mechanical obstruction

Question 6

Dysphagia to solid suggests …..

Answer 6

Mechanical obstruction

Question 7

Signs seen in esophageal pain

Answer 7

Obese or severely underweight in GERD
Severe weight loss may suggest tumor or candidiasis form immune suppression
Oral candidiasis in esophageal candidiasis

Question 8

Investigations in pain originating from esophagus

Answer 8

Barium swallow
Upper GI endoscopy
Esophageal manometry when achalasia is suspected

Question 9

Benefits of bland foods and milk in esophageal pain

Answer 9

May relieve pain

Question 10

Treatment for GERD

Answer 10

PPI
Omeprazole
Esomeprazole
Pantoprazole

Question 11

Treatment for GERD unresponsive to PPI monotherapy

Answer 11

Add Magnesium trisilicate PO 10ml 8 hourly for 10 days

Question 12

Treatment for esophageal candidiasis

Answer 12

Nystatin oral
Adults
400,000 - 600,000U 6 hourly for 7 days
Or
Fluconazole PO
Adults
200mg stat then 100mg daily for 14 days