13 Esophageal Disorders

GERD

  • basal zone: near basement membrane
  • eosinophil in mucosal layer

  • life style
  • scleroderma: collagen deposit

  • worse at night when laying down
  • new asthma (also watch out for Churg Strauss)

  • babies can't complain

  • peppermint classic trigger
  • surgery: nissen fundoplication. Portion of stomach wrapped around lower esophagus

  • ulcer healed = fibrous tissue, obstruct lumen = dysphagia

  • basic substances

Barrett's

  • diagnosis by endoscopy

Esophageal Cancer

  • obesity: fatty tissue pushing stomach up and acid up

  • unique symptoms: hoarse voice and cough

Esophagitis

  • candida: esp immunocompromised

Eosinophilic

  • present with dysphagia: difficulty swallowing

Achalasia

  • both solids and liquids instead of just solids (tumor, partial obstruction)
  • risk for scc

Varices

  • painless

Mallory Weiss

  • mucosa
  • vomit blood with epigastric pain

BoerHaave

  • crepitus when press on skin in neck

Webs

  • ring: circumferential protrusion
  • web: not circumferential

Plummer Vinson

Zenker's

  • not true diverticulum
  • chronic exposure of mucosa to high pressure to force food down leads to zenker's

  • cricopharyngeus encircling esophagus
  • thyropharyngeus slanting