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

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