OnlineMedEd: Gastroenterology - "Esophagus" Flashcards
It’s helpful to categorize dysphagia into two groups: ________________.
motility (related to the failure of peristalsis) and mechanical obstruction (stricture)
What feature of the clinical history suggests a mechanical obstruction?
Progressive dysphagia that goes from solids to liquids
Motility dysphagia will present with dysphagia to solids and liquids at the same time.
Go through the three diagnostic steps of dysphagia.
- First: barium swallow
- Second: manometry for suspected motility issues
- Third: endoscopy with biopsy
Those with achalasia will often complain of _____________.
feeling like food is stuck at the level of the sternum
List three treatment options for achalasia.
- Botox
- Myotomy
- Dilation
Myotomy is the preferred treatment modality. Dilation carries a high risk of perforation. Botox doesn’t last.
Go through CREST syndrome.
- Calcinosis
- Raynaud’s
- Esophageal dysmotility
- Sclerodactyly
- Telangiectasia
The esophageal dysmotility of CREST presents as _____________.
relentless GERD
The lower esophageal sphincter cannot contract in CREST syndrome.
CREST is associated with the anti-___________ antibody.
centromere
Systemic sclerosis is associated with the ______________ antibody.
anti-scl-70 (aka anti-topoisomerase)
What esophageal disorder presents like an MI?
Diffuse esophageal spasm
The esophagus contracts randomly, causing a crushing substernal chest pain that improves with NTG and CCBs.
How does diffuse esophageal spasm present on x-ray?
The barium collects into the random pockets (created by the spasms) that looks like a corkscrew.
The best treatments for DES are _____________.
CCB and NTG
____________ cause a syndrome familiarly referred to as “steakhouse dysphagia”.
Schatsky’s rings (strictures at the LES)
Plummer-Vinson syndrome causes _____________.
iron-deficiency anemia and esophageal webs
The esophageal webs in Plummer-Vinson syndrome can cause what worrisome outcome?
Esophageal cancer
