GERD
Heartburn, regurg upon lying down.
May present with nocturnal cough, dyspnea, adult onset asthma.
Decrease in LES tone
Esophageal varices
Painless bleeding
Esophagitis
Associated with reflux, chemical ingestion, infection:
candida: white pseudomembrane,
HSV-1: punched out ulcers
CMV: linear ulcers
Mallory Weiss and BoerHaave
Mallory weiss: mucosal laceration at GE junction due to vomiting, leads to hematemesis
Boerhaave: transmural esophageal rupture due to violent retching.
Esophageal strictures
Lye digestion
Acid reflux
Plummer vinson syndrome
Dysphagia (esophageal web)
Glossitis
Iron deficiency anemia
Barrett’s esophagus
Glandular metaplasia; replacing nonkeratinized squamous with intestinal.
Esophageal cancer
Squamous or adeno
Typically progressive dysphagia (first solid, then liquid) and weight loss; poor prognosis.
Esophageal cancer:
Risk factors
Achalasia Alcohol: squamous Barrett: adeno Cigarette: both Diverticula: squamous Esophageal web: squamous Familial Fat (obesity): adeno GERD: adeno Hot liquid: squamous.
Esophageal cancer:
prevalence
Worldwide, SCC
US, adeno
Squamous upper 2/3
Adeno lower 1/3