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P&T Block 3 Pulm & GI > SG Esophagus > Flashcards

Flashcards in SG Esophagus Deck (11):
1

3 possible causes of GERD

1. Inappropriate transient lower esophageal relaxations
2. Floppy LES
3. Hiatal hernia

2

Why do GERD pts get dysphagia?

Inflammation // erosive esophagitis
Ineffective esophageal motility
Less likely: peptic stricture, cancer

3

Study for:
- Dysphagia
- Eval esophageal mucosa

Barium CXR
Endoscopy

4

Mechanical or motor: dysphagia to solids and liquids

MOTOR

5

Motor problem w/ dysphagia - what is the disease

Achalasia
- Dysphagia
- Regurg

6

Achalasia patho

Lose inhibitory motor neurons in LES and neuronal drop out in body of esophagus
Net: hypertensive LES + aperistalsis body of esophagus

7

Barium swallow results for achalasia

Bird's beak w/ dilated esophagus behind it`

8

Why perform endoscopy for achalasia

R/o pseudoachalasia
Small, infiltrating distal esophageal cancer or proximal gastric cancer can infiltrate the neuronal plexus of the LES
Mimics achalasia

9

3 ways to treat achalasia

1. Smooth muscle relaxants - Ca CB
2. BoTox injection into LES
3. Balloon dilation or cut LES

10

Treat nutcracker esophagus

1. Reassurance
2. SM relaxants - dysmotility
3. Pyschotropic agents - hypersensitivity

11

Cancer vs peptic stricture on barium swallow

Cancer = irregular narrowing
Peptic = smooth, tapered narrowing of distal esophagus