13 Esophageal Disorders

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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