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Esophageal Disorders (PEARLS) Smarty PANCE (Latest /
- What is esophagitis?
Answer: Esophagitis is simply inflammation that may damage tissues of the esophagus. It usually causes dysphagia or difficulty in swallowing, odynophagia or painful swallowing, and retrosternal chest pain.
- What are the two types of esophagitis?
Answer: Infectious and non-infectious
- How is esophagitis diagnosed?
Answer: The usual workup includes an upper endoscopy with a biopsy. And in case of retrosternal chest pain, an electrocardiogram should always be done in order to rule out cardiac ischemia.
- What is the most common cause of esophagitis?
Answer: The most common cause is gastroesophageal reflux disease or GERD, and in that situation, it's called reflux esophagitis.
- What is the treatment of reflux esophagitis?
Answer: Treatment of reflux esophagitis starts with proton pump inhibitors or PPIs such as omeprazole for 8 weeks. If symptoms disappear, then the dose of PPI is gradually decreased.If PPIs are needed for more than 6 months, then it's replaced by histamine 2 receptor agonists or H2RAs. If the symptoms recur, then the lowest dose of the medication that last controlled the symptoms is restarted.
- How should patients with severe erosive esophagitis be managed?
Answer: For individuals with severe erosive esophagitis, a repeat upper endoscopy should be done after 8 weeks of treatment to make sure that it's healing and to rule out malignancy
- Pt with asthma symptoms and GERD not responsive to antacids.
Answer: - Eosinophilic esophagitis - Pt with Asthma symptoms and GERD not responsive to antacids. Allergic, eosinophilic infiltration of the esophageal epithelium.
- How is eosinophilic esophagitis treated?
Answer: Eosinophilic esophagitis is treated by removing foods that incite allergic response, topical steroids via inhaler
- An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is the most
likely diagnosis?
Answer: Herpes simplex virus
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- Esophagitis caused by NSAIDs or bisphosphonates
Answer: Noninfectious - Medication induced esophagitis
- Dysphagia lasting weeks-months after radiation therapy
Answer: Noninfectious - Radiation-induced esophagitis. Radiation exposure of 5000 cGy associated with increased risk for stricture
- Linear yellow-white plaques with odynophagia or pain on swallowing.
Answer: Infectious fungal (candida) esophagitis
- How is candida esophagitis treated?
Answer: Fluconazole 100 mg PO daily
- What is GERD? (Gastroesophageal reflux disease)
Answer: Gastroesophageal re- flux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.
- What are the signs and symptoms of GERD?
Answer:
- Heartburn, usually after eating, which might be worse at night
- Chest pain
- Dysphagia (difficulty swallowing)
- Regurgitation of food or sour liquid
- Sensation of a lump in your throat
- Chronic cough
- Laryngitis
- New or worsening asthma
- Disrupted sleep
- List four atypical symptoms associated with GERD
Answer:
- Cough
- Hiccups
- Throat clearing
- Wheezing
- What are four dietary examples that can lower LES pressure and worsen symptoms of
GERD?
Answer:
- Fatty foods
- Alcohol
- Caffeine (coffee, tea, chocolate)
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