ASGE Recognized Industry Associate (ARIA) Training Program OPEN | March 2023-6_GI Tract In Disease_Esophagus

6_GI Tract In Disease_Esophagus_Stomach
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This document provides an overview of various diseases and conditions affecting the esophagus and stomach in the gastrointestinal tract. It covers topics such as gastroesophageal reflux disease (GERD), esophagitis, Barrett's esophagus, esophageal motility disorders, peptic ulcer disease, upper gastrointestinal bleeding, gastric outlet obstruction, gastroparesis, and subepithelial masses.<br /><br />GERD is characterized by the reflux of stomach contents into the esophagus or mouth, with symptoms including heartburn and acid regurgitation. Treatment options include lifestyle modifications, proton pump inhibitors, and surgery.<br /><br />Esophagitis, inflammation of the esophagus, can be caused by various factors such as GERD, infection, medications, radiation, or caustic ingestion. It can be classified using the LA classification system, and treatment options may include addressing the underlying cause or using procedures such as radiofrequency ablation or endoscopic mucosal resection.<br /><br />Esophageal motility disorders result in abnormal motility of the esophagus and can cause symptoms such as dysphagia, odynophagia, chest pain, or heartburn. Conditions like achalasia, nutcracker esophagus, diffuse esophageal spasm, and systemic sclerosis fall under this category. Treatment options may include botulinum injection, pneumatic dilation, surgical myotomy, or peroral endoscopic myotomy (POEM).<br /><br />Peptic ulcer disease involves mucosal breaks in the gastrointestinal tract, most commonly in the stomach or duodenum. Causes include Helicobacter pylori infection or the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Symptoms can include abdominal pain, gastrointestinal bleeding, or gastric outlet obstruction. Diagnosis involves upper endoscopy, and treatment often includes eradicating H. pylori or using proton pump inhibitors.<br /><br />Upper gastrointestinal bleeding refers to bleeding from the gastrointestinal tract before the Ligament of Treitz. Causes may include esophageal varices, Mallory Weiss tear, erosions/ulcers, gastritis, or duodenal ulcer. Management involves volume resuscitation, proton pump inhibitors, and endoscopic hemostasis.<br /><br />Gastric outlet obstruction results in mechanical obstruction preventing the emptying of the stomach into the small intestine and can be caused by conditions such as peptic ulcer disease or gastric or pancreatic cancer. Symptoms can include nausea, vomiting, abdominal pain, or weight loss. Diagnosis involves imaging studies such as X-ray, CT scan, or endoscopy, and treatment options may include nasogastric tube placement, gastroduodenal stent insertion, or surgical interventions.<br /><br />Gastroparesis refers to delayed emptying of the stomach, often in the absence of a mechanical obstruction, and can be caused by diabetes, post-surgery complications, post-infections, or idiopathic reasons. Symptoms include nausea, vomiting, early satiety, abdominal pain, bloating, or weight loss. Treatment options may include dietary modifications, prokinetics, anti-emetics, or the use of a gastric pacemaker.<br /><br />Lastly, subepithelial masses are bulges or masses within or outside the gastrointestinal tract, and differential diagnoses can include leiomyoma, pancreatic rest, lipoma, gastrointestinal stromal tumor (GIST), carcinoid, or other benign or malignant conditions. Endoscopic ultrasound is often used for accurate evaluation, and fine needle aspiration may be performed for further investigation.<br /><br />The document concludes by inviting questions on the presented material.
Keywords
esophagus
stomach
GERD
esophagitis
peptic ulcer disease
upper gastrointestinal bleeding
gastric outlet obstruction
gastroparesis
subepithelial masses
endoscopic ultrasound