ASGE Recognized Industry Associate (ARIA) Training Program OPEN | October 2025-GI Tract In Disease_Esophagus

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This document provides a comprehensive overview of diseases affecting the esophagus and stomach within the gastrointestinal tract. It begins with Gastroesophageal Reflux Disease (GERD), characterized by the reflux of stomach contents into the esophagus due to lower esophageal sphincter dysfunction. Symptoms include heartburn and acid regurgitation, with treatment options ranging from lifestyle changes and proton pump inhibitors (e.g., omeprazole) to surgical interventions like Nissen fundoplication.<br /><br />Esophagitis, inflammation of the esophagus, can result from GERD, infections, medications, radiation, or eosinophilic conditions, with symptoms including painful swallowing. The Los Angeles (LA) classification grades the severity of mucosal breaks in esophagitis. Barrett’s esophagus is a precancerous condition where esophageal lining is replaced by intestinal-type cells, increasing adenocarcinoma risk; treatment includes radiofrequency ablation and endoscopic mucosal resection.<br /><br />Esophageal motility disorders, such as achalasia, involve impaired muscle movement and lower esophageal sphincter relaxation, leading to swallowing difficulties and chest pain. Diagnostic tools include esophageal manometry, while treatments include botulinum toxin injections, pneumatic dilation, and surgical myotomy techniques including laparoscopic Heller myotomy and peroral endoscopic myotomy (POEM).<br /><br />Peptic ulcer disease describes mucosal breaks in the stomach or duodenum, primarily caused by Helicobacter pylori infection or NSAID use, presenting with abdominal pain or gastrointestinal bleeding. Diagnosis is by endoscopy, and treatment focuses on H. pylori eradication, proton pump inhibitors, and protective agents like sucralfate.<br /><br />Upper gastrointestinal bleeding sources include esophageal varices, Mallory-Weiss tears, ulcers, and vascular abnormalities, managed by volume resuscitation, proton pump inhibitors, and endoscopic hemostatic techniques.<br /><br />Gastric outlet obstruction, often from benign causes like peptic ulcers or malignancies, leads to nausea, vomiting, and abdominal distension, diagnosed by imaging and treated with nasogastric decompression, stenting, or surgery.<br /><br />Gastroparesis, delayed gastric emptying without mechanical blockage, arises from diabetes or surgery, causing nausea and weight loss; treatment includes dietary adjustments, prokinetic drugs, anti-emetics, and possibly gastric pacemaker implantation.<br /><br />Finally, subepithelial masses in the GI tract may be benign or malignant tumors; endoscopic ultrasound is essential for characterization and biopsy.

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Kajali Mishra, MD

Keywords

Gastroesophageal Reflux Disease

Esophagitis

Barrett’s Esophagus

Esophageal Motility Disorders

Achalasia

Peptic Ulcer Disease

Helicobacter pylori

Upper Gastrointestinal Bleeding

Gastric Outlet Obstruction

Gastroparesis