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GI Tract In Disease_Esophagus_Stomach

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This document reviews major diseases of the esophagus and stomach.

<strong>GERD (gastroesophageal reflux disease)</strong> is reflux of stomach contents into the esophagus or mouth due to relaxation or dysfunction of the lower esophageal sphincter (LES). Causes include normal post-meal reflux, anatomic abnormalities, certain foods, and medications. Common symptoms are heartburn and acid regurgitation; less common symptoms include dysphagia, chronic cough, laryngitis, and asthma. Treatment includes lifestyle changes, weight loss, head-of-bed elevation, avoiding trigger foods, proton pump inhibitors such as omeprazole, and surgery (Nissen fundoplication).

<strong>Esophagitis</strong> is inflammation of the esophagus, causing painful swallowing (odynophagia). Causes include GERD, infection, medications, radiation, caustic injury, and eosinophilic esophagitis. The document also outlines the LA classification of erosive esophagitis from Grade A to D based on mucosal breaks.

<strong>Barrett’s esophagus</strong> is replacement of normal esophageal lining with intestinal-type lining. It is often asymptomatic but is a precancerous condition that increases the risk of esophageal adenocarcinoma. Progression can go from normal to dysplasia to cancer. Treatments include radiofrequency ablation and endoscopic mucosal resection.

<strong>Esophageal motility disorders</strong> cause dysphagia, chest pain, and heartburn. Important examples include achalasia, diffuse/distal esophageal spasm, nutcracker/jackhammer esophagus, and systemic sclerosis. Achalasia is marked by loss of peristalsis and failure of LES relaxation, and can be treated with botulinum injection, pneumatic dilation, Heller myotomy, or POEM.

<strong>Peptic ulcer disease</strong> involves ulcers in the stomach or duodenum, commonly caused by H. pylori or NSAIDs. Symptoms include pain, bleeding, obstruction, and perforation. Diagnosis is typically by upper endoscopy; treatment includes H. pylori eradication, PPIs, and sucralfate.

Other topics include <strong>upper GI bleeding</strong>, <strong>gastric outlet obstruction</strong>, <strong>gastroparesis</strong>, and <strong>subepithelial masses</strong>, along with their causes, symptoms, diagnosis, and management.

Keywords

GERD

esophagitis

Barrett esophagus

achalasia

esophageal motility disorders

peptic ulcer disease

H. pylori

upper GI bleeding

gastroparesis

gastric outlet obstruction