Gastrointestinal System: Esophageal Disorders

Vocabulary flashcards covering the pathophysiology, clinical manifestations, and pharmacological management of esophageal disorders including GERD, Achalasia, and Hiatal Hernia.

Gastroesophageal reflux disease (GERD)

The back-flow of gastric or duodenal contents into the lower esophagus, where acidic secretions cause irritation and inflammation.

Upper esophageal sphincter

The sphincter at the upper end of the esophagus that, when at rest, is closed to prevent air from entering the esophagus during respiration.

Lower esophageal sphincter

The sphincter proximal to the gastroesophageal junction that, when at rest, is closed to prevent reflux of gastric contents into the esophagus.

Pyrosis

A burning sensation in the esophagus, also known as heartburn, which occurs after the ingestion of food or drugs.

Dyspepsia

Indigestion characterized by pain or discomfort centered in the upper abdomen.

Odynophagia

The medical term for experiencing pain while swallowing.

Esophageal stricture

The formation of scar tissue in the esophagus due to repeated exposure to acid, which results in a loss of distenability.

Barrett esophagus

A condition resulting from long-standing untreated GERD where the esophageal mucosa is altered to precancerous cells that are no longer squamous in origin.

Antacids

Medications such as Maalox or Gaviscon that neutralize gastric fluid and provide immediate relief by decreasing the activation of pepsinogen.

Histamine (H2)-receptor blockers

Drugs like Zantac or Tagamet that inhibit gastric acid secretion by antagonizing histamine receptors; they have a slower onset but longer duration than antacids, achieving relief in about $60\%$ of cases.

Proton pump inhibitors (PPIs)

Medications like Prilosec and Nexium that inhibit the $\text{H}^+ / \text{K}^+ \text{ ATPase}$ enzyme; they are preferred for moderate to severe GERD and provide symptom relief in $80\text{-}85\%$ of patients.

Prokinetic drugs

Medications such as Metoclopramide (Reglan) or domperidone (Motilium) that manage GERD by accelerating gastric emptying.

Achalasia

A disorder involving the absence or ineffectiveness of peristalsis in the distal esophagus combined with the failure of the lower esophageal sphincter to relax in response to swallowing.

Hiatal Hernia

A condition where the upper part of the stomach moves up into the lower portion of the thorax through an opening in the diaphragm.

Nissen fundoplication

The most common surgical repair procedure performed when the damage from gastroesophageal reflux is severe.

Diverticulum

A pouch extending out from the normal wall of the swallowing channel that can cause dysphagia and the regurgitation of undigested food hours after ingestion.

Esophageal varices

Extremely dilated vessels in the left gastric vein resulting in bleeding at the inferior end of the esophagus.

Portal Hypertension

Increased portal venous pressure caused by liver disease and congestion, often leading to complications like esophageal varices.

Hematemesis

The vomiting of blood, which may appear bright red if it is new or like coffee grounds if it is old.

Melena

Dark, tarry stools containing blood, which are identified using a stool test as a sign of upper GI bleeding.