🫁 ESOPHAGEAL DISORDERS

Q: What is achalasia?

A: A primary esophageal motility disorder with insufficient LES relaxation and loss of peristalsis.

Q: What are possible causes of achalasia?

A: Hereditary, degenerative, autoimmune, and infectious factors.

Q: What are the main symptoms of achalasia?

A: Dysphagia for solids and liquids, regurgitation, and chest pain.

Q: What is diffuse esophageal spasm (DES)?

A: A disorder with repetitive, high-amplitude smooth muscle contractions in the esophagus.

Q: What parts of the esophagus function normally in DES?

A: The striated portion of the esophagus and the LES relax normally.

Q: What is the histopathology finding in DES?

A: Muscular hypertrophy of the esophageal wall.

Q: Why is DES called “corkscrew esophagus”?

A: Abnormal contractions create a twisted appearance on imaging.

Q: What is nutcracker esophagus?

A: A variant of DES with very high-amplitude contractions in the distal esophagus.

Q: What are esophageal strictures?

A: A loss of lumen area within the esophagus.

Q: What is the normal diameter of the esophagus?

A: Approximately 20 mm.

Q: When do strictures typically cause dysphagia?

A: When the luminal diameter is less than 15 mm.

Q: What is a Schatzki ring?

A: A narrowing of the lower esophagus caused by a ring of mucosal or muscular tissue.

Q: What is GERD?

A: Mucosal damage from abnormal reflux of gastric contents into the esophagus.

Q: What is the classic symptom of GERD?

A: Frequent and persistent heartburn.

Q: What are additional symptoms of GERD?

A: Sore throat, hoarseness, chronic cough, asthma, chest pain, and globus sensation.

Q: What physiological factors contribute to GERD?

A: LES impairment, low resting LES pressure, increased gastric pressure, and reduced esophageal clearance.

Q: What is laryngopharyngeal reflux (LPR)?

A: Reflux where gastric contents reach the UES and spill into the larynx.

Q: What damage can LPR cause?

A: Erosion of laryngeal mucosa, contact ulcers, and possible aspiration.

Q: How is LPR identified?

A: Through pH monitoring.

Q: What are esophageal diverticula?

A: Sacs that protrude from the esophageal wall.

Q: What is the most common esophageal diverticulum?

A: Zenker’s diverticulum.

Q: Where does Zenker’s diverticulum occur?

A: At Killian’s triangle between the cricopharyngeal sphincter and inferior pharyngeal constrictor.

Q: What symptoms are associated with Zenker’s diverticulum?

A: Cough, bad breath, regurgitation of undigested food, throat bulge, and recurrent pneumonia.

Q: What is scleroderma?

A: A connective tissue disorder that weakens the LES and increases GERD risk.

Q: How does scleroderma affect the esophagus?

A: It affects the smooth muscle of the lower two-thirds, causing hypomotility.

Q: What symptoms are common in esophageal scleroderma?

A: Heartburn and dysphagia.