Inflammation Part 2: Disorders of the Esophagus and GI Tract

Flashcards covering disorders of the esophagus and GI tract, including definitions of conditions, clinical manifestations, causes, diagnostic methods, and medical/surgical management, based on lecture notes on Inflammation Part 2.

Achalasia

Absent or ineffective peristalsis in the esophagus, characterized by dysphagia, regurgitation, chest pain, and incomplete lower esophageal sphincter relaxation.

Esophageal Spasm

Abnormal muscle contractions in the esophagus (e.g., Jackhammer esophagus, Diffuse esophageal spasm, Type III achalasia), causing dysphagia, pyrosis, regurgitation, and chest pain.

Esophageal Manometry

A diagnostic procedure using a catheter inserted into the esophagus to measure muscle contractions and evaluate motility disorders like spasms.

Esophageal Stricture

A narrowing of the esophagus, which can cause difficulty swallowing and may require esophageal dilation for treatment.

Esophageal Dilation

A medical procedure using an endoscope with a balloon or dilator to widen a narrowed section (stricture) of the esophagus.

Hiatal Hernia

Herniation of a portion of the stomach through the diaphragm, with types including sliding and paraesophageal. Can be asymptomatic or cause pyrosis, dysphagia, and regurgitation.

Nissen Fundoplication

A surgical procedure, often performed for hiatal hernia or severe GERD, where the fundus of the stomach is wrapped around the lower esophagus to reinforce the lower esophageal sphincter.

Esophageal Diverticulum

A saclike outpouching of one or more layers of the esophagus (e.g., Zenker's diverticulum), causing dysphagia, fullness in the neck, belching, and regurgitation of undigested food.

Esophageal Perforation

A surgical emergency involving a tear or hole in the esophagus, leading to excruciating retrosternal pain, dysphagia, and infection. Causes include iatrogenic trauma, forceful vomiting (Boerhaave Syndrome), foreign bodies, or anatomical issues.

Mallory-Weiss Syndrome

A superficial longitudinal mucosal tear at or near the gastroesophageal junction, typically caused by repetitive and forceful vomiting or coughing. Can cause severe bleeding, pain, and bright red or coffee ground emesis.

Gastroesophageal Reflux Disease (GERD)

A symptomatic condition resulting from the reflux of gastric contents into the lower esophagus, often due to an incompetent lower esophageal sphincter, hiatal hernia, or motility disorders.

Clinical Manifestations of GERD

Symptoms include pyrosis (heartburn), regurgitation, dyspepsia, dysphagia, odynophagia (painful swallowing), and hypersalivation.

Barrett's Esophagus

A complication of GERD where the normal tissue lining the lower esophagus changes, appearing red and velvety instead of pale and glossy, indicating an increased risk of esophageal cancer.

Esophageal pH Monitoring

A diagnostic test involving a probe placed in the esophagus to measure acid reflux over a period, typically 24 hours, to diagnose GERD.

Gastritis

Inflammation of the gastric mucosa (stomach lining), which can be acute (erosive or non-erosive) or chronic, often caused by H. pylori infection, NSAID use, or alcohol.

Helicobacter pylori (H. pylori)

A bacterial infection commonly associated with gastritis and peptic ulcer disease.

Urea Breath Test

A diagnostic test used to detect the presence of Helicobacter pylori infection in the stomach.

Peptic Ulcer Disease (PUD)

A sore or ulcer that develops in the lining of the stomach, pylorus, duodenum, or esophagus, resulting from gastric acid and pepsin damaging the mucosa. Duodenal ulcers are most common.

Zollinger-Ellison Syndrome (ZES)

A rare condition characterized by tumors (gastrinomas) that cause the stomach to produce excessive amounts of acid, leading to severe peptic ulcers.

Proton Pump Inhibitor (PPI)

A class of medications (e.g., Omeprazole, Pantoprazole) that reduce gastric acid secretion by inhibiting the proton pump mechanism, used for GERD, PUD, and gastritis.

Histamine 2 Receptor Antagonists (H2 Blockers)

A class of medications (e.g., Famotidine, Cimetidine) that decrease gastric acid secretion by blocking histamine receptors, used for GERD, PUD, and gastritis.

Antacids

Medications (e.g., Maalox, Mylanta) that neutralize gastric acid, providing symptomatic relief for conditions like heartburn and indigestion.

Sucralfate (Carafate)

A surface agent (GI protectant) medication that adheres to ulcer sites, forming a protective barrier against acid and pepsin.

Metoclopramide

A gastrointestinal stimulant medication that facilitates GI motility. It carries a black box warning for tardive dyskinesia.

Vagotomy

A surgical procedure to cut the vagus nerve, reducing gastric acid secretion, often performed to treat recurrent peptic ulcers.

Pyloroplasty

A surgical procedure to widen the pylorus, the opening between the stomach and the small intestine, to improve gastric emptying.

Antrectomy

A surgical procedure involving the removal of the antrum and pylorus of the stomach, often performed for peptic ulcer disease.

Dysphagia

Difficulty swallowing, which can result from esophageal, neurological, or muscular disorders, or infections. Signs include coughing/choking when eating, wet gurgling voice, and unintentional weight loss.

Enteral Feeding

Nutritional support provided directly into the gastrointestinal tract via a tube (e.g., nasogastric tube (NGT), percutaneous endoscopic gastrostomy (PEG) tube, jejunostomy tube).

Nasogastric Tube (NGT)

A tube inserted through the nose, past the pharynx and esophagus, and into the stomach, used for feeding, medication administration, or gastric decompression.

Percutaneous Endoscopic Gastrostomy (PEG) Tube

A feeding tube inserted directly into the stomach through the abdominal wall via an endoscope, used for long-term enteral nutrition.

Jejunostomy Tube

A feeding tube inserted directly into the jejunum (part of the small intestine) through the abdominal wall, used when stomach feeding is not possible or desirable.

Parenteral Feeding

Nutritional support delivered intravenously, bypassing the gastrointestinal tract. Includes Total Parenteral Nutrition (TPN) and Peripheral Parenteral Nutrition (PPN).

Total Parenteral Nutrition (TPN)

A method of providing all essential nutrients intravenously through a central line, used when the patient cannot adequately digest or absorb nutrients via the GI tract.

Peripheral Parenteral Nutrition (PPN)

A method of providing partial nutritional support intravenously through a peripheral line, typically for shorter durations or when full nutritional support is not needed via the central route.