Gastrointestinal Disorders: Esophagus

Esophageal Disorders Overview

  • Esophageal Issues: Covering various disorders including GERD, Barrett's esophagus, esophageal cancer, esophageal varices, and esophageal strictures.

Esophageal Strictures

  • Etiology: Chronic inflammation or injury results in fibrosis and narrowing; causes include GERD, ingestion of caustic substances, and eosinophilic esophagitis.

  • Pathogenesis: Inflammatory response leads to fibrosis, resulting in reduced compliance and narrowing of the esophagus.

  • Clinical Significance: Symptoms include dysphagia, aspiration risk, and malnutrition; treatment involves dilation procedures.

Esophageal Varices

  • Etiology: Caused by dilated veins from portal hypertension, often due to liver cirrhosis.

  • Pathogenesis: Increased pressure leads to dilation of esophageal veins; risk of rupture and life-threatening hemorrhage.

  • Clinical Significance: May result in hematemesis and melena; high risk of rebleeding and anemia.

Barrett's Esophagus

  • Etiology: Metaplasia of the esophagus due to chronic GERD leading to columnar epithelium; risk factors include smoking and obesity.

  • Pathogenesis: Chronic acid exposure causes epithelial injury and dysplastic changes.

  • Clinical Significance: Increased risk of esophageal adenocarcinoma; requires regular surveillance.

Esophageal Cancer

  • Etiology: Malignment due to chronic irritation from GERD, smoking, and alcohol use; includes adenocarcinoma and squamous cell carcinoma.

  • Pathogenesis: Chronic inflammation and dysplasia lead to invasive cancer.

  • Clinical Significance: Symptoms include dysphagia, weight loss; treatment options are esophagectomy, radiation, and chemotherapy.

Gastroesophageal Reflux Disease (GERD)

  • Etiology: Due to lower esophageal sphincter dysfunction, obesity, and dietary factors.

  • Pathogenesis: Acid reflux leads to inflammation and metaplasia, possibly progressing to Barrett's esophagus.

  • Clinical Significance: Symptoms include heartburn, and risks of complications like esophagitis and esophageal strictures; managed through lifestyle changes and medications.