Causes of esophageal dysphagia:
- Food impaction - most common cause of acute dysphagia in adults
- Esophageal stricture - peptic strictures occur in about 10% of patients with GERD
- Eosinophilic esophagitis - found in up to 15% of people being evaluated by EGD for dysphagia
- Esophageal webs and rings
- Malignancy - carcinoma of the esophagus or gastric cardia can cause dysphagia
- Radiation injury
- Infectious esophagitis - often present with odynophagia, e.g. Candida, CMV, HSV
Posted 08/29/16 10:02:26 AM by Anna Krigel
Reminder of acute upper GI bleed management:
- Establish 2 large bore IVs
- IV crystalloids for hypotension
- transfuse PRBCs for Hgb<7 (or <9 in high risk cardiac patients)
- GI consultation
Posted 08/29/16 10:19:18 AM by Anna Krigel
- Majority of affected adults are men in their 20s to 30s
- Commonly presents with dysphagia to solidsS, food impaction, centrally located chest pain, GERD-like symptoms, and upper abdominal pain
- Strong association with allergic conditions (e.g. food allergies, environmental allergies, asthma, atopic dermatitis)
- Endoscopic findings include stacked circular rings ("feline" esophagus), linear furrows, and strictures
- Esophageal biopsy will show an increased number of eosinophils
- Initial management = acid suppression with PPI ad topical glucocorticoids like aerosolized fluticasone
Posted 08/29/16 10:34:08 AM by Anna Krigel
For further reading...
Posted 08/29/16 10:36:20 AM by Anna Krigel
Created by Christopher Kelly
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