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Esophageal varices
- abnormally enlarged veins in the lower part of the espophagus
- develop when normal blood flow to the liver is slowed
- blood backs up into neatby smaller blood vessels, such as those in the esophagus, causing the vessles to swell
- may rupture, causing life-threatening bleeding
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Diagnosis for esophageal varices
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Treatments of esophageal varices
- to reduce bleeding potential
- medication (infusion of vasopressin)
- medical devices (Minnesota or Sengstaken-Blakemore tube; elastic bands to tie off bleeding veins; TIPS - transjugular intrahepatic portosystemic shunt)
- surgery (liver transplantation)
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Esophagitis (reflux) and GERD (gastroesophageal reflux disorder)
- a general term for any inflammation, irritation or swelling of the esophagus
- due to backflow of acid-containing fluid from the stomach to the esophagus
- causes burning chest pain or heartburn that resembles pain of heart disease
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Risk factors for reflux and GERD
- compromised cardiac or lower esophageal sphincter
- increased acid secretion
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Common symptoms of reflux and GERD
- feeling of food trapped behind the breastbone
- heartburn or a burning pain in the chest
- nausea after eating
- other: coughing or wheezing
- other: difficulty in swallowing
- other: hiccups
- other: hoarseness, change in voice or sore throat
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Risk factors for reflux or GERD
- there are numerous
- yes, I wasted a flash card on that
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Diagnosis for reflux or GERD
- endoscopy
- barium fluoroscopy
- esophageal pH
- esophageal manometry
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Treatments for reflux or GERD
- avoid certain foods and beverages
- changes in eating habits and lifestyle
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Medications for reflux or GERD
- OTC antacids
- anxiolytics
- pepsin inhibitor
- prostaglandin E1 (PGE1) analogue
- gastrointestinal stimulants
- anticholinergics
- histamine2 (H2) receptor antagonists
- proton pump inhibitors
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OTC antacids
neutralize gastric acid secretion and reduces pepsin activity
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Anxiolytics
reduce vagal stimulation and decrease anxiety
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Pepsin inhibitor
binds to surface of proteins of ulcers to coat it, protecting the ulcer from further injury by gastric acid and pepsin
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Prostaglandin E1 (PGE1) analogue
suppresses gastric acid secretion and increases sytoprotective mucus in GI tract
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Gastrointestinal stimulants
increase gastric emptying and motility of upper intestines
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Anticholinergics
decrease GI motility (delaying gastric empyting) and inhibits histamine and gastric acid (HCl) secretion
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Histamine2 (H2) receptor antagonists
reduce histamine-induced gastric acid (HCl) secretion
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Proton pump inhibitors
inhibit gastric acid (HCl) secretion
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