PATHOLOGY. RAJEEV KUMAR, MD. GI SYSTEM. A 45 yr old clerk presented to family physician for “ heart burn” of 7 yr duration. He has been intermittently taking prilosec, a proton pump inhibitor with some relief. What is the most likely diagnosis ?.
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RAJEEV KUMAR, MD
Due to instability of lower esophageal sphincter gastric acid enters into the distal esophagus causing intermittent burning sensation in the retrosternal region and some times regurgitation of ingested food. Patient may also present with excessive salivation and chronic cough.
Endoscopic appearance of the Adenocarcinoma of the esophagus
Etiology: Unknown in most cases
Chaga’s disease: Common in South America
Esophagitis: Inflammation of the esophagus causing chest pain, Dysphagia and Odynophagia. Etiology GERD, Infections ( Candida, CMV, HSV), radiation, uremia.
Hiatal Hernia: Gastroesophageal defect in which part of stomach protrudes above diaphragm. Associated with GERD.
Tracheoesphageal Fistula: Congenital disorders manifesting in affected newborns as hyper salivation and difficulty feeding with choking. Most common type( 90 %) involves distal esophageal atresia with a connection to the trachea.
2) Triple therapy for eradication of H. Pylori. This includes combination of two antibiotics from Metronidazole, Amoxycillin, Clarithromycin with a PPI.
Classic presentation: Burning epigastric pain which worsens with eating. Associated with wait loss.