p.8
Achalasia: Pathophysiology and Diagnosis
What is the purpose of medical management in achalasia?
To provide temporary, mild relief of dysphagia for patients who cannot tolerate other therapies.
p.6
Achalasia: Pathophysiology and Diagnosis
What is the effect of achalasia on esophageal motility?
Loss of relaxation results in aperistalsis and abnormal contractions.
p.2
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
What is the most common esophageal cancer in the United States?
Esophageal adenocarcinoma.
p.5
Achalasia: Pathophysiology and Diagnosis
What does the Integrated Relaxation Pressure (IRP) measure?
It measures LES pressure by evaluating a continuous or interrupted 4-second relaxation in a 10-second window.
p.6
Achalasia: Pathophysiology and Diagnosis
Which parasite infection can lead to achalasia?
Trypanosoma Cruzi (Chagas' disease).
p.2
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
Which demographic is more likely to develop esophageal adenocarcinoma?
Whites compared to blacks, and men compared to women.
p.6
Achalasia: Pathophysiology and Diagnosis
What causes the high lower esophageal sphincter (LES) pressure in achalasia?
Selective loss of post-ganglionic inhibitory neurons containing nitric oxide and substance P.
p.12
Gastroesophageal Reflux Disease (GERD) Management
What is the most common surgical treatment for GERD?
Laparoscopic fundoplication.
p.2
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
What are the risk factors for esophageal adenocarcinoma?
Barrett's esophagus, GERD, smoking, obesity.
p.8
Endoscopic Dilation Techniques for EoE
What is the purpose of pneumatic dilation in achalasia treatment?
To break the muscular fibers of the lower esophageal sphincter.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What is the Stretta procedure?
An FDA approved outpatient procedure for GERD performed in less than an hour.
p.5
Achalasia: Pathophysiology and Diagnosis
What is considered a large peristaltic break?
A discontinuity of peristalsis of > 5 seconds.
p.12
Gastroesophageal Reflux Disease (GERD) Management
What does the LINX® Reflux Management System do?
It augments the pressure of the lower esophageal sphincter (LES) to prevent reflux.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What were the findings of the meta-analysis regarding Stretta?
It showed no difference between Stretta and control for certain GERD outcomes, but a more recent analysis found it improves GERD symptoms and quality of life.
p.4
Management of Caustic Ingestion
Why should EGD be avoided within 5-15 days of corrosive ingestion?
Due to tissue softening and increased risk of perforation.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What is diagnostic of GERD in LA class B esophagitis?
Typical GERD symptoms and PPI response.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What is the role of esophageal manometry in GERD diagnosis?
It is required for accurate placement of the catheter during pH impedance monitoring.
p.9
Gastroesophageal Reflux Disease (GERD) Management
What is the Los Angeles Classification system used for?
It classifies erosive esophagitis based on the length and extent of mucosal breaks.
p.15
Gastroesophageal Reflux Disease (GERD) Management
What are some possible GERD-related syndromes?
Pharyngitis, sinusitis, pulmonary fibrosis, and otitis.
p.14
Gastroesophageal Reflux Disease (GERD) Management
What are the common side effects of baclofen?
Nausea, drowsiness, dizziness, fatigue.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What is the annual incidence rate of adenocarcinoma in patients with low-grade dysplasia?
Approximately 0.7% per year.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What should be documented during an endoscopic examination of Barrett's Esophagus?
Measurements of diaphragmatic pinch, lower esophageal sphincter, circumferential extent of BE, and maximum extent of BE.
p.5
Achalasia: Pathophysiology and Diagnosis
What does a DCI value of ≥ 8000 indicate?
A hypercontractile pattern.
p.12
Gastroesophageal Reflux Disease (GERD) Management
What is the FDA approval status of Vonoprazan?
It is FDA approved for the treatment of erosive esophagitis and for use with amoxicillin +/- clarithromycin to treat H. pylori.
p.5
Achalasia: Pathophysiology and Diagnosis
What supportive measurements may be included in the HRM protocol?
Solid test meal, multiple rapid swallows, rapid drink challenge, and pharmacologic provocation.
p.5
Achalasia: Pathophysiology and Diagnosis
What is indicated by ≥ 20% swallows with premature/spastic contractions?
Type 3 Achalasia (spastic achalasia).
p.3
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
What is the recommended screening for patients with tylosis?
Screening is recommended starting at age 30, to be repeated every 1-3 years.
p.9
Gastroesophageal Reflux Disease (GERD) Management
What is the indication for endoscopy in GERD patients?
Reflux symptoms unresponsive to medical therapy, dysphagia, odynophagia, weight loss, GI bleeding, abnormal imaging, persistent vomiting, and recurrent symptoms following endoscopic or surgical therapy.
p.4
Management of Caustic Ingestion
What treatment is recommended for extensive necrosis (Grade 3b) after caustic ingestion?
NPO (nothing by mouth) and consider further management based on the patient's condition.
p.3
Management of Caustic Ingestion
What are common clinical manifestations of caustic ingestion?
Chest pain, sore throat, odynophagia, dysphagia, stridor, hoarseness, respiratory distress, epigastric pain, hematemesis.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What is the significance of borderline acid exposure time (4-6%)?
Diagnosis of GERD is suggested if there is adjunctive evidence; absence suggests functional heartburn.
p.15
Gastroesophageal Reflux Disease (GERD) Management
What might laryngoscopy reveal in patients with laryngitis?
Nonspecific edema and erythema of the larynx.
p.1
Dupilumab and Eosinophilic Esophagitis (EoE)
What is Dupilumab and its function?
Dupilumab is a human monoclonal IgG4 antibody that inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling, approved for treating EoE in adults and children over 12 years.
p.1
Cricopharyngeal Bar and Zenker's Diverticulum
What is a cricopharyngeal bar (CPB)?
A CPB is a radiologic abnormality appearing as a posterior indentation at the level of the cricoid cartilage on barium swallow.
p.12
Gastroesophageal Reflux Disease (GERD) Management
How does Vonoprazan differ from traditional PPIs?
It is more potent, provides quicker and steadier inhibition of acid secretion, and does not require administration before meals.
p.2
Management of Caustic Ingestion
What is the treatment for small, early tumors (T1a or T1b) of esophageal cancer?
Endoscopic Mucosal Resection (EMR) if there are no regional lymph nodes involved and no distant metastasis.
p.8
Endoscopic Dilation Techniques for EoE
What balloon sizes are typically used for pneumatic dilation?
30, 35, and 40 mm diameters.
p.10
Gastroesophageal Reflux Disease (GERD) Management
Why is describing the extent and severity of inflammation more useful than categorizing esophagitis?
It provides more specific information about the condition.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What does a Symptom Sensitivity Index (SSI) greater than 10% indicate?
It indicates an abnormal association between reflux episodes and symptoms.
p.7
Achalasia: Pathophysiology and Diagnosis
What is the distensibility index (DI) used for?
To assess the distensibility of the GE junction.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What are the types in the Hill classification?
Type 1: Snug fold; Type 2: Less snug; Type 3: No closure; Type 4: Sliding hiatal hernia.
p.11
Gastroesophageal Reflux Disease (GERD) Management
How do PPIs work in treating GERD?
They irreversibly inhibit active hydrogen potassium (H+, K+)-ATPases.
p.15
Gastroesophageal Reflux Disease (GERD) Management
What are common nonspecific symptoms of extraesophageal GERD?
Hoarseness, throat pain, sensation of a lump in the throat, repetitive throat clearing, and excessive phlegm production.
p.15
Gastroesophageal Reflux Disease (GERD) Management
Is EGD without reflux monitoring recommended for diagnosing extraesophageal GERD?
No, it is not recommended.
p.15
Barrett's Esophagus: Definition and Risk of Malignancy
What histological features are demonstrated in Barrett's esophagus?
Intestinal metaplasia and goblet cells.
p.6
Achalasia: Pathophysiology and Diagnosis
What are common symptoms of achalasia?
Dysphagia to solids and liquids, chest pain, regurgitation, heartburn, weight loss, aspiration.
p.6
Achalasia: Pathophysiology and Diagnosis
What imaging is recommended if pseudoachalasia is suspected?
Cross-sectional imaging of the chest and abdomen +/- EUS of the distal esophagus and gastric cardia.
p.5
Achalasia: Pathophysiology and Diagnosis
What characterizes Type 1 Achalasia?
Elevated IRP with 100% failed peristalsis and no panesophageal pressurization.
p.3
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
When is esophagectomy indicated?
In patients with T2, T3 cancers without lymph node involvement.
p.9
Gastroesophageal Reflux Disease (GERD) Management
Why is it important to exclude cardiac disease in GERD patients?
Because GERD is the most common cause of non-cardiac chest pain, especially in older patients and those with cardiac risk factors.
p.8
Achalasia: Pathophysiology and Diagnosis
What is the mechanism of action of botulinum toxin in treating achalasia?
It inhibits excitatory acetylcholine-releasing neurons, resulting in decreased LES pressure.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What does the Hill classification describe?
The integrity of the gastroesophageal flap valve.
p.14
Gastroesophageal Reflux Disease (GERD) Management
What lifestyle modifications are recommended for managing non-acid reflux?
Weight loss and smaller meals.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What is the role of manometry in GERD diagnosis?
It has a limited role but is required prior to surgical fundoplication to rule out motility disorders.
p.10
Gastroesophageal Reflux Disease (GERD) Management
How is acid reflux defined in pH monitoring?
As a decrease in pH to < 4.
p.15
Gastroesophageal Reflux Disease (GERD) Management
What is the recommended treatment for patients with GERD symptoms?
A therapeutic trial of PPI for at least 3 months.
p.15
Barrett's Esophagus: Definition and Risk of Malignancy
What defines Barrett's esophagus (BE)?
The presence of intestinal metaplasia of ≥ 1cm that replaces the normal stratified squamous epithelium.
p.12
Gastroesophageal Reflux Disease (GERD) Management
What is Vonoprazan?
A potassium-competitive acid blocker (PCAB) that blocks the hydrogen-potassium ATPase.
p.8
Achalasia: Pathophysiology and Diagnosis
What are some medical management options for achalasia?
Nifedipine, sublingual isosorbide dinitrate, and sildenafil.
p.3
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
What is the AGA's recommendation for therapy in T1a tumors?
AGA recommends EMR and ablation as a preferred therapy over esophagectomy.
p.3
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
What was the complete endoluminal remission rate for T1b-sm1 tumors in a small retrospective study?
87%, with a higher rate of 97% for small focal neoplasia ≤ 2 cm.
p.9
Gastroesophageal Reflux Disease (GERD) Management
What are the clinical manifestations of GERD?
Esophageal symptoms include heartburn, regurgitation, dysphagia, odynophagia, and chest pain; extra-esophageal manifestations include asthma, cough, and laryngitis.
p.8
Endoscopic Dilation Techniques for EoE
What are some side effects of pneumatic dilation?
Perforation, GERD, and reflux esophagitis.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What defines refractory GERD?
Persistent bothersome heartburn (>2 times/week for 3 months) despite BID PPI therapy.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What lifestyle modifications are recommended for GERD patients?
Weight loss, stopping smoking, elevating the head of the bed, small meals, and avoiding alcohol/caffeine.
p.9
Gastroesophageal Reflux Disease (GERD) Management
What does LA class A indicate in the Los Angeles Classification?
One or more mucosal breaks < 5 mm in length.
p.15
Gastroesophageal Reflux Disease (GERD) Management
What is another name for laryngitis in the context of GERD?
Laryngopharyngeal reflux.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What is Barrett's Esophagus (BE) a significant risk factor for?
Esophageal adenocarcinoma.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
How does the risk of adenocarcinoma change with the length of Barrett's Esophagus?
It is higher in patients with long segment BE (> 3 cm).
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What is the recommended biopsy approach for non-dysplastic Barrett's Esophagus?
Four quadrant biopsies every 2 cm.
p.5
Achalasia: Pathophysiology and Diagnosis
What does a distal latency (DL) less than 4.5 seconds indicate?
Premature/spastic contraction.
p.4
Management of Caustic Ingestion
When can EGD be deferred in asymptomatic patients after caustic ingestion?
If there is a history of ingestion of a small amount of weak caustic substance, EGD can be deferred and the patient discharged within 6-12 hours.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What defines abnormal acid exposure time in the context of GERD?
Acid exposure time greater than 6% is considered abnormal.
p.6
Achalasia: Pathophysiology and Diagnosis
What does a barium swallow test show in achalasia?
A dilated esophagus and tight LES (bird's beak appearance).
p.14
Gastroesophageal Reflux Disease (GERD) Management
What is the possible etiology of functional heartburn?
Esophageal hypersensitivity.
p.12
Gastroesophageal Reflux Disease (GERD) Management
What are potential mechanisms of action for the Stretta procedure?
Increased LES muscle thickness, decreased transient lower esophageal sphincter relaxation (TLESR), and reduced gastro-esophageal junction compliance.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What is the mainstay medical therapy for severe GERD?
Proton Pump Inhibitors (PPIs).
p.14
Gastroesophageal Reflux Disease (GERD) Management
What is the mechanism of action of baclofen?
It decreases transient lower esophageal sphincter relaxations.
p.14
Gastroesophageal Reflux Disease (GERD) Management
What do alginic acid derivatives do in the context of GERD?
Create a mechanical barrier between the esophagus and the stomach.
p.15
Gastroesophageal Reflux Disease (GERD) Management
Does asymptomatic GERD contribute to uncontrolled asthma?
No, it does not appear to be a contributing factor.
p.1
Cricopharyngeal Bar and Zenker's Diverticulum
What is the treatment for Zenker's diverticulum?
Treatment is by surgical or endoscopic cricopharyngeal myotomy.
p.5
Achalasia: Pathophysiology and Diagnosis
What is panesophageal pressurization?
It occurs when esophageal content is trapped between two simultaneously contracting esophageal segments.
p.9
Gastroesophageal Reflux Disease (GERD) Management
What are the most common causes of GERD?
A weak lower esophageal sphincter (LES) and increased frequency of transient lower esophageal sphincter relaxations (TLESR).
p.9
Gastroesophageal Reflux Disease (GERD) Management
What are some contributing factors to GERD?
Hiatal hernia, gastric hyperacidity, delayed gastric emptying, and increased intra-abdominal pressure.
p.8
Endoscopic Dilation Techniques for EoE
What are predictors of therapeutic failure in pneumatic dilation?
Age younger than 40, male gender, pre-dilation LES pressure > 20 mmHg, and type 3 achalasia.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What did the RESPECT trial find about TIF?
It was more effective than PPI in treating regurgitation at 6 months follow-up.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What should patients with severe erosive esophagitis undergo after PPI treatment?
A repeat EGD to evaluate for Barrett's esophagus.
p.7
Achalasia: Pathophysiology and Diagnosis
What clinical features suggest a diagnosis of achalasia?
Chronic dysphagia, dilated esophagus, bird beak appearance on barium, delayed barium emptying, tight LES, and failed swallows.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What does pathologic acid exposure time indicate?
It indicates GERD if the acid exposure time is greater than 6%.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What should be done if a patient does not respond to one PPI?
Switching to another PPI is reasonable to try to achieve symptom relief.
p.14
Gastroesophageal Reflux Disease (GERD) Management
When should laparoscopic fundoplication be considered?
In patients with severe symptoms refractory to medical therapy.
p.1
Dietary Elimination and Six-Food Elimination Diet (SFED)
What does the Six-Food Elimination Diet (SFED) remove?
The SFED removes the most common food allergens: milk, wheat, soy, eggs, nuts, seafood, and sesame.
p.1
Cricopharyngeal Bar and Zenker's Diverticulum
What can lead to the development of Zenker's diverticulum?
Increased upper esophageal sphincter pressure and decreased compliance, possibly due to sphincter fibrosis.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What is the significance of the pH monitoring study in diagnosing GERD?
It measures reflux duration and the association between reflux and symptoms.
p.6
Achalasia: Pathophysiology and Diagnosis
What findings might be observed during an EGD in a patient with achalasia?
Dilated esophagus, residual secretions, candidal plaques, and a tight LES.
p.7
Achalasia: Pathophysiology and Diagnosis
What treatment method is more effective for type 3 achalasia?
Per Oral Endoscopic Myotomy (POEM).
p.12
Gastroesophageal Reflux Disease (GERD) Management
What is the purpose of the Stretta procedure?
To deliver radiofrequency energy to the LES to reduce GERD symptoms.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What is the goal of further investigations in patients with refractory GERD?
To make an accurate diagnosis, suggest effective therapy, and discontinue ineffective medications.
p.7
Achalasia: Pathophysiology and Diagnosis
What is the preferred treatment for patients with type 3 achalasia?
POEM (Per Oral Endoscopic Myotomy).
p.9
Gastroesophageal Reflux Disease (GERD) Management
What does LA class D indicate in the Los Angeles Classification?
Mucosal breaks extend between ≥ 1 mucosal fold, involving > 75% of esophageal circumference.
p.3
Management of Caustic Ingestion
What is the management approach for patients with hoarseness or respiratory distress after caustic ingestion?
They should undergo laryngoscopy and consider endotracheal intubation.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What is the absolute annual risk of adenocarcinoma in patients with BE according to a population-based study?
0.12% (1.2 cases per 1000 person-years).
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
Who should undergo endoscopic screening for Barrett's Esophagus?
Male patients with >5 years of GERD symptoms and two or more risk factors.
p.14
Gastroesophageal Reflux Disease (GERD) Management
What is the diagnosis for a patient with a history of GERD, normal acid exposure on pH impedance, and negative symptom association?
Functional heartburn overlapping with GERD.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What is EsophyX TM Transoral Incisionless Fundoplication (TIF)?
A completely per oral procedure under general anesthesia that creates a full thickness partial circumferential fundoplication.
p.4
Management of Caustic Ingestion
What is Zargar's endoscopic grading used for?
To classify caustic esophageal injury and provide corresponding management recommendations.
p.4
Management of Caustic Ingestion
What management is recommended for Grade 1 caustic esophageal injury?
Start a liquid diet and advance within 1-2 days to a full diet.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What does the AFS Hiatus Grade score range indicate?
It describes the flap valve and degree of hiatal disruption.
p.7
Achalasia: Pathophysiology and Diagnosis
Do botulinum toxin injections affect the success rates of future myotomy in achalasia?
No, they do not affect success rates.
p.15
Barrett's Esophagus: Definition and Risk of Malignancy
How is Barrett's esophagus recognized endoscopically?
By its salmon-colored mucosa.
p.2
Esophageal Adenocarcinoma and Squamous Cell Carcinoma
What are the common symptoms of esophageal cancer?
Dysphagia, odynophagia, hematemesis, and weight loss.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What indicates GERD in the presence of erosive esophagitis?
Class C or D esophagitis and/or long segment Barrett’s esophagus.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What does a Symptom Association Probability (SAP) greater than 95% suggest?
It suggests a strong likelihood that the patient's symptoms are related to reflux.
p.7
Achalasia: Pathophysiology and Diagnosis
How do untreated achalasia patients' DI values compare to healthy controls?
Untreated achalasia patients have lower DI values.
p.13
Gastroesophageal Reflux Disease (GERD) Management
What should be done if a patient has a normal endoscopy?
Proceed with pH testing, ideally during the same session as EGD.
p.4
Management of Caustic Ingestion
What is the recommended follow-up for patients with a history of lye or caustic esophageal injury?
Screening for squamous cell carcinoma is recommended 15-20 years after injury, to be repeated every 1-3 years.
p.1
Endoscopic Dilation Techniques for EoE
What is the effectiveness of endoscopic dilation for EoE strictures?
Endoscopic dilation is highly effective, resulting in 90% symptom improvement.
p.1
Cricopharyngeal Bar and Zenker's Diverticulum
What symptoms do symptomatic patients with Zenker's diverticulum typically experience?
Oropharyngeal dysphagia to solids and/or liquids, cough, choking, and throat pain with swallowing.
p.4
Management of Caustic Ingestion
What is the recommended time frame for performing EGD after caustic ingestion if the patient is symptomatic?
EGD should be performed within 24-48 hours of caustic ingestion.
p.11
Gastroesophageal Reflux Disease (GERD) Management
What is the purpose of the Symptom Index (SI) in GERD assessment?
It calculates the percentage of symptom episodes occurring at documented pH < 4.
p.7
Achalasia: Pathophysiology and Diagnosis
What does the Endoscopic Functional Luminal Imaging Probe (EndoFLIP) measure?
Luminal geometry and mechanical characteristics of the esophagus.
p.9
Gastroesophageal Reflux Disease (GERD) Management
What is the typical endoscopic finding in most GERD patients?
Most patients will have a normal endoscopy, known as Non-Erosive Reflux Disease (NERD).
p.4
Management of Caustic Ingestion
What late complication can arise from caustic esophageal injury?
Strictures can be multiple and tortuous.
p.3
Management of Caustic Ingestion
What should be avoided in the management of caustic ingestion?
Emetics and gastric lavage.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What is specialized intestinal metaplasia of the GE junction associated with?
It is not associated with increased risk of malignancy or dysplasia.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What defines GERD in terms of acid exposure time?
A total acid exposure time of >6% of the duration of the study.
p.1
Endoscopic Dilation Techniques for EoE
What are the complications associated with endoscopic dilation?
Complications include chest pain (2%), esophageal tears, and perforations (0.3%).
p.1
Cricopharyngeal Bar and Zenker's Diverticulum
What is the management approach for a patient with dysphagia and a CPB finding?
Consider the patient for endoscopic dilation.
p.4
Management of Caustic Ingestion
What are some contraindications to performing EGD?
Respiratory distress, severe chest pain, and suspicion or confirmation of esophageal perforation.
p.6
Achalasia: Pathophysiology and Diagnosis
What are the manometric features of achalasia?
Absent esophageal peristalsis and EGJ outflow abnormality.
p.6
Achalasia: Pathophysiology and Diagnosis
What are the three types of achalasia based on pressure topography?
Type 1: classic achalasia; Type 2: achalasia with esophageal compression; Type 3: spastic achalasia.
p.12
Gastroesophageal Reflux Disease (GERD) Management
What were the remission rates for PPIs compared to surgical therapy in the LOTUS trial?
PPIs had a 92% remission rate, while surgical therapy had an 85% remission rate.
p.15
Gastroesophageal Reflux Disease (GERD) Management
What are established extraesophageal reflux syndromes?
Asthma, cough, laryngitis, and dental erosions.
p.7
Achalasia: Pathophysiology and Diagnosis
What should be considered if a hiatal hernia is present in achalasia patients?
Heller myotomy with hernia repair.
p.10
Gastroesophageal Reflux Disease (GERD) Management
What is the purpose of pH monitoring in GERD?
To document abnormal esophageal acid exposure and evaluate persistent symptoms.
p.15
Gastroesophageal Reflux Disease (GERD) Management
Why should the diagnosis of reflux laryngitis not rely solely on laryngoscopic findings?
Many healthy asymptomatic individuals may have abnormal laryngeal findings.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What does abnormal TP53 immunohistochemistry in Barrett’s mucosa indicate?
It can identify patients with a higher risk of progression, including those with non-dysplastic BE.
p.16
Barrett's Esophagus: Definition and Risk of Malignancy
What is the Prague classification used for in Barrett's Esophagus?
To report the length of BE as C/M.
