Esophageal and Gastric Disorders

Dysphagia

  • Oropharyngeal: inability to propel food from mouth through UES into esophagus
  • Esophageal: difficulty swallowing & passing food from esophagus into stomach
Figure 3-1 Etiologies of and approach to dysphagia (NCP Gastrohep 2008;5:393; Neurogastro 2012;24:57)

Structural dysphagia (solids > liquids; JAMA 2015;313:18; Gastro 2018;155:1022)

  • Oropharyngeal
    • Zenker’s divertic. (pharyngeal pouch): in elderly, a/w aspir., dx w/ video fluoro, Rx endo/surg
    • Malignancy; proximal strictures/rings/webs; infection; radiation injury; goiter; osteophytes
  • Esophageal
    • Rings (intermittent dysphagia, concentric obstructing tissue, eg, Schatzki ring): near GE jxn, a/w food impaction, linked to GERD; Rx w/ PPI, dilation