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Achalasia

Definition
a primary motor disorder of the esophagus characterized by insufficient lower esophageal
sphincter relaxation and loss of esophageal peristalsis
Classification
Divided into 2 parts:
primary achalasia -> neurotropic virus (nukleus dorsalis vagus,ganglia misentrikus)
secondary achalasia-> chagas diseases,interluminary tumor
Common symptoms
Difficulty in swallowing(dysphagia), chest pain and regirgitation of food and liquids
Complication
Lung problems,weight loss,(> the risk of cancer)
Diagnose
X-ray(chest xray: mediastinum hipertrophy ), endoscopy, esophageal manometry(LES
increases,abnormality of sphingtr relaxation,no peristaltic)
Farmacology treatments
Oral
medications:
nitrat
(isosorbid
dinitrat),calcium
channel
blockers(nifedipin&verapamil),tingtur beladona,atrofin sulfat -> (<LES pressure) & (>emptying
esophagus).
LES dilatation-> businasi hurst,esofagomiotomi distal,injection of muscle relaxing-> botulinum
toxin directly to the esophagus
Non-farmaco treatments
Drinking liquid foods, drinking more water with meals and drinking carbonated beverages
DD : adenokarsinoma gaster to esophagus,karsinoma paru&pankreas,sarkoma sel retikulum

Atresia
Definition
Absence of a normal opening, or failure of structure to be tubular, it can affect many structures in the
body
Causes
congenital defect
Symptomps
Bluish coloration to the skin (cyanosis) with attempted feedings, coughing, gagging, choking with
attempted feeding, drooling, poor feeding
Diagnose
USG on the pregnant mom: show too much amniotic fluid or other blockage of digestive tract, after birth
when feeding is attempted and the infant cough,chokes,turns blue, Xray: shows an air filled pouch and
air in the stomach&intestine
Treatment
Surgery to repair esophagus, before the surgery, the baby is not fed by mouth
Complication
Feeding problems, reflux, Narrowing of the esophagus due to scarring from surgery

Gastroesophageal reflux
Definition
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak
backwards from the stomach into the esophagus. This can irritate the esophagus and cause
heartburn and other symptoms.
Causes
Stomach contents back into the esophagus. Reflux may cause symptomps, harsh stomach
acids can also damage the lining of the esophagus
Risk Factors
Alcoholic, obesity, preganancy, sclerodema, smoking
Can also be caused by certain medicines, such as : antiholigernics,beta-blockers for high blood
pressure,dopamine active for parkinsons dss, progestin for abnorm menstrual, sedative for
insomnia/anxiety, tricyclic antidepressant.
Symptoms
Feeling that food is stuck the breastbone, heartburn/burning pain in the chest, nausea after
eating (symptomps may get worse when you lie down and eat,may be worse at night)
Diagnoses
Upper endoscopy, esophageal monometry
Farmaco treatment
Antacid, Proton pump inhibitors (PPIs)& H2 blockers: decrease the amount of acid, endoscopy
Non farmaco treatment
Maintaining a healthy body weight
Compications
Asthma, cancer, bronchospasm, chronic cough/hoarseness, dental problems, ulcer in the
esophagus, stricture