Esophageal Disorders
(PEARLS) Smarty PANCE
100% VERIFIED ANSWERS
2024/2025
What is esophagitis?
Esophagitis is simply inflammation that may damage tissues of the esophagus. It
usually causes dysphagia or difficulty in swallowing, odynophagia or painful
swallowing, and retrosternal chest pain.
What are the two types of esophagitis?
Infectious and non-infectious
How is esophagitis diagnosed?
The usual workup includes an upper endoscopy with a biopsy. And in case of
retrosternal chest pain, an electrocardiogram should always be done in order to rule
out cardiac ischemia.
What is the most common cause of esophagitis?
The most common cause is gastroesophageal reflux disease or GERD, and in that
situation, it’s called reflux esophagitis.
What is the treatment of reflux esophagitis?
Treatment of reflux esophagitis starts with proton pump inhibitors or PPIs such as
omeprazole for 8 weeks. If symptoms disappear, then the dose of PPI is gradually
decreased. If PPIs are needed for more than 6 months, then it’s replaced by histamine 2

receptor agonists or H2RAs. If the symptoms recur, then the lowest dose of the
medication that last controlled the symptoms is restarted.
How should patients with severe erosive esophagitis be managed?
For individuals with severe erosive esophagitis, a repeat upper endoscopy should be
done after 8 weeks of treatment to make sure that it’s healing and to rule out
malignancy
Pt with asthma symptoms and GERD not responsive to antacids.
Eosinophilic esophagitis - Pt with Asthma symptoms and GERD not responsive to
antacids. Allergic, eosinophilic infiltration of the esophageal epithelium.
How is eosinophilic esophagitis treated?
Eosinophilic esophagitis is treated by removing foods that incite allergic response,
topical steroids via inhaler
An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is
the most likely diagnosis?
Herpes simplex virus
Esophagitis caused by NSAIDs or bisphosphonates
Noninfectious - Medication induced esophagitis
Dysphagia lasting weeks-months after radiation therapy
Noninfectious - Radiation-induced esophagitis. Radiation exposure of 5000 cGy
associated with increased risk for stricture
Linear yellow-white plaques with odynophagia or pain on swallowing.
Infectious fungal (candida) esophagitis

How is candida esophagitis treated?
Fluconazole 100 mg PO daily
What is GERD? (Gastroesophageal reflux disease)
Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows
back into the tube connecting your mouth and stomach (esophagus). This backwash
(acid reflux) can irritate the lining of your esophagus.
What are the signs and symptoms of GERD?
- Heartburn, usually after eating, which might be worse at night
- Chest pain
- Dysphagia (difficulty swallowing)
- Regurgitation of food or sour liquid
- Sensation of a lump in your throat
- Chronic cough
- Laryngitis
- New or worsening asthma
- Disrupted sleep
List four atypical symptoms associated with GERD
1. Cough
2. Hiccups
3. Throat clearing
4. Wheezing
What are four dietary examples that can lower LES pressure and worsen
symptoms of GERD?
1. Fatty foods
2. Alcohol

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3. Caffeine (coffee, tea, chocolate)
4. Peppermint
List five medicines that can lower LES pressures, thus leading to GERD:=
1. Calcium channel blockers
2. Theophylline
3. Diazepam (Valium)
4. Meperidine (Demerol)
5. Morphine
Diagnostic tests for GERD
- Upper endoscopy
- Ambulatory acid (pH) probe test
- Esophageal manometry
- X-ray of the upper digestive system
Do all patients with GERD need esophageal function testing?
No, any additional testing beyond an EGD should be reserved for patients who
either fail medical therapy and lifestyle modification or in whom the correlation of
reflux symptoms is in doubt
Provide five extraesophageal manifestations of GERD
1. Asthma
2. Laryngitis/pharyngitis
3. Dental decay
4. Recurrent sinusitis
5. Recurrent otitis media
What happens when the disease worsens?

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2024-2025 Esophageal Disorders (PEARLS) (Smarty PANCE) with Answers (57 Solved Questions)

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