Esophagus

#Esophageal reflux

Chronic. Currently well-controlled with PPI therapy. No acute concerns at this time. 

-Continue with home medication. 

#Barrett esophagus 

Men with gastroesophageal reflux disease symptoms for 5 years and additional risk factors (nocturnal reflux symptoms, hiatal hernia, elevated BMI, intra-abdominal distribution of body fat, tobacco use) should be screened for Barrett esophagus 

Barrett esophagus progresses as follows: intestinal metaplasia, indefinite for dysplasia, low-grade dysplasia, high-grade dysplasia, intramucosal carcinoma, and, finally, invasive adenocarcinoma 

Patients with high-grade dysplasia and confirmed low-grade dysplasia should undergo treatment to eradicate all neoplastic and at-risk epithelium. Patients with Barrett esophagus without dysplasia should undergo surveillance endoscopy every 3 to 5 years to monitor for dysplasia or precancerous changes. 

#Eosinophilic esophagitis 

Eosinophilic esophagitis is a condition commonly associated with dysphagia and food bolus obstruction, usually found in younger men with atopic conditions. 

Diagnostic criteria for eosinophilic esophagitis are dysphagia, esophageal biopsy specimens with eosinophil counts of at least 15/hpf, and exclusion of other causes of eosinophilia 

#Caustic Ingestion

Figure 3, Tosca et al, AJG 2022