Esophageal Metaplasia and Neoplasia

Esophageal cancer accounts for a jaw-dropping amount of cancer-related deaths, and is now classified as the 6th-highest cause of death in this group.  In this installment of the study guide series, I will discuss Barrett Esophagus (I learned this entity as Barrett Metaplasia) and esophageal cancer (neoplasia).   Barrett Metaplasia Metaplasia:  columnar epithelium replaces the physiologic squamous epithelium…

Gastroesophageal Reflux Disease (GERD)

GERD is incredibly common, with an estimated prevalence of 10-20% in the Western hemisphere.  It’s important to note that GERD has many overlap symptoms with cardiac chest pain, thus cardiovascular causes should be ruled out first before the diagnosis of GERD.   GERD Clinically Insomnia/poor sleep quality, diminished work output Typical heartburn, liquid regurgitation with resultant metallic or…

Inflammatory Bowel Disease (IBD)

IBD is an important clinical entity, made up of two idiopathic processes:  Crohn Disease (CD) and Ulcerative Colitis (UC).  Risk factors involve both genetic (higher incidence in identical twins) and environmental sources.  Cigarette smoking = risk factor for CD, protective for UC.  Northern populations see higher rates of IBD.  Note:  may utilize ESR and CRP levels to…

Introduction to Esophageal Problems

The very first entry in my GI & Hepatology study outline series will set the stage/define major descriptors of proximal GI (esophageal) symptoms and help with categorizing pathology. Dysphagia = the sensation that food and/or liquid is not appropriately going through the mouth/throat/esophagus.  Typical symptoms:  “food is getting stuck / impeded.” Oropharyngeal phase – food bolus…

PGY-2 Life And Decisions

It’ll take some time to shake the feeling of being the “Intern” after twelve months with that role.  One of my primary goals for intern year (first year) was to learn the fundamentals of real-world medical practice.  If I had to choose a few from a long-list, some fundamentals would include:  recognize life-threatening and other urgent but common…