Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Management of Jackhammer Esophagus or Esophageal Spasm
Step 1: Assess the severity of the motility disturbance
Step 2:
Management of Jackhammer ... Esophagus or Esophageal ... Consider further diagnostics ... #Jackhammer #Esophagus ... #Esophageal #Spasm
Eosinophilic Esophagitis (EoE) - Spectrum of Response
Non-response:
 • Histology: Persistent eosinophilia, ≥ 15 eos/hpf
 • Symptoms:
Eosinophilic Esophagitis ... Histology: Persistent eosinophilia ... Histology: Reduced eosinophilia ... Endoscopy: Normal esophagus ... EoE #Response #diagnosis
Acute Esophageal Necrosis
History: Hematemesis and/or melena (70%), Dysphagia, Epigastric/chest pain, Sepsis
Diagnosis EGD and Biopsy
Differential: Melanosis, Melanoma,
Acute Esophageal ... chest pain, Sepsis Diagnosis ... KBrag_MD #Acute #Esophageal ... Necrosis #black #esophagus ... #diagnosis #management
Barrett's Esophagus (BE) Documentation 
1. 1st description as - ESEM (endoscopically suspected esophageal metaplasia), NOT as
Barrett's Esophagus ... endoscopically suspected esophageal ... (histological diagnosis ... BE - distal esophagus ... Documentation #EGD #diagnosis
Secondary Causes of Esophageal Eosinophilia (EoE) - Differential Diagnosis
 • Gastroesophageal reflux disease
 • Eosinophilic gastrointestinal
Secondary Causes of Esophageal ... Eosinophilia (EoE ... - Differential Diagnosis ... Hypereosinophilic syndrome • Esophageal ... #Differential #Diagnosis
Prague Criteria - For Endoscopically Suspected Esophageal Columnar Metaplasia/Barrett's Esophagus
1) Ensure Hiatus Hernia Is Recognised By
Endoscopically Suspected Esophageal ... Metaplasia/Barrett's Esophagus ... Criteria #Barretts #Esophagus ... #diagnosis #endoscopy
Eosinophilic Gastroenteritis: Treatment Options Based on Severity of the Disease
Mild:
 • Trial of PPI
 • Trial
Eosinophilic Gastroenteritis ... • Additional diagnostic ... scan #EoE #Eosinophilic ... Gastroenteritis #Treatment #management
Esophageal Motility Disorders
Obstructive Physiology: EGJ, Distal Esophagus
Distal Contractility: Hyper-contractile, Hypo-contractile
Type I achalasia, Type II achalasia, Type
Esophageal Motility ... Physiology: EGJ, Distal Esophagus ... obstruction, Distal esophageal ... peristalsis, GERD #Esophageal ... gastroenterology #diagnosis
Eosinophilic Esophagitis (EoE) - Topical Corticosteroids
 • Liquid - Budesonide - 1 mg PO BID -
Eosinophilic Esophagitis ... bedtime increases esophageal ... @GIreview #Eosinophilic ... Corticosteroids #management