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:
Esophagus or Esophageal ... Spasm Step 1: ... 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,
chest pain, Sepsis Diagnosis ... Klebsiella, pneumoniae) Management ... Necrosis #black #esophagus ... #diagnosis #management
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
Physiology: EGJ, Distal Esophagus ... Distal esophageal spasm ... gastroenterology #diagnosis