1.

Dysphagia
 Oropharyngeal dysphagia- difficulty emptying material from the oropharynx into the
esophagus; it results from abnormal function proximal to the esophagus. with neurologic
conditions or muscular disorders that affect skeletal muscles.
Most often, oropharyngeal dysphagia occurs in patients with neurologic conditions or
muscular disorders that affect skeletal muscles.

 Esophageal dysphagia-difficulty passing food down the esophagus. It results from either a
motility disorder or a mechanical obstruction.

Complicationscan cause acute pneumonia; recurrent aspiration may eventually lead to chronic

lung disease, Esophageal dysphagia can lead to weight loss, malnutrition

Tests:

 Upper endoscopy
 Barium swallow

2. Esophageal diverticula
Diverticulum is outpouching of mucosa through the muscular layer of esophagus. Types of diverticula:

 Zenker- (pharyngeal) diverticula are posterior outpouchings of mucosa and submucosa

through the cricopharyngeal muscle
  Midesophageal-  (traction) diverticula are caused by traction resulting from mediastinal
inflammatory lesions or, secondarily, by esophageal motility disorders .
 Epiphrenic diverticula- occur just above the diaphragm and usually accompany a motility
disorder (eg, achalasia , diffuse esophageal spasm).

Diagnosis barium swallow

3. Hiatus herinia
Hiatus hernia is protrusion of stomach through diaphragmatic hiatus. Most patients with a sliding
hiatus hernia are asymptomatic, but chest pain and other reflux symptoms  can occur. There are 2
types of hernias:

 Sliding hernia-(most common): Gastroesophageal junction and a portion of the stomach are
above the diaphragm
 Paraesophageal hernia- Gastroesophageal junction is in the normal location, but a portion of
the stomach is adjacent to the esophagus in the diaphragmatic hiatus

Diagnosis:

 Barium swallow
 Upper endoscopy

4. Mallory Weiss syndrome

Malory Weiss syndrome is mucosal laceration of the distal esophagus and proximal stomach caused by
vomiting, retching or hiccupping. Mallory-Weiss syndrome can occur in any patient who vomits
forcefully.

Diagnosisupper endoscopy. Upper endoscopy can also be therapeutic because a clip can be
placed over the tear to control bleeding

5. Achalasia
Achalasia is a neurogenic esophageal motility disorder characterized by impaired
esophageal peristalsis and a lack of lower esophageal sphincter relaxation during
swallowing. Symptoms are slowly progressive dysphagia, usually to both liquids and
solids, and regurgitation of undigested food

Diagnosis:

 Esophageal manometry
 Barium swallow (shows dilated esophagus with narrow esophageal spinchter)
 Upper endoscopy
 6. Diffuse esophageal spasm
Sometimes, diffuse esophageal spasm is asymptomatic and is found incidentally When
symptomatic, diffuse esophageal spasm typically causes substernal chest pain with dysphagia for
both liquids and solids. Very hot or cold liquids may aggravate the pain. Esophageal spasms can
cause severe pain without dysphagia. This pain is often described as a substernal squeezing pain
and may occur in association with exercise. Such pain may be similar to angina pectoris , and
patients often present to the emergency department concerned they are having a heart attack.

Diagnosis:

 Barium swallow
 Esophageal manometry