GASTROENTEROLOGY ARTICLE OF THE WEEK
September 15, 2005
Arora AS. Management strategies for dysphagia with a normal-appearing esophagus. Clin Gastroenterol Hepatol 2005;3:299-302
1. Features of eosinophilic esophagitis include
a. More common in older (age >60) individuals
b. Solid and liquid dysphagia which is progressive
c. Repeated episodes of food impactions over the years
d. Esophageal rings noted during endoscopy
e. Deep mucosal tears developing during endoscopy, usually leading to perforation
True or False
2. Dysphagia to solids and liquids at the onset of symptoms suggest the presence of esophageal dysmotility disorder.
3. Barium swallow is more sensitive than upper endoscopy in detecting subtle esophageal narrowing caused by rings
4. When obtaining biopsies from a normal esophagus in a patient with dysphagia, mid and distal esophageal biopsies should be obtained.
5. The presence of any amount of eosinophils in esophageal biopsies suggest eosinophilic esophagitis
6. Empiric dilation using 18mm dilators may help patients with solid food dysphagia alone, but rarely those with solid and liquid dysphagia
7. The treatment of eosinophilic esophagitis requires high dose systemic steroids