Many of the pharmacologic agents widely used in medical therapy adversely affect the upper gastrointestinal (GI) tract ( Fig. 20.1 ). Therefore every patient with symptoms referable to the esophagus, stomach, or duodenum should be questioned carefully regarding the recent…
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Anatomy of the Stomach: Normal Variations and Relations The stomach is a J -shaped reservoir of the digestive tract in which ingested food is soaked in gastric juice containing enzymes and hydrochloric acid and then is released spasmodically into the…
Benign Lesions of the Esophagus Benign tumors of the esophagus are rare, accounting for less than 10% of all esophageal tumors and occurring with a prevalence of 0.5%. However, autopsy studies indicate that benign lesions occur in 8% of the…
Esophageal Motility Disorders The connection between unexplained chest pain and esophageal spasm was first discovered by William Osler in 1892. Since then, multiple esophageal motility disorders have been encountered in clinical practice, with a wide range of symptoms, manometric findings,…
Hiatal hernias develop in 10% to 50% of the population with an average age of 48 for patients with a sliding hernia and 65 to 75 for a paraesophageal hernia. There are four types of hiatal hernias. Type 1, accounting…
Gastroesophageal Reflux Disease Gastroesophageal reflux is a normal occurrence involving the movement of gastric contents through the lower esophageal sphincter (LES) into the esophagus. Physiologic reflux is usually harmless until the process causes symptoms and physical changes in the esophagus;…