Barrett's esophagus differential diagnosis: Difference between revisions

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Revision as of 14:33, 5 February 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amresh Kumar MD [2]

Overview

Barrett's Oesophagus must be differentiated from Esophagitis, Peptic ulcer disease and Esophageal motor disorders.

Differentiating Barrett's Esophagus from other Diseases

Esophagitis

Pills esophagitis
Eosinophilic esophagitis
Infectious esophagitis^[1]

GERD^[2]
Peptic ulcer disease
Esophageal motor disorders

Disease	Signs and Symptoms								Barium esophagogram	Endoscopy	Other imaging and laboratory findings	Gold Standard
	Onset	Dysphagia			Weight loss	Heartburn	Other findings	Mental status
	Onset	Solids	Liquids	Type	Weight loss	Heartburn	Other findings	Mental status
Barrett's esophagus	Gradual	+	-	Progressive	+/-	+	GERD Symptoms Chest pain Chronic cough Laryngitis Regurgitation Heartburn	Normal	Mid or high esophageal ulcer Mid or high esophageal web-like stricture Reticular mucosal pattern	The esophageal lining appears pink or red and velvety.	No any other test is done to diagnose Barrett's esophagus	Esophageal Biopsy
Eosinophilic esophagitis	Gradual	+		Progressive	+/-	+/-	Chest pain Food impaction Cough	Normal	Multiple rings in the esophagus	Concentric rings of the esophagus- Trachealization of the esophagus	Increased serum IgE levels	Esophageal biopsy
Esophageal carcinoma	Gradual	+	+	Progressive	+	+/-	Lymphadenopathy Cachexia	Normal	Irregular stricture Pre-stricture dilatation Case courtesy of Dr Bruno Di Muzio, Radiopaedia.org, rID: 4232f	Esophageal obstruction Staging of disease	CT and PET scan is an optional test for staging of the disease	Biopsy
Motor disorders (Myasthenia gravis)	Gradual	+	+	Progressive	+/-		Ptosis Diplopia Fatigue	Normal	Stasis in pharynx and pooling in pharyngeal recesses	Velopharyngeal insufficiency Delayed swallowing function	CT may show anterior mediastinal mass (thymoma) Positive tensilon test	Anti–acetylcholine receptor antibody test
GERD	Gradual Sudden onset	+	-	Progressive	+/-	+	Cough Hoarseness	Normal	Free acid reflux Esophagitis with scarring Strictures Barrett's oesophagus	Erythema, erosions and ulceration Barrett's esophagus	Esophageal manometry may show decreased tone of LES	24 hour esophageal pH monitoring

References

↑ Moayyedi P, Talley NJ (2006). "Gastro-oesophageal reflux disease". Lancet. 367 (9528): 2086–100. doi:10.1016/S0140-6736(06)68932-0. PMID 16798392. Unknown parameter |month= ignored (help)
↑ http://www.wrongdiagnosis.com/b/barretts_esophagus/misdiag.htm

Template:WH Template:WS

[pmid16798392-1] Moayyedi P, Talley NJ (2006). "Gastro-oesophageal reflux disease". Lancet. 367 (9528): 2086–100. doi:10.1016/S0140-6736(06)68932-0. PMID 16798392. Unknown parameter |month= ignored (help)

[2] ttp://www.wrongdiagnosis.com/b/barretts_esophagus/misdiag.htm

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[2]

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 * 24 hour [[esophageal]] pH monitoring
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-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
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-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 3
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 4
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 5
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
 |}

Barrett's esophagus differential diagnosis: Difference between revisions

Revision as of 14:33, 5 February 2018

Overview

Differentiating Barrett's Esophagus from other Diseases

References

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