Differentials
Esophagitis
SIGNS / SYMPTOMS
None.
INVESTIGATIONS
Upper GI endoscopy with biopsy will show no Barrett esophagus findings on biopsy.
GERD
SIGNS / SYMPTOMS
None.
INVESTIGATIONS
Upper GI endoscopy with biopsy will show no Barrett esophagus findings on biopsy.
Esophageal adenocarcinoma
SIGNS / SYMPTOMS
May have none, or may have constitutional signs such as involuntary weight loss, low energy, and lymphadenopathy.
INVESTIGATIONS
Biopsy reveals adenocarcinoma.
Gastritis
SIGNS / SYMPTOMS
Patient may have a history of chronic or frequent nonsteroidal anti-inflammatory drug (NSAID) use.
Mild epigastric tenderness is common.
INVESTIGATIONS
Upper GI endoscopy commonly shows no mucosal changes in the distal esophagus. Esophagitis may occur in patients with gastritis, due to hypersecretion of gastric acid, in which case treatment with acid-suppressive agents is indicated. A repeat endoscopy may be indicated a few months later to evaluate the esophagitis, and to obtain biopsies to rule out Barrett esophagus.
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