Brief, factual descriptions of conditions that may be discussed during a gastroenterology consultation.
Hong Kong gastroenterology and hepatology information from Dr Paul Ng. Consultations in Central and Tsim Sha Tsui are by appointment; assessment and care are individual.
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Oesophagus
Reflux oesophagitis
Reflux oesophagitis is inflammation or injury to the oesophageal lining caused by stomach contents flowing back into the oesophagus. It may be seen during gastroscopy, although reflux symptoms do not always mean that visible inflammation is present. It is a specific possible consequence of reflux and is not identical to GERD: GERD can cause troublesome symptoms without visible oesophagitis, and oesophagitis severity does not always match how strongly symptoms are felt.
Visible oesophageal inflammation on gastroscopy is one form of reflux-related injury, but symptoms and the appearance of the lining do not always move together. GERD is a broader clinical condition and can be present without visible oesophagitis; likewise, an inflamed lining can be found when symptoms are mild. The report should be interpreted with the reason for the examination, medicines and biopsy results if taken. If swallowing becomes painful or difficult, food sticks, or bleeding occurs, seek prompt medical advice.
For discussion in consultation
Assessment considers the endoscopy findings, symptoms, medicines and any warning signs such as painful or difficult swallowing, bleeding, repeated vomiting or unexplained weight loss. The clinician may review other possible causes of oesophageal inflammation and decide whether further testing or follow-up is useful. Bleeding or food becoming stuck requires prompt medical advice.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
Globus pharyngeus is a persistent or intermittent feeling of a lump or something stuck in the throat without necessarily having an actual object there. Typical globus is painless, often occurs between meals and may improve with eating, while food and drinks still pass normally. It is different from food genuinely sticking, difficulty swallowing (dysphagia) or painful swallowing.
Throat muscle tension, heightened sensitivity and gut–brain interaction may contribute. Stress can amplify symptoms, but this does not make them imaginary. Reflux may coexist in some people; a throat sensation alone does not establish acid reflux. Assessment reviews the symptom pattern, medicines, smoking and alcohol use and includes examination of the mouth and neck; ENT assessment with flexible nasolaryngoscopy may be needed. Gastroscopy, reflux monitoring or oesophageal manometry are considered selectively, not automatically for everyone. After appropriate assessment finds no concerning cause, care may include explanation, hydration, reducing repeated throat clearing and dry swallowing, and speech therapy or relaxation techniques when appropriate. Acid-suppressing medicines do not help everyone and should be used only when indicated.
For discussion in consultation
Have persistent or recurrent symptoms assessed. Progressive swallowing difficulty, painful swallowing, unexplained weight loss, persistent hoarseness, one-sided throat pain or a neck lump need prompt medical review rather than being assumed to be globus. Breathing difficulty, food impaction or inability to swallow saliva requires immediate emergency care.
Barrett’s oesophagus is a change in the cells lining the lower oesophagus, usually associated with long-term reflux. It is diagnosed by gastroscopy with tissue biopsies, not by symptoms alone. Barrett’s is not cancer, and most people with it do not develop oesophageal cancer, although a small increase in future risk means that the biopsy findings and extent may guide discussion of monitoring.
The diagnosis is based on the endoscopy appearance together with biopsies confirming the characteristic lining change. The pathology report may describe whether dysplasia is present; uncertain or dysplastic findings may need specialist review. Barrett’s is not cancer, and monitoring decisions are individualized according to the biopsy result, segment length, examination quality, overall health and preferences. New swallowing difficulty, bleeding, persistent vomiting or unexplained weight loss needs assessment rather than waiting for routine surveillance.
For discussion in consultation
The endoscopy and pathology reports are reviewed to confirm the diagnosis, the length of the affected segment and whether dysplasia (precancerous cell changes) is present. Sampling and specialist pathology review may matter when findings are uncertain. Surveillance is not identical for everyone; the likely benefit, examination quality, biopsy results, overall health and preferences help determine an individual plan.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
EoE is a chronic immune-mediated inflammatory disease of the oesophagus in which eosinophils, a type of white blood cell, accumulate in the lining. It can cause difficulty swallowing, food sticking or impaction, and sometimes reflux-like symptoms; children may have feeding or growth problems. Symptoms can lead to gradual adaptations such as eating slowly or avoiding certain textures.
EoE can be present even when the oesophagus looks unremarkable during endoscopy, making biopsies from multiple levels important when it is suspected. The number and distribution of eosinophils are interpreted with symptoms and other possible causes; narrowing can develop over time, and follow-up may use both symptoms and tissue findings.
For discussion in consultation
Diagnosis requires symptoms of oesophageal dysfunction, biopsies showing an increased eosinophil count and consideration of other causes. Endoscopy may appear normal, so tissue samples from more than one oesophageal level are important. Assessment may also consider narrowing or rings and how symptoms and biopsy findings change over time; symptoms alone cannot confirm EoE.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
Oesophageal dysmotility refers to abnormal movement or coordination of the oesophagus during swallowing. It is a broad description rather than one diagnosis and may be associated with difficulty swallowing, chest discomfort or regurgitation. Similar symptoms can also arise from narrowing, inflammation, reflux or problems outside the oesophagus.
High-resolution manometry records pressure patterns during swallowing and is used to classify oesophageal motor function; it does not directly show mucosal inflammation or exclude a structural narrowing. Endoscopy or imaging may be needed first or alongside it, and borderline patterns are interpreted with symptoms and the conditions under which the test was performed.
For discussion in consultation
Evaluation usually begins by considering structural or mucosal causes, often with endoscopy or imaging as appropriate. High-resolution manometry measures pressure and coordination during swallows and can classify several movement patterns, but results must fit the symptoms and other findings. Further tests may be considered when the first results do not explain the problem or when a specific motor disorder is suspected.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
Achalasia is an uncommon oesophageal motor disorder in which the lower oesophageal sphincter does not relax normally and the oesophagus loses effective forward contractions. It can cause progressive difficulty swallowing both solids and liquids, regurgitation, chest discomfort and sometimes weight loss. Similar symptoms can be caused by other disorders, so symptoms alone do not diagnose achalasia.
Manometry is the principal test for identifying the impaired sphincter relaxation and absent normal peristalsis characteristic of achalasia. Endoscopy helps exclude mechanical obstruction or another cause, while timed barium imaging can show oesophageal emptying; these tests provide complementary information rather than interchangeable answers.
For discussion in consultation
Assessment commonly combines upper endoscopy to exclude a blockage or other disease, high-resolution manometry to identify the characteristic motor pattern, and a timed barium oesophagram to assess emptying. Test findings are interpreted together, and additional imaging or biopsies may be needed in selected cases. The diagnosis and type of achalasia guide discussion of the available treatment approaches.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
These summaries are for general information only. They cannot establish a diagnosis or determine whether you need tests, surveillance or treatment. Your own results, risks and options must be reviewed in an actual consultation with a qualified clinician. Do not start, stop or change treatment based on this page.
References are provided for background reading; they do not replace a consultation.
Questions about a finding on your scan, blood test or endoscopy report? Discuss the full report and your history in a consultation.
About this information
This is general educational information, not a diagnosis, a personalised recommendation or consent for a procedure. Whether to investigate or treat, the alternatives (including no procedure), benefits and risks require individual clinical assessment and discussion.