ABIM GI key terms

Replacement of the normal squamous lining of the distal esophagus by intestinal-type columnar mucosa with goblet cells, developing as a complication of chronic gastroesophageal reflux and carrying an increased risk of esophageal adenocarcinoma.

Condition in which reflux of gastric contents into the esophagus produces troublesome symptoms or mucosal injury; diagnosed by typical symptoms, response to acid suppression, or ambulatory pH monitoring when presentation is atypical.

Endoscopically visible breaks in the esophageal mucosa caused by acid reflux, graded by severity (Los Angeles classification); its presence confirms reflux disease and predicts risk of stricture and recurrence.

Primary motility disorder with failure of lower esophageal sphincter relaxation and absent esophageal peristalsis, presenting with progressive dysphagia to solids and liquids, regurgitation, and weight loss; diagnosed by manometry.

Catheter-based study measuring pressure and coordination along the esophagus with closely spaced sensors, using the Chicago Classification to define motility disorders such as achalasia, absent contractility, and esophagogastric junction outflow obstruction.

Secondary cause of achalasia-like manometric findings, usually from malignant infiltration at the esophagogastric junction (for example gastric or distal esophageal cancer), suggested by short symptom duration, older age, and marked weight loss.

Manometric pattern of impaired relaxation of the esophagogastric junction with preserved peristalsis, which may reflect mechanical obstruction, medication effect, or an early achalasia variant and requires clinical correlation and endoscopic evaluation.

Fibrotic narrowing of the distal esophagus from chronic acid injury, causing progressive solid-food dysphagia; treated with endoscopic dilation plus acid suppression, with biopsy to exclude malignancy when features are atypical.

Immune-mediated, antigen-driven disease producing esophageal eosinophilia, dysphagia, and food impaction, often with rings or furrows; treated with proton pump inhibitors, swallowed topical steroids, or dietary elimination.

Chronic gastric bacterial infection causing antral-predominant gastritis, peptic ulcer disease, and distal gastric cancer or mucosa-associated lymphoid tissue lymphoma; diagnosed by urea breath test, stool antigen, or biopsy and treated with guideline-based eradication regimens.

Mucosal defect extending through the muscularis mucosae of the stomach or duodenum, most often caused by Helicobacter pylori or nonsteroidal anti-inflammatory drugs and complicated by bleeding or perforation.

Malignant tumor of gastric epithelium, classified as intestinal or diffuse type; risk factors include Helicobacter pylori, atrophic gastritis, smoking, and hereditary syndromes, and stage determines endoscopic resection versus surgery and chemotherapy.

Low-grade B-cell lymphoma of the stomach arising in the setting of chronic Helicobacter pylori gastritis; early localized disease often regresses with eradication therapy alone, with chemotherapy or radiation reserved for nonresponders.

Immune-mediated enteropathy triggered by dietary gluten, causing villous atrophy and malabsorption; diagnosed by positive tissue transglutaminase IgA with confirmatory duodenal biopsy while on a gluten-containing diet.

Histologic flattening and shortening of small-intestinal villi with crypt hyperplasia and increased intraepithelial lymphocytes, the hallmark duodenal lesion of celiac disease and other enteropathies.

Serologic test used to screen for celiac disease; high titers are strongly predictive, but IgA deficiency causes false negatives, so total IgA should be measured concurrently.

Intensely pruritic vesicular rash on extensor surfaces caused by granular IgA deposition in the skin, representing the cutaneous manifestation of gluten-sensitive enteropathy and responding to a gluten-free diet.

Excess bacteria in the small bowel causing bloating, diarrhea, and malabsorption, often from motility disorders, strictures, or surgery; diagnosed by breath testing or small-bowel aspirate culture and treated with antibiotics.

Malabsorption resulting from extensive intestinal resection leaving insufficient absorptive surface; management includes parenteral nutrition, antidiarrheal and antisecretory drugs, and intestinal adaptation or lengthening procedures.

Impaired absorption of macronutrients, micronutrients, or both, producing weight loss, steatorrhea, and specific deficiencies depending on the site and mechanism of the defect.

Laboratory measurement of fat excreted in stool over a collection period, used to confirm steatorrhea when malabsorption is suspected; elevated values indicate fat maldigestion or fat malabsorption.

Inadequate delivery of pancreatic digestive enzymes to the duodenum from chronic pancreatitis, cystic fibrosis, or obstruction, causing steatorrhea and weight loss; treated with pancreatic enzyme replacement taken with meals.

Pancreas-specific enzyme measured in stool that degrades little during transit; low values indicate exocrine pancreatic insufficiency and are useful when pancreatic function is in question.

Progressive fibroinflammatory disease of the pancreas causing pain, exocrine and endocrine insufficiency, and calcifications; most commonly from alcohol use but also genetic, obstructive, and autoimmune causes.

Encapsulated fluid collection rich in pancreatic enzymes that develops after pancreatitis, typically maturing over several weeks; symptomatic or enlarging cysts may require endoscopic or surgical drainage.

Sudden pancreatic inflammation diagnosed when at least two of characteristic pain, lipase elevation above three times normal, and imaging findings are present; management centers on fluids, analgesia, and early enteral nutrition.

Chronic cholestatic liver disease with inflammation and fibrosis of intrahepatic and extrahepatic bile ducts, strongly associated with ulcerative colitis and carrying risk of cholangiocarcinoma and colorectal cancer.

Malignancy of bile duct epithelium, often presenting with painless jaundice and biliary obstruction; risk is increased by primary sclerosing cholangitis and other chronic biliary diseases.

Endoscopic procedure combining duodenoscopy with fluoroscopic imaging and instrumentation of the bile and pancreatic ducts, used to remove stones, relieve obstruction, and obtain biliary tissue.

Noninvasive magnetic resonance technique producing images of the biliary and pancreatic ducts, useful for detecting stones, strictures, and ductal dilation without the risks of invasive cholangiography.

Chronic immune-mediated intestinal inflammation encompassing Crohn disease and ulcerative colitis, distinguished by distribution, depth of involvement, and histology; treatment escalates from aminosalicylates to biologics and surgery.

Transmural, segmental inflammatory bowel disease that can affect any part of the gastrointestinal tract, often with skip lesions, fistulas, and perianal involvement, and frequently requiring surgery without cure.

Inflammatory bowel disease limited to the colon, beginning in the rectum and extending proximally in a continuous pattern, with bloody diarrhea and an increased risk of colorectal cancer.

Biologic drug class that neutralizes TNF-alpha to induce and maintain remission in inflammatory bowel disease; requires screening for latent tuberculosis and hepatitis B before initiation.

Functional bowel disorder defined by recurrent abdominal pain related to defecation or stool changes, without structural disease, diagnosed by symptom criteria and limited targeted testing rather than exhaustive workup.

Consensus symptom-based diagnostic standards for functional gastrointestinal disorders, including irritable bowel syndrome, used to classify patients and support diagnosis without extensive structural investigation.

Testing of average-risk adults to detect colorectal cancer or its precursors before symptoms arise, using stool-based tests or direct visualization such as colonoscopy, with intervals determined by the chosen modality.

Premalignant colorectal lesion arising from dysplastic epithelium; size, number, histology, and completeness of removal determine surveillance intervals after colonoscopy.

Autosomal dominant hereditary cancer syndrome from mismatch repair gene defects, causing early-onset colorectal and endometrial cancer; identified by tumor testing and confirmed with germline analysis, with intensive surveillance for carriers.

Autosomal dominant syndrome from CDH1 mutations causing early-onset diffuse gastric cancer and lobular breast cancer; prophylactic gastrectomy is offered after confirmed pathogenic variant and counseling.

Advanced endoscopic technique that removes superficial gastrointestinal neoplasms en bloc by dissecting the submucosal plane, allowing precise pathologic staging and organ preservation in selected lesions.

Endoscopic removal of superficial mucosal lesions by lifting the tissue and resecting it, sometimes in pieces; used for large polyps and early neoplasia when en bloc dissection is not required.

Upper endoscopic examination of the esophagus, stomach, and duodenum used for diagnosis, biopsy, and therapy; requires attention to sedation, anticoagulation, and procedural indications.

Microscopically confirmed neoplastic change of epithelium that stops short of invasive cancer, graded as low or high grade; in Barrett esophagus it guides surveillance intervals and ablative or resective therapy.

Malignancy arising from Barrett mucosa in the distal esophagus, linked to chronic reflux and obesity; treated with endoscopic resection for superficial disease and esophagectomy or chemoradiation for advanced disease.

Sensation of impaired passage of food through the mouth, pharynx, or esophagus; solids alone suggest mechanical obstruction while solids and liquids together suggest a motility disorder.

Drug class that irreversibly blocks the gastric proton pump to suppress acid secretion, used for reflux disease, peptic ulcer, and eradication regimens; best taken before meals.

Small-intestinal mucosal injury, including erosions, ulcers, and strictures, caused by nonsteroidal anti-inflammatory drugs and often missed because standard upper endoscopy does not reach the affected bowel.

Most common primary immunodeficiency, marked by low serum IgA; it causes falsely negative celiac serology and is associated with giardiasis and other gastrointestinal infections.

Small-intestinal protozoal infection from contaminated water causing diarrhea, bloating, and malabsorption; diagnosed by stool antigen or microscopy and treated with tinidazole or metronidazole.