Esophagitis

Is a chronic relapsing disease, 50-80% of patients will have a recurrence within 6 to 12 months after discontinuation of therapy.

Accounts for 10% of upper G.I. bleeds.

Severe gastroesophageal reflux and alcohol abuse are the two most common risk factors for erosive esophagitis complicated by bleeding.

Other causes of esophagitis associated with bleeding include pill esophagitis and infectious esophagitis.

Rarely, ischemia may lead to esophageal necrosis.

Associated with oral bisphosphonates, usually when not taken appropriately.

Any inflammation or irritation of the esophagus.

Common causes include acid reflux, side effects of certain medications, and bacterial or viral infections.

Associated with a variety of symptoms that include:

trouble swallowing

sore throat

heartburn

When untreated can lead to ulcers, scarring, and severe narrowing of the esophagus.

Eosinophilic esophagitis is caused by too many eosinophils in the esophagus.

it is an over response to an allergen.

Common triggers include:

milk

soy

eggs

wheat

peanuts

tree nuts

shellfish

Inhaled allergens, such as pollen, can also contribute to this form of esophagitis.

Reflux esophagitis is usually result of gastroesophageal reflux disease (GERD).

Drug-induced esophagitis can occur when certain medications are taken without enough water, allowing medications to linger in the esophagus too long.

Such medications include:

pain relievers

antibiotics

potassium chloride

bisphosphonates

Infectious esophagitis is rare entity can due to bacteria, viruses, fungi, or parasites.

Infectious esophagitis is common in people with HIV or AIDS, cancer, and diabetes.

Symptoms of esophagitis:

difficulty swallowing

pain on swallowing

sore throat

hoarse voice

heartburn

acid reflux

chest pain

nausea

vomiting

epigastric abdominal pain

decrease in appetite

cough

Very young children may have difficulty feeding.

Risk factors for esophagitis:

weakened immune system due to HIV or AIDS

diabetes

leukemia/lymphoma

hiatal hernia

chemotherapy

radiation therapy of the chest

surgery in the chest area

medications

aspirin and anti-inflammatory medications

chronic vomiting

obesity

alcohol and cigarette use

a family history of allergies or esophagitis

Your chance of developing an infection of the esophagus is low if you have a healthy immune system.

Complications of esophagiitis include:

Barrett’s esophagus

stricture, or narrowing, ulcers of the esophagus.

Evaluation includes:

endoscopy with biopsies

upper GI series

allergy testing

Management includes:

antiviral medications

antifungal medications

antacids

pain relievers

oral steroids

proton pump inhibitors

Elimination allergic trigger foods

avoiding spicy, acidic foods and drinks, and raw or hard foods.

avoiding tobacco and alcohol.

Esophageal dilation may be required

Refrain from lying down for 30 minutes after taking medications or food.