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Esophagitis

more about Esophagitis


  • The esophagus is the passageway through the chest that carries food from the mouth to the stomach.  If the esophagus becomes irritated, infected, or inflamed, it creates a condition known as esophagitis.

  • Difficulty swallowing
  • Refusal to drink
  • Nausea/vomiting
  • Pain in chest on swallowing
  • Thrush (white patches) in mouth may be present in candida esophagitis
  • Caustic ingestion
  • Burning chest pain
  • Gagging
  • Difficulty swallowing
  • Drooling
  • Wheezing
  • Whistling sound in neck (stridor)

  • Infection:
    1. Candida (yeast) -- often only in individuals with other diseases such as diabetes, cancer, or HIV
    2. Cytomegalovirus (CMV) -- often only in individuals with other diseases, such as diabetes, cancer, and HIV
    3. Herpes simplex
  • Reflux of gastric acid
  • Medication -- examples include anti-inflammatories, potassium, and antibiotics
  • Caustic Injury (e.g., accidental ingestion of drain cleaners)

  • Endoscopy with biopsy and brushings (done by passing scope via the mouth into the esophagus)
  • Barium esophagography in severe cases shows mucosal irregularities.

  • Candida esophagitis (choice of medications depends on severity):
    1. Nystatin swish and swallow
    2. Fluconazole by mouth
    3. Ketoconazole by mouth
    4. For immunocompromised (e.g., have underlying disease like HIV) and systemic infections -- amphotericin and/or flucytosine
  • Cytomegalovirus esophagitis:
    1. Ganciclovir intravenously
    2. Foscarnet intravenously if ganciclovir fails or is not tolerated
  • Viral esophagitis:
    1. Normal individuals -- often do not need treatment or only analgesics and antacids.
    2. Acyclovir oral or intravenously for herpetic or Varicella-zoster esophagitis
    3. Foscarnet IV if Acyclovir fails or is not tolerated
  • Medication induced: Stop offending medication
  • Caustic esophagitis:
    1. Needs immediate emergency medical treatment.  Its usual cause in children is accidental ingestion.  The peak age of incidence is under 5 years.  The child's airway needs to be protected.  Chest and abdominal X-rays are necessary to rule out perforation.  Endoscopy needs to be performed to assess the degree of Injury within 48 hours.
    2. Prednisone therapy for prevention of stricture formation.

  • Esophageal stricture
  • Esophageal cancer
  • Esophageal ring
  • Esophageal web




more about Esophagitis


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