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Esophagitis – Diagnosis and Treatment

Ertan BEYATLI
Ertan BEYATLI - Genel Cerrahi Uzmanı

The inflammation of the Esophagus is called oesophagitis . As in every medical word, this disease is called esophagitis whis is yhe combination of the name of the Latin esophagus (esophagus) and – itis . Esophagitis can be acute (sudden) or chronic (chronic).

What are the causes of esophagitis?

There are many reasons for oesophagitis, but the most common cause in society is of course the type of esophagitis associated with reflux of the stomach acid and is commonly referred to as reflux oesophagitis . This is due to the inadequate (open, loose or paralyzed) lid between the food conduit and the stomach ( Gastro-esophageal reflux, LES Slack, LOS Insufficiency ).

Other reasons are:

Infection: this is usually seen in immunocompromised patients, eg fungal (candidiasis → esophageal candidiasis) and viral (Herpes simplex → Herpes esophagitis and cytomegalovirus) infections.
Chemical trauma: burning substances can be, for example, acid or alkali. This is usually seen in children, in mental retardation patients and in suicide attempts.
Mechanical trauma: eg radiotherapy, nasogastric catheter application, endoscopy, etc.
drug :(eg doxycycline), alcohol and some foods with allergies (eosinophilic esophagitis)
Crohn’s disease

How to understand Esophagitis?

The most common findings in the esophagitis cases are:

  1. Stomach pain
  2. Pain: a pain that can spread from the breast to the chest, neck and jaw.
  3. Nausea (and rarely vomiting)
  4. Complaints increase after meals
  5. In the presence of these complaints, the upper gastrointestinal endoscopy should first be performed for diagnosis ( esophagoscopy ).

Los Angeles Esophagitis classification

The intensity of inflammation seen on the endoscope is according to Los Angeles (LA) classification:

Grade A – one or more short mucus loss of Grade B – > 5 mm long one or more loss of mucosa (no connection between mucous membrane folds)
Grade C – loss of mucosa extending between folds of the mucosa ( Grade D – loss of mucosa over 75% of the esophagus periphery.

How Is Esophagitis Treated?

Treatment options for oesophagitis are based on the causes. For example, in case of infection, correct antibiotics are started. Various drugs can be given to reduce acidity of the stomach in acid reflux esophagitis.

The most important aspect of treatment is early diagnosis because in untreated cases serious damage to the lower esophageal region occurs over time. Depending on this injury, mucosal changes (dysplasia, metaplasia , Barrett’s esophagus) can sometimes be seen , sometimes stenoses and sometimes covering the food pipe. In advanced and untreated cases, there is a possibility of development of food borne cancers (Esophagus). Various anti-reflux operations can be performed in surgical treatment.

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This post first appeared on Op.Dr.Ertan BEYATLI, please read the originial post: here

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Esophagitis – Diagnosis and Treatment

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