Esophagitis
| Esophagitis | |
|---|---|
 | |
| Micrograph of herpes esophagitis. H&E stain. | |
| Classification and external resources | |
| Specialty | gastroenterology |
| ICD-10 | K20 |
| ICD-9-CM | 530.10 |
| DiseasesDB | 9182 |
| MedlinePlus | 001153 |
| MeSH | D004941 |
Esophagitis (or oesophagitis) is inflammation of the esophagus. It may be acute or chronic. Acute esophagitis can be catarrhal or phlegmonous, whereas chronic esophagitis may be hypertrophic or atrophic.
Symptoms
- Heartburn (pain in chest - retrosternal)
- Nausea
- Postprandial worsening of symptoms
Symptoms may be relieved by antacids. Esophagitis causes symptoms of abdominal pain and vomiting. If not treated, it causes discomfort and scarring of the esophagus. This makes swallowing food more difficult.[1]
Causes
Infectious
Forms of infectious esophagitis are typically seen in immunocompromised people. Types include:
- Fungal
- Viral
Endoscopy can be used to distinguish among these conditions.[2]
Other
- The most common cause is gastroesophageal reflux disease (GERD, or GORD in Standard English). If caused by GERD, the disease is also called reflux esophagitis.
- Chemical injury by alkaline or acid solutions may also cause esophagitis, and is usually seen in children, or in adults who attempt suicide by ingestion of caustic substances.[3]
- Physical injury resulting from radiation therapy or by nasogastric tubes may also be responsible.
- Pill esophagitis
- Hyperacidity
- Alcohol abuse
- Eosinophilic esophagitis is a poorly understood form of esophagitis, which is thought to be related to food allergies.
- Crohn's disease – a type of IBD which is also an autoimmune disease where the immune system inflames the gastrointestinal tract – can cause esophagitis if it attacks the esophagus.
- Certain medications, including doxycycline may cause esophagitis if taken incorrectly.[4]
Grading of severity
The severity of reflux esophagitis is commonly classified into four grades according to the Los Angeles Classification:[5][6]
| Grade A | One or more mucosal breaks < 5 mm in maximal length |
| Grade B | One or more mucosal breaks > 5mm, but without continuity across mucosal folds |
| Grade C | Mucosal breaks continuous between > 2 mucosal folds, but involving less than 75% of the esophageal circumference |
| Grade D | Mucosal breaks involving more than 75% of esophageal circumference |
References
- ↑ MedlinePlus Encyclopedia Esophagitis
- ↑ Classen, Meinhard; Tytgat, Guido N. J.; Lightdale, Charles J. (2010). Gastroenterological Endoscopy. Thieme. p. 490. ISBN 978-3-13-125852-6.
- ↑ Tierney, Lawrence M., Jr; McPhee, Stephen J.; Papadakis, Maxine A. (2007). Current Medical Diagnosis & Treatment 2007 (46 ed.). McGraw-Hill. ISBN 0-07-147247-9.
- ↑ "Oesophogagitis with Doxycycline".
- ↑ Farivar M. "Los Angeles Classification of Esophagitis". webgerd.com. In turn citing: Lundell LR, Dent J, Bennett JR, et al. (August 1999). "Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification". Gut. 45 (2): 172–80. doi:10.1136/gut.45.2.172. PMC 1727604
. PMID 10403727. - ↑ Laparoscopic bariatric surgery, Volume 1. William B. Inabnet, Eric J. DeMaria, Sayeed Ikramuddin. ISBN 0-7817-4874-7.
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