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Esophagitis

Esophagitis
Micrograph of herpes esophagitis. H&E stain.
Classification and external resources
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.

Contents

  • Symptoms 1
  • Causes 2
    • Infectious 2.1
    • Other 2.2
  • Grading of severity 3
  • References 4

Symptoms

  • Heartburn (pain in chest/abdomen and may radiate to neck/jaw)
  • Nausea
  • Postprandial worsening of symptoms

Symptoms may be relieved by antacids. Esophagitis causes symptoms of abdominal pain 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:

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, as well as 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, an autoimmune disease where the immune system inflames the gastrointestinal tract and a type of IBD, can cause oesophagitis if it attacks the oesophagus.
  • Certain medications, including doxycycline may cause oesophagitis if taken incorrectly.[4]

Grading of severity

The severity of 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

  1. ^ MedlinePlus Encyclopedia Esophagitis
  2. ^ Classen, Meinhard; Tytgat, Guido N. J.; Lightdale, Charles J. (2010). Gastroenterological Endoscopy. Thieme. p. 490.  
  3. ^ Tierney, Lawrence M., Jr; McPhee, Stephen J.; Papadakis, Maxine A. (2007). Current Medical Diagnosis & Treatment 2007 (46 ed.). McGraw-Hill.  
  4. ^ "Oesophogagitis with Doxycycline". 
  5. ^ 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.  
  6. ^ Laparoscopic bariatric surgery, Volume 1. William B. Inabnet, Eric J. DeMaria, Sayeed Ikramuddin. ISBN 0-7817-4874-7.
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