Esophagitis

Esophagitis: Description:esophagitisEsophagitis is a general term for any inflammation, irritation, or swelling of the esophagus, the tube that leads from the back of the mouth to the stomach.Alternative Name: Inflammation - esophagus.Esophagus: Portion of the digestive tube that conducts food from the mouth to the stomach. When food is swallowed it passes from the pharynx into the esophagus, initiating rhythmic contractions (peristalsis) of the esophageal wall, which propel the food along toward the stomach. The walls of the esophagus are lined with mucous glands that continue the lubrication of the food as it is conducted to the stomach. The human esophagus is about 10 in. (25 cm) long and 1 in. (2.5 cm) in diameter.Esophagitis is an inflammation of the lining of the esophagus, the tube that carries food from the throat to the stomach. If left untreated, this condition can become very uncomfortable, causing problems with swallowing, ulcers and scarring of the esophagus. In rare instances, a condition known as "Barrett's esophagus" may develop, which is a risk factor for cancer of the esophagus.If untreated, esophagitis may cause severe discomfort, swallowing difficulty to the extent of causing malnutrition or dehydration, and eventual scarring of the esophagus. This scarring may lead to a stricture of the esophagus, and food or medications may not be able to pass through to the stomach.A condition called Barrett's esophagus can develop after years of gastroesophageal reflux. Rarely, Barrett's esophagus may lead to cancer of the esophagus.Symptoms:The infection or irritation may cause the tissues to become inflamed and occasionally form ulcers. Symptoms may include:Difficulty swallowing. Sometimes it also causes:Nausea or vomiting.
  • Fever.
  • Belly pain.
Causes and Risk factors:Gastroesophageal reflux disease, or GERD, is the most common cause of esophagitis. When you have GERD, stomach acid and juices flow backward into your esophagus. This can irritate the esophagus.Other causes include:1. Infection: People who have a weak immune system are more likely to get esophagitis. This includes people with HIV, diabetes, or kidney problems, as well as older adults and people who take steroid medicine. Infections that cause esophagitis include:Candida. This is a yeast infection of the esophagus caused by the same fungus that causes vaginal yeast infections. The infection develops in the esophagus when the body's immune system is weak (such as in people with diabetes or HIV). It is usually very treatable with antifungal drugs.
  • Herpes. Like Candida, this viral infection can develop in the esophagus when the body's immune system is weak. It is treatable with antiviral drugs.
2. Medicines that irritate the esophagus, including:
  • Medicines for osteoporosis, such as alendronate (Fosamax), ibandronate (Boniva), or risedronate (Actonel).
  • Antibiotics, such as tetracycline or clindamycin.
  • Other medicines, such as mycophenolate or quinidine.
  • Vitamin and mineral supplements, such as vitamin C, iron, and potassium pills.
3. Radiation therapy.4. Certain diseases that make it hard to swallow, such as scleroderma.Diagnosis:Once your doctor has performed a thorough physical examination and reviewed your medical history, there are several tests that can be used to diagnose esophagitis. These include:Upper endoscopy: A test in which a long, flexible lighted tube, called an endoscope, is used to look at the esophagus.
  • Biopsy: During this test, a small sample of the esophageal tissue is removed and then sent to a laboratory to be examined under a microscope.
  • Upper GI series (or barium swallow): During this procedure, x-rays are taken of the esophagus after drinking a barium solution. Barium coats the lining of the esophagus and shows up white on an x-ray. This characteristic enables doctors to view certain abnormalities of the esophagus.
Treatment:The treatment you need depends on what is causing the esophagitis. Esophagitis caused by acid reflux or GERD is usually treated with medicines that reduce stomach acid. Reducing the reflux gives the esophagus a chance to heal. Over-the-counter medicines include:Antacids, such as Tums, Maalox, or Mylanta.
  • Stronger acid reducers, such as famotidine (Pepcid), ranitidine (Zantac), or omeprazole (Prilosec OTC).
Treatment for esophagitis depends on its cause. Possible treatments include:Medications that block acid production, like heartburn drugs.
  • Antibiotics, antifungals, or antivirals to treat an infection.
  • Pain medications that can be gargled or swallowed.
  • Corticosteroid medication to reduce inflammation.
  • Intravenous (by vein) nutrition to allow the esophagus to heal and to reduce the likelihood of malnourishment or dehydration.
  • Endoscopy to remove any lodged pill fragments.
  • Surgery to remove the damaged part of the esophagus.
While being treated for esophagitis, there are certain steps you can take to help limit discomfort.Avoid spicy foods such as those with pepper, chili powder, curry, and nutmeg.
  • Avoid hard foods such as nuts, crackers, and raw vegetables.
  • Avoid acidic foods and beverages such as tomatoes, oranges, grapefruits, and their juices. Instead, try imitation fruit drinks with vitamin C.
  • Add more soft foods such as applesauce, cooked cereals, mashed potatoes, custards, puddings, and high protein shakes to your diet.
  • Take small bites and chew food thoroughly.
  • If swallowing becomes increasingly difficult, try tilting your head upward so the food flows to the back of the throat before swallowing.
  • Drink liquids through a straw to make swallowing easier.
  • Avoid alcohol and tobacco.
If esophagitis is caused by an infection, you may need to take antibiotics or other medicines to treat the infection. If swallowing pills is causing the problem, talk to your doctor about your options. He or she may advise you to drink plenty of water and sit up straight when you swallow pills. You might need surgery if you have a tear in your esophagus or if something is blocking your esophagus, such as a tumor.Medicine and medications:Treatment goals include pain relief, decreased acid production, decreased acid reflux, and protection of the esophageal mucosa. Multiple pharmacologic agents are available, including histamine-2 receptor antagonists, proton pump inhibitors, gastroprokinetic agents, and protective agents.Medications Include:Histamine-2 receptor antagonists.
  • Ranitidine hydrochloride (Zantac).
  • Cimetidine (Tagamet).
  • Famotidine (Pepcid, Pepcidine).
  • Gastrointestinal coating agents.
  • Sucralfate (Carafate).
  • Proton pump inhibitors.
  • Omeprazole (Prilosec).
  • Lansoprazole (Prevacid).
  • Esomeprazole magnesium (Nexium).
  • Rabeprazole (Aciphex).
  • Pantoprazole (Protonix).
Note: The following drugs and medications are in some way related to, or used in the treatment. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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