esophagitis msn mr pritesh patel

1. ESOPHAGITIS
Mr Pritesh patel

2. Esophagitis is inflammation in your
esophagus, the swallowing tube that
runs through the middle of your chest.
It might feel like chest pain, or it might
make swallowing painful or difficult.

3. TYPES OF ESOPHAGITIS
Reflux esophagitis
The most common type of esophagitis occurs when acids and
digestive agents escape your stomach and reflux into your
esophagus, irritating the mucous lining (mucosa). This may
happen if you have frequent acid reflux or if you vomit
frequently. Causes include:
GERD (gastroesophageal reflux disease).
Bile reflux.
Bulimia nervosa.

4. Eosinophilic esophagitis
Eosinophilic esophagitis is a type of immune
hypersensitivity reaction (an overreaction of your
immune system). It happens when your immune
system sends too many white blood cells
(eosinophils) to attack a perceived threat, such as
infection or allergy. The white blood cells
accumulate in your esophagus and cause chronic
inflammation. This is a rare condition that’s more
likely to affect people with multiple allergies.

5. Drug-induced esophagitis happens when medicines
touch the lining of your esophagus for too long. For
your doctor might:
• Change your medication
• Give it to you in liquid form, if possible

6. Infectious esophagitis
Infections in your esophagus are uncommon unless you
have a weaker immune system and frequent and more
severe infections in general. When they do occur,
infections usually spread to your esophagus from
somewhere else. Fungal infections are the most
common type, followed by viral infections. Infections
that may cause esophagitis include:
• HIV/AIDS.
• Primary immunodeficiency disorders (PIDD).
• Immunosuppressants.
• Diabetes.
• Systemic cancers, such as leukemia and lymphoma.
• Chemotherapy.

7.  Esophagitis is caused by an infection or irritation in the esophagus.
An infection can be caused by bacteria, viruses, fungi, or diseases
that weaken the immune system. Infections that cause esophagitis
include:
• GERD, or gastroesophageal reflux disease
• Vomiting
• Surgery
• Medications such as aspirin and other anti-inflammatory drugs
• Taking a large pill with too little water or just before bedtime
• Swallowing a toxic substance
• Hernias
• Radiation treatment for cancer

8.  Esophagitis Symptoms
 Symptoms of esophagitis include:
• Difficult or painful swallowing
• Acid reflux
• Heartburn
• A feeling of something of being stuck in the throat
• Chest pain
• Nausea
• Vomiting
• A sore throat.
• Heartburn.
• Difficulty swallowing.
• Regurgitations.
• Food getting stuck in your throat.
• Indigestion.

9. Get emergency care if you:
• Have pain in your chest that lasts more than a few
minutes.
• Suspect you have food stuck in your esophagus.
• Have a history of heart disease and experience chest
pain.
• Have pain in your mouth or throat when you eat.
• Have shortness of breath or chest pain that happens
shortly after eating.
• Vomit large amounts, often have forceful vomiting, have
trouble breathing after vomiting or have vomit that is
yellow or green, looks like coffee grounds, or contains
blood.

10. DIAGNOSIS
Endoscopy
During this procedure, a long, thin tube equipped with a tiny
camera is guided down your throat and into the esophagus. This
instrument is called an endoscope. Using the endoscope, your
provider can look for any unusual appearance of the esophagus.
Small tissue samples may be taken for testing. This is called a
biopsy. The esophagus may look different depending on the cause
of the inflammation, such as drug-induced or reflux esophagitis.
You'll be lightly sedated during this test.

11. Barium X-ray
For this test, you drink a solution or take a pill containing a
compound called barium. Barium coats the lining of the esophagus
and stomach and makes the organs visible. These images can help
identify narrowing of the esophagus, other structural changes, a
hiatal hernia, tumors or other irregularities that could be causing
symptoms.
Laboratory tests
Small tissue samples removed during an endoscopic exam are sent to the
lab for testing. Depending on the suspected cause of the disorder, tests
may be used to:
Diagnose a bacterial, viral or fungal infection.
Determine the concentration of allergy-related white blood cells, called
eosinophils.
Identify irregular cells that would indicate esophageal cancer or
precancerous changes.

12. TREATMENT
 Acid-blocking medication. Antacids, H2 blockers and proton-pump inhibitors
(PPIs) can help treat acid reflux. There are over-the-counter (OTC) and
prescription-strength options.
 Pantoprazole & domperidone tab
 Lansoprazole
 Omeprazole and sodium bicarbonate
 Anti-inflammatory drugs. For eosinophilic esophagitis, healthcare providers
sometimes recommend swallowing a liquid steroid formula. The formula coats
your esophagus and relieves inflammation without causing the same side
effects that you may get from the pill form.
 Antifungal medication for fungal infections, such as candida.
 Antiviral medication for viral infections, such as herpes.
 Monoclonal antibodies. These are synthetic versions of proteins that
communicate with your immune system to stop inflammation. Dupilumab is a
monoclonal antibody medication that’s been recently approved by the U.S. Food
and Drug Administration to treat eosinophilic esophagitis.

13. • Dietary changes. Identify the foods and drinks that
trigger acid indigestion and reflux or that trigger an
allergic reaction.
• Medication changes. Ask your provider about switching
medications that cause esophagitis, or consider
switching to a liquid form. If you have to take a pill,
it with a full glass of water.
• Evening routine. To reduce acid reflux, eat smaller
meals, especially at dinner time. Make sure dinner is at
least three hours before bedtime to give it a chance to
digest before you lie down.
• Commonsense self-care. Quit smoking and avoid
alcohol to protect your esophagus.

14.  Esophagitis Prevention
 While you have treatment for esophagitis, there are certain steps you can take to
yourself feel better:
• Avoid spicy foods such as those with pepper, chili powder, curry, and nutmeg.
• Stay away from hard foods such as nuts, crackers, and raw vegetables.
• Try not to eat right before bedtime.
• 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 to your diet such as applesauce, cooked cereals, mashed
potatoes, custards, puddings, and protein shakes.
• Try to stay clear of meals with a lot of fatty foods.
• Keep caffeine, chocolate, and mint-flavored foods to a minimum.
• Take small bites and chew food thoroughly.
• Drink liquids through a straw to make swallowing easier.
• Avoid alcohol and tobacco.