Esophagitis

DONE BY :- HAMAD EMAD THUHAYR

SUPERVISOR BY :- DR. MOHAMMED SADDIQE

BGM SOEPLE 5

Contents

Soepel

Introduction

anatomy

Histology

Sings and Symptomes

Causes

Grading of severity

Complications

Test and diagnosis

Treatment

References

SOEPEL

SUBJECT:

A 31-year-old female from K.S.A. She is married has 3 children. lives and born in Unaizah.

  the last 1 week she has difficult breathing and she can not swallowing with pain.

she has become much worse over 1 week with episodes of difficult breathing and she can not eat .

She has no relevant previous medical history. Up to 1 year ago, her bowels were regular. There is no disturbance of micturition or menstruation.

 In her family history, she thinks one of her sister may have had esophagitis.

She travelled to Dubi from 2 years and makkah from 1 year.

SOEPEL

OBJECTIVE:

taking history, physical examination ( General and abdominal )

EVALUATION (DD):

GERD, peptic strictures and eosophigitis

PLAN:

Barium X-ray, Endoscopy, tissue sample and Laboratory tests.

ELABORATION:

drug therapy or surgery.

LEARNING GOALS:

eosophigitis

Introduction

Esophagitis

is inflammation that damages tissues of the esophagus, the muscular tube that delivers food from your mouth to your stomach.

Esophagitis often causes painful, difficult swallowing and chest pain. Causes of esophagitis include stomach acids backing up into the esophagus, infection, oral medications and allergies.

Treatments for esophagitis depend on the underlying cause and the severity of tissue damage. If left untreated, esophagitis may change the structure and function of the esophagus.

Anatomy

Histology

Signs and symptoms

Abdominal pain.

Adynophagia - pain when swallowing.

Dysphagia - difficulty swallowing.

Food gets stuck in the esophagus.

Lack of appetite.

Nausea, and possibly vomiting.

Cough.

Pain when eating, heartburn.

Mouth sores.

Feeding difficulties, and subsequently possible failure to thrive in young children and babies. At this age, most patients are too young to describe their symptoms.

 causes

GERD - known as reflux esophagitis.

Allergies - they can cause eosinophilic esophagitis, triggered by an allergic reaction.

Some medications - known as drug-induced esophagitis such as antibiotic and Fosamax

Infectious :- People who are immunocompromised.

Fungal

Candida (Esophageal candidiasis)

Viral

Herpes simplex (Herpes esophagitis)

Cytomegalovirus

Grading of severity

Grade A One or more mucosal breaks < 5 mm in maximal length

Grade BOne 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

The severity of esophagitis is commonly classified into four grades according to the Los Angeles Classification:

Complications

Left untreated, esophagitis can lead to changes in the structure and function of the esophagus. Possible complications include:

Narrowing of the esophagus (esophageal stricture)

Rings of abnormal tissue in the lining of the esophagus (esophageal rings)

Barrett's esophagus, a condition in which the cells lining the esophagus are changed — a condition that's a risk factor for esophageal cancer

Test and Diagnosis

Barium X-ray

For this test, you drink a solution containing a compound called barium or take a pill coated with barium. Barium coats the lining of the esophagus and stomach, and it enables the organs to be well outlined in a series of X-ray images. 

Endoscopy

A long, thin tube equipped with a tiny camera (endoscope) is guided down your throat and into the esophagus.

Laboratory tests

Small tissue samples removed during an endoscopic exam .

Allergy tests

some tests may be performed to find out whether the patient is sensitive to one or more allergens. This may involve a skin-prick test or elimination diet.

Treatment

Treatment for esophagitis depends on its cause. Possible treatments include:

•Medications that block acid production such as heartburn drugs.•Antibiotics, anti-fungals, 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 prevent dehydration and malnutrition.•Endoscopy to remove any lodged pill fragments.•Surgery to remove the damaged part of the esophagus.

Lifestyle modifications

Elevate the head of the bed 6 inches  

Stop smoking  

Stop excessive alcohol consumption  

Reduce dietary fat  

Reduce meal size  

Avoid bedtime snacks  

Lose weight (if overweight)  

Avoid:

chocolate,

carminatives (spearmint, peppermint),

coffee (caffeinated and decaffeinated),

tea,

cola beverages,

tomato juice,

citrus fruit juices  

References

Kumar & clark’s- clinical medicine- 8 edition.

http://www.siumed.edu/~dking2/erg/GI005b.htm

http://www.webmd.com/digestive-disorders/esophagitis