Ch. 324 - Non-GERD Esophagitis Flashcards
Eosinophilic esophagitis is a chronic esophageal disorder characterized by infiltration of the esophageal epithelium by eosinophils, typically in a density exceeding ___
15/HPF
Common presentation of EoE in infants
1) Vomiting 2) Feeding problems 3) Poor weight gain
Common presentation of EoE in older children and adolescents
1) Solid food dysphagia 2) Occasional food impactions or strictures 3) Chest or epigastric pain
EoE: Males vs females
Males
EoE: Mean age at diagnosis
7 (range: 1-17)
EoE: Duration of symptoms
3 years
T/F: Many patients with EoE have other atopic diseases (or a positive FH) and associated food allergies
T
T/F Patients with EoE may favorably respond to PPI therapy
T, PPI may have an antieosinophil effect
T/F EoE evaluation should include a thorough search for food and environmental allergies via skin prick and patch tests
T
Treatment for EoE
Dietary restrictions, successful remission in 70-98% of patients
Used successfully for non responders to dietary modification and for nonallergic (primary) EoE, with histologic and symptomatic remission rates reaching 90%
Topical and systemic corticosteroids
T/F EoE has a potential for stricture formation
T
Organisms that cause infective esophagitis
Candida, Torulopsis glabrata, HSV, CMV, HIV, VZV, diphtheria, Tb
Leading cause of infective esophagitis in IMMUNOCOMPETENT AND IMMUNOCOMPROMISED CHILDREN
Candida
Causative agent of infective esophagitis that presents with concurrent oropharyngeal infection in the majority of immunocompromised patients
Candida
Diagnosis of infectious esophagitis is made by
Endoscopy
Agent of infective esophagitis: White plaques
Candida
Agent of infective esophagitis: Multiple superficial ulcers
HSV
Agent of infective esophagitis: Single deep ulcer
CMV
Treatment for infective esophagitis aside from antibiotic
Analgesic and antacid
Medications implicated in “pill” esophagitis
1) Tetracycline, 2) KCl, 3) FeSO4, 4) NSAIDs, 5) Alendronate
T/F Most often, the offending agent in “pill” esophagitis is a tablet ingested at bedtime with inadequate water
T
Treatment of “pill” esophagitis
Supportive, lacking evidence for use of antacids, topical anesthetics, and bland or liquid diets
