Esophagitis Flashcards
What are the most common features of esophagitis?
- Dysphagia
- Odynophagia
- Retrosternal chest pain
What investigations should be undertaken?
Upper endoscopy w/ biopsy and electrocardiogram to rule out cardiac ischaemia.
In reflux oesophagitis, what are the two systems used to classify the severity of the disease?
- The Los Angeles system (C/D severe)
2. The Savary-Miller grade 3/4 severe erosive esophagitis.
What is the treatment of reflux esophagitis?
For individuals with >2 episodes of reflux or erosive esophagitis: Consider PPIs for 8 weeks (decrease dose if symptoms improve)
If symptoms persists for more than >6 months what drug should you use instead of PPIs?
Histamine receptor antagonists (H2RA)
Severe esophagitis treatment
Repeat upper endoscopy after 8 weeks of treatment.
What medication disrupt the lining of the oesophagus?
- NSAIDs
- Antibiotics
- Potassium Chloride
- Bisphosphonates
What is a complication of medication induced esophagitis?
Upper gastrointestinal bleeding and weight loss.
How medication induced esophagitis is treated?
Stop medication or switch to liquid version, PPIs and restart medication if necessary.
What is an eosinophilic esophagitis?
The esophagus gets inflammed as a reaction to allergies (e.g atopic dermatitis), food, or acid reflux.
What are the endoscopical findings of an eosinophilic esophagitis?
- Mucosal fragility
- Esophageal rings
- High number of eosinophils
What is the treatment of eosinophilic esophagitis?
- prick skin test
- PPIs
- Corticosteroids such as FLUTICAZONE PROPIONATE
What is a feature of CANDIDA esophagitis?
Oral thrush
What is a feature of HSV esophagitis?
Small rounded vesicles
What is the treatment for HSV esophagitis?
- Acyclovir oral (14 to 21 days) or IV if patient cannot swallow
- IV Foscarnet for acyclovir resistant strains
