Oesophagitis

Question 1

What is Oesophagitis?

Answer 1

• Inflammation/irritation of oesophagus
• Tends to be due to reflux of stomach acid into oesophagus = damage and inflammation to lining

Question 2

Aetiology

Answer 2

• Primary condition cause: Gastroesophageal reflux disease (GORD)
• Lower oesophageal sphincter weakens/relaxes
• So stomach acid flow back into oesophagus = irritation and inflammation
• Infections caused by herpes simplex virus/certain bacteria.
• Use of NSAIDs, bisphosphates, certain antibiotics cause condition to develop

Question 3

Pathophysiology

Answer 3

• Lining of oesophagus exposed to acidic gastric content = issues
• Stomach acid gets in contact with oesophageal mucosa = damage to tissue = inflammation and formation of ulcers
• Happens over time again and again = chronic inflammation and scarring development in oesophagus

Question 4

Risk Factors

Answer 4

• Obesity, smoking, excessive alcohol consumption
• Hitatal hernia = condition where part of stomach protrudes into chest through diaphragm

Question 5

Signs/symptoms

Answer 5

• Heartburn, chest pain, difficulty swallowing (dysphagia)
• Regurgitation of food/sour liquid

Question 6

Diagnosis

Answer 6

• Endoscopy :
  o Insert flexible tube with camera into oesophagus
  o See oesophageal lining/look into signs of inflammation/ulceration
• Biopsy samples
• ECG.CXR: out rule other causes

Question 7

Management

Answer 7

• Lifestyle changes: loose weight, avoid trigger foods, elevate head of bed, avoid smoking, reduce alcohol intake
• Meds: proton pump inhibitor (PPIs) = omeprazole/H2 receptor antagonists (ranitidine) = reduce stomach acid acid
• Surgery: fundoplication (severe cases/complications)