Ulcerative oesophagitis Flashcards
What are 5 types of causes of oesphagitis?
- Reflux oesophagitis
- Corrosive chemical
- Infections
- Malignancies
- Eosinophilic oesophagitis
What are 4 types of infections which can cause oesophagitis?
- Candida
- Cytomegalovirus
- Herpes simplex virus
- Mycobacterium avium complex
What are 2 types of malignancy which can cause oesophagitis?
- Kaposi’s sarcoma
- Lymphoma
Which patients are particularly susceptible to oesophageal infections causing oesophagitis? 2 groups
- Patients with HIV/AIDS
- Patients taking broad-spectrum antibiotics or cytotoxic drugs - candidiasis
What are 2 types of corrosives that can cause oesophagitis when ingested?
- Household bleach
- Battery acid
–> suicide attempts
What are 3 types of drugs which can cause oesophagitis?
- Potassium supplements
- NSAIDs
- Bisphosphonates
What causes reflux oesophagitis?
gastro-oesophageal reflux disease due to abnormal lower oesophageal sphincter - reduced tone, inappropriate relaxation, hiatus hernia or delayed gastric empty
What are 6 factors that contribute to gastro-oesophageal reflux disease?
- Obesity, dietary factors
- Defective oesopahgeal clearance
- Hiatus hernia
- Abnormal lower oesophageal sphincter - reduced tone/inappropriate relaxation
- Delayed gastric emptying
- Increased intrabadominal pressure
What are 3 symptoms of oesophagitis?
- Heartburn - retrosternal burning pain
- Nausea ± vomitin
- Odynophagia (painful swallowing)
What investigation enables a diagnosis of oesphagitis?
endoscopy - allows direct visualisation and can be used to grade degree of oesophagitis
What are 2 types of scoring systems that can be used to grade the degree of oesophagitis on endoscopy?
- Savary-Miller grading system
- Los Angeles grading system
What procedure may be performed at the same time as endoscopy for oesohpagitis?
biopsy
What are 2 investigations which can be used for diagnosing reflux oesophagitis?
- Oesophageal pH monitoring
- Endoscopy
What is the management of reflux oesophagitis? 2 aspects
- conservative: lifestyle - weight loss, stopping smoking, reducing alcohol intake
- pharmacological; full-dose PPI for one month
What is the commonest cause of oesphagitis?
reflux
In which individuals is eosinophilic oesophagitis more common?
children, increasingly recognised in young adults
more in atopic individuals
What is eosinophilic oesophagitis?
eosinophilic infiltration of the oesophageal mucosa
What are 4 key symptoms of eosinophilic oesophagitis?
- Dysphagia
- Food bolus obstruction
- Chest pain
- Vomiting
What may be seen on endoscopy in eosinophilic oesophagitis?
usually normal but mucosal rings, strictures or narrow-calibre oesophagus can occur
What management may work to treat eosinophilic oesophagitis in children?
elimination diets
What are 2 aspects of the management of eosinophilic oesophagitis?
- 8-12 weeks topical glutocorticoids (e.g. fluticasone or metamethasone) using metered-dose inhaler but swallow rather than inhale
- In adults: PPIs
How long should topical steroids be used to treat eosinophilic oesophagitis?
8-12 weeks
