Presentation
Gastritis, esophagitis, and peptic ulcer disease (PUD) present commonly with epigastric pain or dyspepsia. [pennstate.pure.elsevier.com]
[…] in 52% of adults (Am J Surg Pathol 1984;8:899) - correlates best with endoscopic findings Difficult to identify with Bouin or Hollande fixative Occasional eosinophils are also present in normal lamina propria and in non-GERD esophagitis Rarely large [pathologyoutlines.com]
Challenges for Thoracic Surgery 1442 Investigation and Management of Nodules Less than One Centimeter in Size 1451 THE DIAPHRAGM 1471 Present Concepts in the Molecular Biology of Lung Cancer 1481 Clinical Presentation of Lung Cancer 1508 Radiologic Evaluation [books.google.de]
The unpleasant postoperative sequela which we have termed the "gas-bloat syndrome" was noted in 1971 to be present in the early postoperative period in approximately one-half the patients. [ncbi.nlm.nih.gov]
Treatment and prognosis Treatment depends on the clinical presentation. [radiopaedia.org]
Entire Body System
- Candidiasis
16][14][15] Pathology The histopathological findings vary depending on the severity of mucosal damage: [4] References:[4][3] Differential diagnoses Other forms of esophagitis Infectious esophagitis: generally in immunocompromised patients Esophageal candidiasis [amboss.com]
Infection (especially in the immunocompromised): cytomegalovirus, herpes, candidiasis. Peptic ulcer. Gastrointestinal (GI) cancers. Non-ulcer dyspepsia. Oesophageal spasm. [patient.info]
Types include: Fungal Candida (Esophageal candidiasis) Viral Herpes simplex (Herpes esophagitis) Cytomegalovirus Drug-induced esophagitis Damage to the esophagus due to medications. [en.wikipedia.org]
Unique Manifestations of Esophagitis by Causative Agent Causative Agent Unique manifestation Candida albicans Patients usually also have acute pseudomembranous candidiasis Herpes simplex virus (HSV) Abrupt onset of symptoms Earliest esophageal lesions [atsu.edu]
Candidiasis. 2006 Red Book: Report of the Committee on Infectious Diseases. American Academy of Pediatrics; 2006. 242-6. Committee on Infectious Diseases. [emedicine.medscape.com]
Respiratoric
- Cough
A reduced cough threshold was found in the majority of our patients even if the actual prevalence of cough was lower. This finding indicates that cough is facilitated in most patients with GOR. [gut.bmj.com]
In 6 to 10% of patients with chronic cough, GERD is the underlying cause. There may be repeated burping in some individuals. Some patients experience water brash or excessive salivation. [news-medical.net]
Symptoms of Reflux Esophagitis Difficulty swallowing (dysphagia) Painful swallowing (odynophagia) Chest pain Swallowed food becoming stuck in the esophagus Nausea Vomiting Abdominal pain Cough Decreased appetite Factors that can increase the risk for [universityendoscopy.com]
• Dysphagia (Difficulty swallowing) • Dry cough, hoarseness of voice • Occasionally, nausea • Regurgitation of food or sour liquid (acid reflux) • Common symptoms in children include vomiting and respiratory problems Investigations for GERD (Gastro-Esophageal-reflux [drthindhomeopathy.com]
- Hoarseness
Chronic hoarseness secondary to gastroesophageal reflux disease: Documentation with 24-h ambulatory pH monitoring. Am J Gastroenterol 1989;84(12):1503-1507. 17. Katz PO. [hon.ch]
• Dysphagia (Difficulty swallowing) • Dry cough, hoarseness of voice • Occasionally, nausea • Regurgitation of food or sour liquid (acid reflux) • Common symptoms in children include vomiting and respiratory problems Investigations for GERD (Gastro-Esophageal-reflux [drthindhomeopathy.com]
Also call if you have: Bleeding Choking (coughing, shortness of breath) Feeling filled up quickly when eating Frequent vomiting Hoarseness Loss of appetite Trouble swallowing (dysphagia) or pain with swallowing (odynophagia) Weight loss Prevention Following [stlukes-stl.com]
Symptoms may include: Cough Difficulty swallowing Painful swallowing Heartburn (acid reflux) Hoarseness Sore throat Treatment depends on the cause. [medlineplus.gov]
This leads to laryngitis and manifests as a hoarse and raspy voice. If the acid seeps into the airways, it may lead to worsening of symptoms of asthma and cause wheezing. This occurs due to irritation of the linings of the airways. [news-medical.net]
- Non-Cardiac Chest Pain
Cardiac Chest Pain (NCCP) Terminated NCT02825342 Phase 4 Citalopram 43 The Effect of Dexilant Treatment on Esophageal Hypersensitivity in GERD Related Non Cardiac Chest Pain Patients Withdrawn NCT01637571 Phase 4 Dexilant;Dexilant Placebo 44 A Prospective [malacards.org]
Non-cardiac chest pain caused by GORD has been found in up to 50% of patients with chest pain and normal coronary angiography. [patient.info]
Gastrointestinal
- Dysphagia
Typical symptoms include pyrosis, dysphagia and regurgitation. [symptoma.com]
Dysphagia, requiring repeat dilation, occurred in two patients after operation. Transthoracic fundoplication with intraoperative stricture dilation is a reasonable alternative in treating complicated esophagitis. [ncbi.nlm.nih.gov]
Like odynophagia, dysphagia is linked to a variety of causes. The precise treatment depends on the underlying health problem. Dysphagia can be so severe that you may not be able to swallow at all. [healthline.com]
Intermittent dysphagia, separated by long periods of no symptoms, is most probably suggestive of a Schatzki's ring. The first recommended diagnostic procedure for patients with dysphagia is endoscopy, if not otherwise contraindicated. [nature.com]
- Odynophagia
Sometimes swallowing difficulties, known as dysphagia, can accompany the pain, but odynophagia is often a condition of its own. There’s no one single cause or treatment measure designated for odynophagia. [healthline.com]
Symptoms of Reflux Esophagitis Difficulty swallowing (dysphagia) Painful swallowing (odynophagia) Chest pain Swallowed food becoming stuck in the esophagus Nausea Vomiting Abdominal pain Cough Decreased appetite Factors that can increase the risk for [universityendoscopy.com]
Diagnosis Odynophagia, painful swallowing, is a symptom that is unique to infectious esophagitis. [atsu.edu]
Esophagitis can produce symptoms of chest pain (usually behind the sternum), heartburn, odynophagia (painful swallowing), and/or dysphagia (difficulty swallowing, sensation of food sticking). [uclahealth.org]
- Failure to Thrive
[…] to thrive, or difficulty gaining adequate weight. [medicalnewstoday.com]
In children, symptoms can include: trouble feeding or drinking weight loss vomiting failure to thrive Symptoms of eosinophilic esophagitis in adults can include: being unable to pass food into the stomach heartburn chest pain abdominal pain food regurgitation [healthline.com]
[…] to thrive When to see a doctor Most signs and symptoms of esophagitis can be caused by a number of different conditions affecting the digestive system. [mayoclinic.org]
- Hiccup
Although heartburn or regurgitations are specific to characterize GERD, patients usually report a number of associated symptoms such as cough, eructation, globus, hiccups, chest pain, and sleep disturbances. [ncbi.nlm.nih.gov]
Symptoms Common symptoms of GERD include: Feeling that food is stuck behind the breastbone Heartburn or a burning pain in the chest Nausea after eating Less common symptoms are: Bringing food back up (regurgitation) Cough or wheezing Difficulty swallowing Hiccups [stlukes-stl.com]
An 80 year-old male, presents with 3 months of having hiccups. Patient has been drinking alcoholic beverages during several years. Video Endoscopic Sequence 2 of 4. Hemorrhagic Esophagitis due to alcoholic beverages. [gastrointestinalatlas.com]
- Pyrosis
Typical symptoms include pyrosis, dysphagia and regurgitation. [symptoma.com]
The typical presentation of esophageal stricture includes the insidious and sometimes sudden occurrence of dysphagia to solid food with antecedent pyrosis. [nature.com]
Jaw & Teeth
- Halitosis
Mild, nonspecific laryngitis and halitosis are also commonly present. In some patients with laryngitis severe enough to involve the oral cavity, there is also loss of dental enamel. [hon.ch]
[…] retrosternal burning pain (heartburn) that worsens while lying down (e.g., at night) and after eating [3] Pressure sensation in the chest Belching, regurgitation [4] Dysphagia [4] Chronic non-productive cough and nocturnal cough [11] Nausea and vomiting [4] Halitosis [amboss.com]
[…] acid reflux, or unpleasant taste in mouth Sore throat or hoarseness Mouth sores Nausea, vomiting, or indigestion Chest pain, in the middle of the chest, often radiating to the back, usually associated with swallowing or soon after a meal Bad breath (halitosis [emedicinehealth.com]
Workup
Diagnostic Workup The history can often facilitate diagnosing the cause of complications of esophageal stricture in the majority of cases. [nature.com]
Microbiology
- Candida
Candida infection:This is a type of fungal (yeast) infection that may occur in your mouth. It can spread and cause esophageal symptoms like painful swallowing. [healthline.com]
Candida albicans is the most common infective agent in immunocompromised or immunocompetent patients; it can be associated with inhaled steroid therapy and long-term PPI use. [13, 19, 20] Rare pathogens may include Aspergillus species, Candida glabrata [emedicine.medscape.com]
Like Candida, this viral infection can develop in the esophagus when the body's immune system is weak. It is treatable with antiviral drugs. [webmd.com]
Infections that cause esophagitis include: Candida is a yeast infection of the esophagus. [emedicinehealth.com]
Stool
- Occult Blood Positive
blood positive test acute presentation: melena / hematochezia (20%) hematemesis (30%) both melena and hematemesis (50%) perforation affects up to 6% of ulcer patients 1 generalized acute abdominal pain, peritonism and shock 2 pain may radiate to the [radiopaedia.org]
Treatment
Sucralfate was, therefore, found to be as effective and as well tolerated as the alginate/antacid compound in the treatment of peptic esophagitis. [ncbi.nlm.nih.gov]
Klinkenberg-Knol EC, Meuwisen SGM: Treatment of reflux oesophagitis resistant to H 2 -receptor antagonists. Digestion 44(suppl 1):47–53, 1989 Google Scholar 17. Jansen JMBJ, Lamers CBHW: Omeprazole in the shortterm treatment of reflux oesophagitis. [springerlink.com]
FEV 1 was normal in all patients and did not change after treatment. PD20 methacholine could not be determined under basal conditions or after treatment, thus proving the absence of bronchial hyperreactivity. [gut.bmj.com]
Prognosis
Prognosis of GERD (Gastro-Esophageal-reflux Disease) Prognosis is good with changes in lifestyle and taking proper medications. [drthindhomeopathy.com]
Normally, the prognosis would be good with no serious illnesses. If there are more causes than one, the prognosis could move to fair. [en.wikipedia.org]
What to Avoid Spicy foods Acidic foods and beverages, such as citrus juices and juices, and tomato-based products Hard foods that can cause pain in the esophagus when swallowed, such as nuts and raw vegetables Tobacco Prognosis Whether the esophagitis [verywellhealth.com]
Treatment and prognosis Treatment depends on the clinical presentation. [radiopaedia.org]
Prognosis for esophagitis is normally good. Esophagitis can be caused by certain allergies. Being overweight increases the risk of esophagitis. Depending on the cause of esophagitis, there are various possible treatments. [medicalnewstoday.com]
Etiology
Esophagitis is probably the commonest disease of the esophagus.1 There are many varieties of esophagitis: acute, subacute, and chronic, with a wide variety of etiological agents. [jamanetwork.com]
IV: DISEASES OF THE GASTRO INTESTINAL TRACT Etiological Factors Symptoms Diagnostic tests and dietary treatment for Esophagitis and hiatus hernia Gastritis, Peptic Ulcer and Ulcerative colitis Malabsorption Syndrome –Celiac Sprue UNIT. [play.google.com]
Etiology Main mechanism: transient lower esophageal sphincter relaxations (tLESRs) [5] Risk factors/associations Lifestyle habits such as smoking, caffeine and alcohol consumption [5][6] Stress [2] Obesity [7] Pregnancy [5][3] Diaphragm dysfunction [3 [amboss.com]
Spiegel (Philadelphia) Occult chronic gastroesophageal reflux (GER) is an etiologic factor in a high percentage of patients with laryngological complaints. [hon.ch]
Chronic exposure to gastric juices impairs reparative capacity of esophageal mucosa; gastric acid injury to mucosa is critical to pathophysiology (Med Clin North Am 2005;89:219); bile reflux may also contribute (J Pediatr Gastroenterol Nutr 2003;36:266) Etiology [pathologyoutlines.com]
Epidemiology
The most common endoscopic finding associated with esophageal mucosal injury is reflux esophagitis. [1] References:[1][2][3][4] Epidemiology References:[3][4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Epidemiology of reflux disease and reflux esophagitis. Scand J Gastroenterol. 1989;156 (suppl):7-13. Peters JH, DeMeester TR. Gastroesophageal reflux. Surg Clin North Am. 1993;73:1119-1144. [genrevista.org]
[…] esophagus Esophageal squamous epithelium is prone to injury from acid May be erosive or nonerosive (Clin Gastroenterol Hepatol 2007;5:690) Long term consequences are bleeding (almost never massive), stricture, Barrett esophagus with possible Barrett ulcer Epidemiology [pathologyoutlines.com]
Epidemiology of digestive cancers in India. I. General principles and oesophageal cancer. Indian J Gastroenterol. 1997; 16 :98 – 102. 48. Goh KL, Chang CS, Fock KM, Ke M, Park HJ, Lam SK. Gastrooesophageal reflux disease in Asia. [tropicalgastro.com]
Epidemiology Approximately 50% of the world’s population is infected with H pylori; prevalence of H pylori infection in the U.S. is about 35–40%. [atsu.edu]
Pathophysiology
The authors have long thought that texts on pathology ofthe gastrointestinal tract tend to cover the clinical aspects, pathophysiology, and radiology in a rather sketchy fashion. [books.google.de]
Savary M, Monnier P (1985) Diagnosis, pathophysiology and adenocarcinogenesis of Barrett’s esophagus, in: DeMeester TR, Skinner DB: esophageal disorders. Pathophysiology and therapy. Raven Press, New-York 101–108 Google Scholar 6. [link.springer.com]
Transient reflux is normal, especially postprandial but usually asymptomatic; when threshold exceeded, GERD occurs Chronic exposure to gastric juices impairs reparative capacity of esophageal mucosa; gastric acid injury to mucosa is critical to pathophysiology [pathologyoutlines.com]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44. Updated by: Michael M. [medlineplus.gov]
Prevention
Additive surgery such as vagotomy and pyloroplasty is not useful in preventing recurrence and is associated with increased morbidity. [ncbi.nlm.nih.gov]
Prevention of complications Although it is logical and physiologically sensible, little data is available showing that aggressive medical therapy prevents the development of complicated GERD. [oeso.org]
[…] the esophagus cause of reflux esophagitis backflow of stomach acids through cardiac sphincter upwards into the esophagus symptoms of reflux esophagitis heartburn long term complications: bleeding, ulceration, and scarring of the esophagus treatment/prevention [quizlet.com]
[…] heartburn prevention techniques may help prevent symptoms. [stlukes-stl.com]