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Peptic Esophagitis

Reflux Esophagitis

Gastroesophageal reflux disease (gastric reflux disease) is a chronic, relapsing condition of esophageal mucosal damage. Typical symptoms include pyrosis, dysphagia and regurgitation.


Presentation

  • 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]
  • The aim of the present study was to evaluate the therapeutic efficacy of nizatidine in children with reflux esophagitis.[ncbi.nlm.nih.gov]
  • OBJECTIVES: The aim of the present study was to estimate the rate of clinical and endoscopic relapse after initial treatment of erosive peptic esophagitis in children and adolescents.[ncbi.nlm.nih.gov]
  • […] 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]
Anemia
  • Patients with dysphagia, odynophagia, weight loss, and/or anemia should undergo endoscopy in a facilitated manner because of a higher risk of malignancy. Video Endoscopic Sequence 3 of 4.[gastrointestinalatlas.com]
Mucosal Edema
  • The positive radiologic findings consisted of signs of mucosal inflammation (mucosal edema, ulceration, esophageal narrowing) in five cases and abnormalities of esophageal function (aperistalsis, continuous reflux) in three.[ncbi.nlm.nih.gov]
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]
  • 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]
  • Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing. Anyone, including infants and children, can have GERD. If not treated, it can lead to more serious health problems. In some cases, you might need medicines or surgery.[icdlist.com]
Hoarseness
  • . • 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]
  • Other mouth and throat symptoms sometimes occur, such as gum problems, bad breath, sore throat, hoarseness and a feeling of a lump in the throat. Severe chest pain develops in some cases (and may be mistaken for a heart attack).[patient.info]
  • The following symptoms were considered: heartburn, belching, acid regurgitation, throat clearing, throat burning, cough, and hoarseness.[gut.bmj.com]
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]
  • The combination of cimetidine and sucralfate suspension was superior to cimetidine alone in improving daytime heartburn symptoms (p less than 0.05) but not nighttime heartburn, dysphagia, or regurgitation.[ncbi.nlm.nih.gov]
  • 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]
Odynophagia
  • 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]
  • Patients with dysphagia, odynophagia, weight loss, and/or anemia should undergo endoscopy in a facilitated manner because of a higher risk of malignancy. Video Endoscopic Sequence 3 of 4.[gastrointestinalatlas.com]
Hiccup
  • 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]
Progressive Dysphagia
  • Progressive dysphagia for solids is the most common presenting symptom. This may progress to include liquids. For more endoscopic details, download the video clip by clicking on the endoscopic image.[gastrointestinalatlas.com]
Pyrosis
  • Typical symptoms include pyrosis, dysphagia and regurgitation.[symptoma.com]
Suggestibility
  • On this basis, such alterations should not be related to possible mucosal injuries, as suggested by several authors, but most likely to a reflected or primary phenomenon, common to that causing the gastroesophageal reflux.[ncbi.nlm.nih.gov]
  • That a gluten free diet significantly decreased the relapse rate of GORD symptoms suggests that coeliac disease may represent a risk factor for development of reflux oesophagitis.[ncbi.nlm.nih.gov]
  • If these medications do not offer relief for your symptoms, your doctor may suggest surgery. There are also lifestyle changes you can make to alleviate the symptoms of reflux esophagitis.[universityendoscopy.com]
  • Studies suggest that when endoscopy is performed to study reflux symptoms erosive esophagitis is found in approximately 50% of patients [10] – [14].[journals.plos.org]
  • They also suggest that the prevalence and seriousness of the problem may be underestimated and underdiagnosed.[healthonnet.org]

Workup

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]
  • The effectiveness of omeprazole was evaluated in all infants by clinical assessment and endoscopy before and after treatment and by 24-hour gastric pH monitoring during treatment in seven infants.[ncbi.nlm.nih.gov]
  • Relapse occurs rapidly when treatment is stopped.[ncbi.nlm.nih.gov]
  • OBJECTIVES: The aim of the present study was to estimate the rate of clinical and endoscopic relapse after initial treatment of erosive peptic esophagitis in children and adolescents.[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]

Prognosis

  • Prognosis of GERD (Gastro-Esophageal-reflux Disease) Prognosis is good with changes in lifestyle and taking proper medications.[drthindhomeopathy.com]
  • Treatment and prognosis Treatment depends on the clinical presentation.[radiopaedia.org]

Etiology

  • […] 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

  • […] 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]
  • Dent J, El-Serag HB, Wallander MA, Johansson S (2005) Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 54: 710–717. View Article Google Scholar 2.[journals.plos.org]
Sex distribution
Age distribution

Pathophysiology

  • This volume provides a history of Eosinophilic Esophagitis (EoE), a basic understanding of the physiology of the eosinophil, and a current understanding of the pathophysiology and genetics of EoE.[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]
  • Pera M, Trastek VF, Pairolero PC, Cardesa A, Allen MS, Deschamps C (1993) Barrett’s disease: pathophysiology of metaplasia and adenocarcinoma. Ann Thorac Surg 56: 1191–1197 Google Scholar 11.[link.springer.com]
  • Gastric pathophysiology of antisecretory drugs. Ital J Gastroenterol 1990;22(suppl 2):32-5. Keywords: H2 blockers ; Nizatidine ; Reflux esophagitis Lippincott-Raven Publishers[journals.lww.com]

Prevention

  • Additive surgery such as vagotomy and pyloroplasty is not useful in preventing recurrence and is associated with increased morbidity.[ncbi.nlm.nih.gov]
  • The Nissen procedure prevents recurrence of hernia and has recurrence of esophagitis in 4 per cent. Hill posterior gastropexy has a recurrence of about 12 per cent.[ncbi.nlm.nih.gov]
  • After this, it is common to 'step down' the dose to the lowest dose that prevents symptoms. However, the maximum full dose taken each day is needed by some people.[patient.info]
  • […] 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]
  • It should also be noted that this bacteria could be transferred from person to person, so an utmost care is required to prevent its spread.[torrancegastro.com]

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Last updated: 2017-08-09 15:29