Esophagitis

When esophagitis is a circumscribed or diffuse inflammation of the lining of the gullet ( esophagus). This may be acute or chronic.

Causes

Esophagitis can be caused by different toxicants:

  • Chemically: Gastroesophageal reflux disease (see below), burns and Others
  • Thermal
  • Mechanically
  • Infectious ( herpes simplex virus, CMV, Candida )
  • Eosinophil (usually in connection with an allergic diathesis)

Far the most common form is the reflux esophagitis due to reflux of acidic gastric contents ( gastroesophageal reflux ösophagialer ) or stomach contents with bile ( duodeno - gastro- oesophageal reflux ösophagialer ). This form is chronic in the rule. Typical symptoms are heartburn, acid regurgitation and retrosternal pain. For chronic reflux esophagitis, there is the risk of the formation of Barrett 's esophagus. For about every 10 Barrett's esophagus to esophageal carcinoma developed.

In eosinophilic esophagitis is an immune- mediated, chronic inflammatory, stenotic disease of the esophagus, in which there is a fibrotic remodeling of the mucosa and thereby typically long segment of stenotic changes in the esophagus. The proof is done by biopsies. Most can also be increased to prove [ IgE ] values ​​. Symptomatic of this group of patients is usually carried trouble swallowing food and shaped by frequent jamming of larger food pieces or tablets. Therapeutically, the avoidance of allergens out of the question, moreover, the use of steroids and possibly the dilatation.

Morphology

Grossly, one recognizes, as a rule in the context of esophagogastroduodenoscopy a significantly reddened, vascular mucous membrane injected with longitudinally placed ulcerative defects. The Candidia esophagitis also shows typical deposits.

Stadiums

According to Savary- Miller There are four stages in the esophagitis.

  • Stage I: single mucosal erosions, not confluent, with redness
  • Stage II: confluent ulcers (not over the entire circumference )
  • Stage III: Circumferential lesion without Stenosezeichen
  • Stage IV: wall fibrosis, stenosis
Cytomegalovirus Candida (fungus) Diathesis (medicine)
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