Esophagitis
Encyclopedia
Esophagitis is inflammation
of the esophagus
. It may be acute or chronic. The acute esophagitis can be catarrhal or phlegmon
ous, whereas the chronic esophagitis may be hypertrophic or atrophic.
Endoscopy
can be used to distinguish among these conditions.
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of the esophagus
Esophagus
The esophagus is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. During swallowing, food passes from the mouth through the pharynx into the esophagus and travels via peristalsis to the stomach...
. It may be acute or chronic. The acute esophagitis can be catarrhal or phlegmon
Phlegmon
Phlegmon is a spreading diffuse inflammatory process with formation of suppurative/purulent exudate or pus. This is the result of acute purulent inflammation which is due to bacterial infection.An example would be phlegmon of diverticulitis...
ous, whereas the chronic esophagitis may be hypertrophic or atrophic.
Infectious
Forms of infectious esophagitis are typically seen in immunocompromised people. Types include:- candidaCandida (genus)Candida is a genus of yeasts. Many species are harmless commensals or endosymbionts of animal hosts including humans, but other species, or harmless species in the wrong location, can cause disease. Candida albicans can cause infections in humans and other animals, especially in immunocompromised...
(Esophageal candidiasisEsophageal candidiasisEsophageal candidiasis is an opportunistic infection of the esophagus by Candida albicans. The disease occurs in patients in immunocompromised states, including post-chemotherapy and in AIDS. It is also known as candidal esophagitis or monilial esophagitis.-Clinical presentation:Patients with...
) - Viral
- herpes simplexHerpes simplexHerpes simplex is a viral disease caused by both Herpes simplex virus type 1 and type 2 . Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection. Oral herpes, the visible symptoms of which are colloquially called cold sores or fever...
(herpes esophagitisHerpes esophagitisHerpes esophagitis is a viral infection of the esophagus caused by Herpes simplex virus .While the disease most often occurs in immunocompromised patients, including post-chemotherapy, immunosuppression with organ transplants and in AIDS, herpes esophagitis can also occur in immunocompetent...
) - cytomegalovirusCytomegalovirusCytomegalovirus is a viral genus of the viral group known as Herpesviridae or herpesviruses. It is typically abbreviated as CMV: The species that infects humans is commonly known as human CMV or human herpesvirus-5 , and is the most studied of all cytomegaloviruses...
- herpes simplex
Endoscopy
Endoscopy
Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...
can be used to distinguish among these conditions.
Other
- The most common cause is gastroesophageal reflux diseaseGastroesophageal reflux diseaseGastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...
(GERD, or GORD in British English). If caused by GERD, the disease is also called reflux esophagitis. - Chemical injury by alkaline or acidAcidAn acid is a substance which reacts with a base. Commonly, acids can be identified as tasting sour, reacting with metals such as calcium, and bases like sodium carbonate. Aqueous acids have a pH of less than 7, where an acid of lower pH is typically stronger, and turn blue litmus paper red...
solutions may also cause esophagitis, and is usually seen in children, as well as in adults who attempt suicideSuicideSuicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
by ingestion of caustic substances - Physical injury resulting from radiation therapyRadiation therapyRadiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...
or by nasogastric tubes may also be responsible. - HyperacidityHyperacidityHyperacidity, also known as acid dyspepsia is the condition of excreting more than the normal amount of hydrochloric acid in the stomach.Some causes for hyperacidity are peptic ulcers, gastroesophageal reflux disease, stomach cancer and certain types of diet that contains spicy food.Hyperacidity or...
. - AlcoholAlcoholic beverageAn alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption...
abuse. - Eosinophilic esophagitisEosinophilic esophagitisEosinophilic esophagitis is an allergic inflammatory condition of the esophagus. Symptoms are swallowing difficulty, food impaction, and heartburn. The disease was first described in children but occurs in adults as well...
is a little understood form of esophagitis, which is thought to be related to food allergiesFood allergyA food allergy is an adverse immune response to a food protein. They are distinct from other adverse responses to food, such as food intolerance, pharmacological reactions, and toxin-mediated reactions....
.
Grading of severity
The severity of esophagitis is commonly classified into four grades according to the Los Angeles Classification:Grade A | One or more mucosal breaks < 5 mm in maximal length |
Grade B | One or more mucosal breaks > 5mm, but without continuity across mucosal folds |
Grade C | Mucosal breaks continuous between > 2 mucosal folds, but involving less than 75% of the esophageal circumference |
Grade D | Mucosal breaks involving more than 75% of esophageal circumference |