Esophagitis: Difference between revisions
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==Background== | ==Background== | ||
* | [[File:Gray1032.png|thumb|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]] | ||
[[File:Layers of the GI Tract english.svg|thumb|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]] | |||
[[File:Illu esophagus.jpg|thumb|Esophagus anatomy and nomenclature based on two systems.]] | |||
*Inflammation of the esophagus | |||
==Clinical Features== | ==Clinical Features== | ||
*Odynophagia and/or dysphagia | *Odynophagia and/or [[dysphagia]] | ||
*Chest pain | **Commonly causes [[dehydration]] | ||
*Nausea | *[[Chest pain]] | ||
*Dyspepsia | *[[Nausea]] | ||
*[[Dyspepsia]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Esophagitis types}} | {{Esophagitis types}} | ||
== | ==Evaluation== | ||
[[File:Esophageal ulcer.jpg|thumb|Eophageal ulcer (the reddened area at 10 o'clock on the surface of the mucosa) and due to refulx esophatitis (GERD).]] | |||
[[File:Oral Candidiasis.jpg|thumb|[[Esophageal candidiasis]]]] | |||
===Work-Up=== | ===Work-Up=== | ||
*CBC | *CBC | ||
*CMP | *CMP | ||
*Consider HIV workup if unknown causation, risk factors | *Consider [[HIV]] workup if unknown causation, risk factors | ||
===Evaluation=== | ===Evaluation=== | ||
| Line 21: | Line 28: | ||
==Management== | ==Management== | ||
*PPI for GERD-induced esophagitis | *[[PPI]] for [[GERD]]-induced esophagitis | ||
* | *[[IV fluids]] for dehydration | ||
*[[esophageal candidiasis|Candida infection]]<ref>Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD. Clin Infect Dis. 2016 Feb 15;62(4):e1-50. doi: 10.1093/cid/civ933. Epub 2015 Dec 16.</ref> | |||
**[[Fluconazole]]: 200mg PO loading dose x1 followed by 100-200 mg PO for 7-14 days | |||
==Disposition== | ==Disposition== | ||
| Line 30: | Line 38: | ||
==See Also== | ==See Also== | ||
*[[HIV - AIDS (Main)]] | *[[HIV - AIDS (Main)]] | ||
*[[Esophageal candidiasis]] | |||
==References== | ==References== | ||
Latest revision as of 22:24, 7 February 2024
Background
- Inflammation of the esophagus
Clinical Features
- Odynophagia and/or dysphagia
- Commonly causes dehydration
- Chest pain
- Nausea
- Dyspepsia
Differential Diagnosis
Esophagitis Types
- Inflammatory
- GERD
- Allergic (eosinophilic)
- Infectious Mainly seen in patients w/ immunosuppression (HIV/AIDS, cancer, steroids)
- Esophageal candidiasis: often an AIDS defining lesion
- HSV
- CMV esophagitis
- aphthous ulceration
- Medication-induced (i.e. "pill") esophagitis, common culprits:
- Doxycycline
- Tetracycline
- Clindamycin
- NSAIDs
- ASA
- Bisphosphonates
- Ferrous sulfate
- Potassium chloride
- Ascorbic acid
Evaluation
Work-Up
- CBC
- CMP
- Consider HIV workup if unknown causation, risk factors
Evaluation
- Generally clinical diagnosis in ED (requires EGD for conclusive diagnosis)
Management
- PPI for GERD-induced esophagitis
- IV fluids for dehydration
- Candida infection[1]
- Fluconazole: 200mg PO loading dose x1 followed by 100-200 mg PO for 7-14 days
Disposition
- Admit if unable to tolerate PO or if underlying immunosuppression (e.g. HIV)
See Also
References
- ↑ Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD. Clin Infect Dis. 2016 Feb 15;62(4):e1-50. doi: 10.1093/cid/civ933. Epub 2015 Dec 16.