Esophagitis: Difference between revisions
(Created page with "==Background== *Almost always causes odynophagia *Can cause prolonged periods of chest pain ==Types== ===Inflammatory Esophagitis=== Causes #GERD #Pill esophagitis (NSAIDs, anti...") |
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==Background== | ==Background== | ||
*Almost always causes odynophagia | *Almost always causes odynophagia and/or dysphagia | ||
*Can cause prolonged periods of chest pain | *Can cause prolonged periods of chest pain | ||
*Nausea and dyspepsia | |||
==Types== | ==Types== | ||
| Line 9: | Line 10: | ||
#Pill esophagitis (NSAIDs, antibiotics) | #Pill esophagitis (NSAIDs, antibiotics) | ||
===Infectious Esophagitis=== | ===Infectious Esophagitis=== | ||
*Mainly seen in pts w/ immunosuppression (AIDS, cancer) | *Mainly seen in pts w/ immunosuppression (HIV/AIDS, cancer, steroids) | ||
*Pathogens | *Pathogens | ||
** | **Esophageal candidiasis: often an AIDS defining lesion | ||
**HSV, CMV, aphthous ulceration | |||
==Diagnosis== | ==Diagnosis== | ||
*Clinical | |||
*Needs further evaluation via endoscopy | |||
==Work-Up== | ==Work-Up== | ||
*CBC with dif | |||
*Chem 7 | |||
*Fluids if dehydrated | |||
*Consider HIV workup if unknown causation, risk factors | |||
==Treatment== | ==Treatment== | ||
*PPI for GERD-induced esophagitis | *PPI for GERD-induced esophagitis | ||
*Candidal Infection: fluconazole for 14 to 21 days | |||
**consider IV if unable to tolerate PO | |||
*Consider dehydration secondary to decreased PO intake | |||
==Disposition== | ==Disposition== | ||
*Low threshold to admit if not tolerating PO | |||
*Consider additional workup depending on causation | |||
==Source== | ==Source== | ||
Tintinalli | *Tintinalli | ||
*Hess JM, Lowell MJ: Esophagus, Stomach and Duodenum, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 89: p 1170-1187. | |||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:ID]] | |||
Revision as of 02:54, 4 January 2015
Background
- Almost always causes odynophagia and/or dysphagia
- Can cause prolonged periods of chest pain
- Nausea and dyspepsia
Types
Inflammatory Esophagitis
Causes
- GERD
- Pill esophagitis (NSAIDs, antibiotics)
Infectious Esophagitis
- Mainly seen in pts w/ immunosuppression (HIV/AIDS, cancer, steroids)
- Pathogens
- Esophageal candidiasis: often an AIDS defining lesion
- HSV, CMV, aphthous ulceration
Diagnosis
- Clinical
- Needs further evaluation via endoscopy
Work-Up
- CBC with dif
- Chem 7
- Fluids if dehydrated
- Consider HIV workup if unknown causation, risk factors
Treatment
- PPI for GERD-induced esophagitis
- Candidal Infection: fluconazole for 14 to 21 days
- consider IV if unable to tolerate PO
- Consider dehydration secondary to decreased PO intake
Disposition
- Low threshold to admit if not tolerating PO
- Consider additional workup depending on causation
Source
- Tintinalli
- Hess JM, Lowell MJ: Esophagus, Stomach and Duodenum, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 89: p 1170-1187.