Esophagitis

Classification according to ICD-10
K20	Esophagitis
ICD-10 online (WHO version 2019)

In the esophagitis or esophageal inflammation is a localized or diffuse inflammation of the gullet ( esophagus ). Usually only the mucous membrane of the esophagus is affected. The inflammation can be acute or chronic.

causes

Esophagitis can be triggered by different noxae:

infectious ( herpes simplex viruses , CMV , Candida )
chemical (acute and chronic): reflux esophagitis (see below), chemical burns, etc. a.
traumatic: food that is too hot and too cold, bolus injuries, foreign bodies
drug-toxic: e.g. chemotherapeutic agents
tumorous: lumen obstruction, tumor necrosis
idiopathic (exfoliative and corrosive)
eosinophil (usually associated with an allergic diathesis )
other: Crohn's disease , poorly controlled diabetes mellitus

By far the most common form is reflux esophagitis due to reflux of acidic gastric contents (gastro-oesophageal reflux) or of gastric contents with bile (duodeno-gastro-oesophageal reflux). This form is usually chronic. Typical symptoms are heartburn , acid regurgitation and retrosternal pain. Chronic reflux esophagitis is at risk of Barrett's esophagus . Esophageal carcinoma develops from around every tenth Barrett's esophagus .

Mycoses of the esophagus are the second most common type of esophagitis.

When eosinophilic esophagitis is an immune-mediated chronic inflammatory, stenotic disease of the esophagus, in which there is a fibrotic remodeling of the mucous membrane and thus long segment to a typically stenotic change in the esophagus. Evidence is provided by biopsies. In most cases, increased IgE values can also be detected in the serum. Symptoms in this group of patients are mostly caused by discomfort when swallowing shaped food and by frequent getting stuck with larger pieces of food or tablets. Therapeutically, avoiding allergens comes into question, as well as the use of steroids and, if necessary, bougienage .

morphology

Macroscopically, an esophagogastroduodenoscopy usually reveals a clearly reddened, vascular-injected mucous membrane with longitudinal ulcerative defects. Candida esophagitis also shows typical deposits.

Stages

According to Savary-Miller, there are four stages in esophagitis.

Stage I: single erosions of the mucous membrane, not confluent, with reddening
Stage II: confluent erosions (not over the whole circumference)
Stage III: circumferent lesion, without signs of stenosis
Stage IV: wall fibrosis, stenosis

literature

Helmut Messmann: Clinical Gastroenterology: The book for advanced and advanced training. Thieme, 2011. ISBN 9783131659910 . P. 179ff.
Manfred Stolte, Josef Rüschoff: Pathology: digestive tract and peritoneum. Springer, Berlin and Heidelberg 2013. ISBN 978-3-642-02321-7 . P. 22ff.

Web links

Wiktionary: Esophagitis - explanations of meanings, word origins, synonyms, translations

Individual evidence

^ ^A ^b ^c Manfred Stolte, Josef Rüschoff: Pathology: digestive tract and peritoneum. Springer, Berlin and Heidelberg 2013. ISBN 978-3-642-02321-7 . P. 22ff.
↑ Mark Buchta, Dirk W. Höper, Andreas Sönnichsen: The second StEx: Basic knowledge of clinical medicine for exams and practice. Springer, 2013. ISBN 9783642185694 . P. 1155.

[stolte-1] A ^b ^c Manfred Stolte, Josef Rüschoff: Pathology: digestive tract and peritoneum. Springer, Berlin and Heidelberg 2013. ISBN 978-3-642-02321-7 . P. 22ff.

[2] Mark Buchta, Dirk W. Höper, Andreas Sönnichsen: The second StEx: Basic knowledge of clinical medicine for exams and practice. Springer, 2013. ISBN 9783642185694 . P. 1155.