esofagit

Esofagit, or esophagitis, is inflammation of the esophagus. It is a common condition that can arise from acid reflux, infections, medications, or chemical injury. The most frequent form is reflux esophagitis associated with gastroesophageal reflux disease (GERD). Other causes include infectious esophagitis in immunocompromised individuals (such as Candida species, herpes simplex virus, or cytomegalovirus), pill-induced esophagitis from medications that irritate the lining (for example bisphosphonates, NSAIDs, potassium chloride), and chemical or radiation injury. Eosinophilic esophagitis is a chronic allergic condition marked by eosinophilic inflammation of the esophagus.

Symptoms commonly include heartburn, retrosternal chest pain, odynophagia (painful swallowing), dysphagia (difficulty swallowing), regurgitation, and sometimes a sore throat or cough. In children, irritability or poor feeding may be observed.

Diagnosis typically starts with history and physical examination. Endoscopy with biopsy is the standard test to assess mucosal changes and guide treatment, and special tests can identify infectious causes. Imaging such as a barium swallow may be used if perforation is suspected or to evaluate strictures. pH monitoring or impedance testing is used mainly for GERD-related disease when endoscopy is inconclusive.

Treatment depends on the underlying cause. GERD-related esophagitis is managed with acid-suppressive therapy (usually proton pump inhibitors), lifestyle modifications (weight management, elevating the head of the bed, avoiding late meals and trigger foods), and sometimes H2 blockers. Infectious esophagitis requires targeted antimicrobials (e.g., fluconazole for Candida; antivirals for HSV or CMV). Pill esophagitis involves stopping or substituting the offending medication, taking pills with water, and staying upright after dosing. Eosinophilic esophagitis may be treated with dietary elimination and swallowed topical corticosteroids. Severe cases may require hospitalization or procedures for complications. Prognosis varies with the cause and response to therapy.