Reflux Esophagitis(oesophagitis)-Causes-Clinical Features-Complications-Treatment

Reflux Esophagitis (Oesophagitis)
Definition:
It refers to chronic inflammation of the oesophagus (oesophagus) due to reflux of Gastric Acid.

Causes and Predisposing Factors:
1. Decreased efficacy of oesophagal sphincter.
2. Use of drugs that cause CNS depression.
3. Hypothyroidism
4. Pregnancy
5. Alcoholism
6. Smoking
7. Nasogastric intubation
8. Delayed gastric emptying.

Morphology:
Under the microscope, you will notice the following aspects of reflux esophagitis.
1. Presence of neutrophils, eosinophils and lymphocytes in the epithelial layer.
2. Hyperplasia of the basal layers of the epithelium.
3. Elongation of papillae of lamina propria
4. Congestion.

Clinical Features:
1. Dysphagia
2. Heartburn
3. Regurgitation
4. Hematemesis
5. Malena (black stool)
6. Chest Pain.

Complications:
1. Bleeding
2. Strictures
3. Barrett esophagus

Treatment.
Following drugs are being used to treat reflux esophagitis.

1. Antacids: neutralize acids and decrease their corrosive effect on the oesophagal epithelium.
2. Acid-suppressing drugs: such as H2 receptors blockers and Proton pump inhibitors are used. these drugs suppress acid secretion.
3. Domperidone and Metoclopramide are sometimes useful because they enhance the gastric emptying.
4. Surgery: to tighten the lower oesophagal sphincter.

Other esophatis:
1. Barrett's oesophagus
2. Infectious and chemical Esophagitis.

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