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

reflex esophagitis-image-reload
Reflux Esophagitis (Oesophagitis)
It refers to chronic inflammation of esophagus (oesophagus) due to reflux of Gastric Acid.

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

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

Clinical Features:
1. Dysphagia
2. Heart burn
3. Regurgitation
4. Hemetemesis
5. Malena (black stool)
6. Chest Pain.

1. Bleeding
2. Strictures
3. Barrett esophagus

Following drugs are being used to treat reflux esophagits.

1. Antacids: neutralize acids and decrease their corrosive effect on esophageal 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 sometime useful because they enhance the gastric emptying.
4. Surgery: to tighten the lower esophageal sphincter.

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

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