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- The esophagus is the passageway through the chest that carries food from the mouth to the stomach. If the esophagus becomes irritated, infected, or inflamed, it creates a condition known as esophagitis.
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- Difficulty swallowing
- Refusal to drink
- Nausea/vomiting
- Pain in chest on swallowing
- Thrush (white patches) in mouth may be present in candida esophagitis
- Caustic ingestion
- Burning chest pain
- Gagging
- Difficulty swallowing
- Drooling
- Wheezing
- Whistling sound in neck (stridor)
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- Candida (yeast) -- often only in individuals with other diseases such as diabetes, cancer, or HIV
- Cytomegalovirus (CMV) -- often only in individuals with other diseases, such as diabetes, cancer, and HIV
- Herpes simplex
- Reflux of gastric acid
- Medication -- examples include anti-inflammatories, potassium, and antibiotics
- Caustic Injury (e.g., accidental ingestion of drain cleaners)
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- Endoscopy with biopsy and brushings (done by passing scope via the mouth into the esophagus)
- Barium esophagography in severe cases shows mucosal irregularities.
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- Candida esophagitis (choice of medications depends on severity):
- Nystatin swish and swallow
- Fluconazole by mouth
- Ketoconazole by mouth
- For immunocompromised (e.g., have underlying disease like HIV) and systemic infections -- amphotericin and/or flucytosine
- Cytomegalovirus esophagitis:
- Ganciclovir intravenously
- Foscarnet intravenously if ganciclovir fails or is not tolerated
- Normal individuals -- often do not need treatment or only analgesics and antacids.
- Acyclovir oral or intravenously for herpetic or Varicella-zoster esophagitis
- Foscarnet IV if Acyclovir fails or is not tolerated
- Medication induced: Stop offending medication
- Caustic esophagitis:
- Needs immediate emergency medical treatment. Its usual cause in children is accidental ingestion. The peak age of incidence is under 5 years. The child's airway needs to be protected. Chest and abdominal X-rays are necessary to rule out perforation. Endoscopy needs to be performed to assess the degree of Injury within 48 hours.
- Prednisone therapy for prevention of stricture formation.
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- Esophageal stricture
- Esophageal cancer
- Esophageal ring
- Esophageal web
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