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Esophagitis
From WikEM
Contents
Background
- Inflammation of the esophagus
Clinical Features
- Odynophagia and/or dysphagia
- Commonly causes dehydration
- Chest pain
- Nausea
- Dyspepsia
Differential Diagnosis
Esophagitis Types
- Inflammatory
- GERD
- Pill esophagitis (NSAIDs, antibiotics)
- Allergy (esoninophillic)
- Infectious Mainly seen in pts w/ immunosuppression (HIV/AIDS, cancer, steroids)
- Esophageal candidiasis: often an AIDS defining lesion
- HSV, CMV esophagitis, aphthous ulceration
- Pill esophagitis common culprits:
- Doxycycline
- Tetracycline
- Clindamycin
- NSAIDs
- ASA
- Bisphosphonates
- Ferrous sulfate
- Potassium chloride
- Ascorbic acid
Evaluation
Work-Up
- CBC
- CMP
- Consider HIV workup if unknown causation, risk factors
Evaluation
- Generally clinical diagnosis in ED (requires EGD for conclusive diagnosis)
Management
- PPI for GERD-induced esophagitis
- IV Fluids for dehydration
- Candidal Infection[1]
- 400mg PO loading dose x1
- 100-400mg PO for 14-21 days
Disposition
- Admit if unable to tolerate PO or if underlying immunosuppression (e.g. HIV)
See Also
References
- ↑ Hess JM, Lowell MJ. Esophagus, stomach, and duodenum, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, Ch. 89:1170-1185.
