Esophagitis

Diagnosis

The presence of esophagitis can be determined through the following diagnostic tests:

• Physical examination: Healthcare providers often diagnose esophagitis based on the presence of typical symptoms. To determine its effectiveness, a healthcare provider may prescribe an acid-blocking medication and observe the response. If the symptoms improve, they can make a reasonable assumption that the individual has reflux esophagitis.
• Barium X-ray: The patient is given the option to consume a solution or a tablet containing the substance barium. The lining of the stomach and esophagus is coated with barium, which also makes the organs visible. With the use of these images, it may be possible to spot esophageal constriction, other structural changes, a hiatal hernia, tumors, or other irregularities that may be contributing to symptoms.
• Endoscopy: A long, thin tube with a tiny camera on it is inserted down the neck and into the esophagus during this procedure. The name of this device is an endoscope. A healthcare provider can examine the esophagus with an endoscope to check for any odd features. Depending on the underlying cause of the inflammation, such as medication usage or acid reflux, the esophagus may seem differently. This test will be performed while the patient is under sedation.
• Esophageal sponge: One method for assessing the level of inflammation in the esophagus without resorting to an endoscopy involves the use of a capsule attached to a string. The individual ingests the capsule, which eventually dissolves in the stomach. By pulling on the string, the healthcare provider can retrieve a sponge that used to sample the esophageal tissues during its removal. This technique allows the healthcare provider to evaluate the degree of esophageal inflammation.
• Laboratory tests: During an endoscopic examination, small tissue samples are extracted and sent to the lab for analysis. This is referred to as a biopsy.

Tests may be used to diagnose a bacterial, viral, or fungal infection and determine the concentration of eosinophils, or allergy-related white blood cells, depending on the probable underlying cause of the condition.

Treatment

The primary goals of esophagitis treatments are to manage complications, alleviate symptoms, and address the underlying causes of the disorder. Treatment plans vary depending on the specific root cause of the condition.

• Lifestyle changes: Diet modifications by determining the meals and beverages that cause acid reflux and indigestion or that cause an allergic reaction.
• Evening routine: Eat smaller meals, especially at dinner, to lessen acid reflux. Make sure to eat dinner at least three hours before going to bed so it has time to digest.
• Self care: Patient is recommended to stop smoking and alcohol consumption to protect the esophagus.
• Reflux esophagitis: Reflux esophagitis treatment options include:
  • Over-the-counter medications. Antacids; H-2-receptor blockers, such as cimetidine; and proton pump inhibitors, which stop acid production and treat the esophagus, including omeprazole and lansoprazole.
  • Prescribed medication: These include proton pump inhibitors and H-2 receptor blockers with a prescription.
  • Fundoplication: If previous treatments are unsuccessful, this kind of surgery might be done to treat the condition of the esophagus. In this surgery, a section of the stomach is wrapped around the lower esophageal sphincter, the valve dividing the esophagus from the stomach. As a result, the sphincter is strengthened and acid cannot back up into the esophagus.
  • LINX: The LINX method is a more recent operation that includes wrapping a ring of small magnetic titanium beads around the lower esophageal sphincter. Since the sphincter is stronger in that position, acid reflux is prevented.
• Eosinophilic esophagitis: Eosinophilic esophagitis is treated by avoiding the allergen and using medications to lessen the allergic reaction. Among the prescribed medications are:
  • Proton pump inhibitors: A proton pump inhibitor, such as esomeprazole, lansoprazole, omeprazole, or pantoprazole, will probably be recommended initially by the healthcare provider.
  • Steroids: The surface tissue of the esophagus may be affected by swallowed steroids like fluticasone and budesonide, according to several research. To treat eosinophilic esophagitis, the same steroid drugs that are breathed to treat asthma are ingested as a liquid.
  • Elimination and elemental diets: Eosinophilic esophagitis is most often brought on by a reaction to a food allergy. Eliminating the offending food could therefore be a successful therapeutic plan.

The patient’s healthcare provider might advise eliminating common food allergies from their diet. Patient should reintroduce foods gradually and track any recurrence of symptoms.

• • Monoclonal antibodies: Dupilumab has just received FDA approval for the treatment of eosinophilic esophagitis in adults and children 12 years of age and older. A monoclonal antibody is a kind of medication that includes dupilumab. It functions to stop the body’s production of certain proteins that lead to inflammation. Dupilumab is injected once a week.
• Drug-induced esophagitis: Drug-induced esophagitis is treated by refraining from using the offending drug and minimizing the risk through improved pill-taking habits. Healthcare provider might advise the patient to use an alternate medication that is less likely to result in esophagitis brought on by medications. To reduce the risk of drug-induced esophagitis, it is advisable to consider the following measures:
  • Whenever feasible, opt for a liquid formulation of the medication.
  • Consume a full glass of water with the pill, unless instructed otherwise by your healthcare provider due to conditions like kidney disease that require fluid intake restriction.
  • Avoid lying down after taking the medication. Maintain an upright sitting or standing position for a minimum of 30 minutes after swallowing the pill.
• Infectious esophagitis: An infectious esophagitis-causing bacterial, viral, fungal, or parasitic illness may be treated with medication by a healthcare provider.
• Treatment for other complications: An esophageal dilation procedure may be carried out by a gastroenterologist. Usually, only very severe narrowing or food that has become caught in the esophagus requires this treatment.