ESOPHAGITIS

Definition
Esophagitis refers to any inflammation, irritation, or swelling of the
esophagus. The esophagus is the tube that leads from the back of the
mouth to the stomach. It may be acute or chronic.

Risk Factors
Esophagitis is most commonly results from recurrent reflux of gastric
contents into the distal esophagus. Reflux may result from:

 Incompetent lower esophageal sphincter

 Gastric or duodenal ulcers
 Prolonged nasogastric intubation

Symptoms

Common signs and symptoms of esophagitis include:

 Difficult swallowing

 Painful swallowing

 Chest pain, particularly behind the breastbone, that occurs with eating

 Swallowed food becoming stuck in the esophagus (food impaction)

 Heartburn
  Acid regurgitation

Diagnosis

Your doctor will likely perform a physical examination. They may also order
diagnostic tests including:

 endoscopy with biopsies
 barium X-ray, also called an upper GI series
 allergy testing, which may include skin tests. Food elimination may
be discussed after a diagnostic endoscopy.

Treatment for esophagitis

Treatment depends on the cause of your symptoms. Medications may
include:

 antiviral medications
 antifungal medications
 antacids
 pain relievers
 oral steroids
 proton pump inhibitors (these medications block stomach acid
production)

If food allergies cause your condition, you must identify trigger foods and
eliminate them from your diet. The top 6 food allergens include:

 milk
 soy
 eggs
 wheat
 peanuts
 tree nuts
 shellfish

You can also ease your symptoms by avoiding spicy foods, acidic foods
and drinks, and raw or hard foods. Take smaller bites and chew your food
well. And ask your doctor for dietary guidelines. You should avoid tobacco
and alcohol.

A procedure to dilate the esophagus may be necessary if the esophagus

becomes too narrow and causes food to lodge.

If your symptoms are due to medication, you may need to drink more
water, take a liquid version of the medication, or try a different medication.
And you may need to refrain from lying down for 30 minutes after taking
medication in pill form.

Nursing Management
 Promote adequate nutritional intake. Instruct the client to:
 Eat small, frequent meals of mostly bland foods
 Chew food thoroughly before swallowing
 Drink fluids to aid swallowing and food passage down the
esophagus.
 Refrain from laying down after eating
 Avoid eating within 3 hours of bedtime
 Assess all vomitus for content, note undigested food and blood (i.e.
coffee-ground or bright red appearance)
 Maintain integrity of the oral mucosa.
 Minimize pain.
 Instruct the client to avoid irritants. Advise the client to elevate
head of his bed with blocks to help minimize reflux.
Complications

Left untreated, esophagitis can lead to changes in the structure of the esophagus.
Possible complications include:

 Scarring or narrowing (stricture) of the esophagus

 Tearing of the esophagus lining tissue from retching (if food gets stuck) or during
endoscopy (due to inflammation)

 Barrett's esophagus, characterized by changes to the cells lining the esophagus,

increasing your risk of esophageal cancer