Chronic esophagitis - Causes, Symptoms, Diagnosis and Treatment

Chronic esophagitis - Inflammation of the inner layer of the esophagus (mucosa), whose symptoms persist for more than six months. Chronic esophagitis is manifested dysphagia, chest pain, heartburn, regurgitation and vomiting. The survey plan in chronic esophagitis include X-rays of the esophagus and oesophagoscopy with biopsy, and esophageal manometry esophageal pH meter, a sample of acid perfusion according to Bernstein, a general analysis of blood, fecal occult blood. Treatment of predominantly conservative (pharmacological and non-pharmacological), with its inefficiency and the development of complications - surgical.

  • Classification of chronic esophagitis
  • Causes of chronic esophagitis
  • Symptoms of chronic esophagitis
  • Diagnosis of chronic esophagitis
  • Treatment and prognosis of chronic esophagitis
  • Chronic esophagitis - Treatment

  • Chronic esophagitis


    esophagitis - a relatively rare disease diagnosed primarily in adults and in most cases caused by gastroesophageal reflux disease. There are many special forms of chronic esophagitis, such as esophagitis baby (due to regurgitation), infectious (developed exclusively for persons with severe immunodeficiency, tuberculosis, after injuries), allergic (affects up to 50 people per 100 thousand population in developed countries) and others. chronic esophagitis general population develops not more than 5% of people. The risk for chronic affections of the esophagus include people who do not observe the proper diet, drinking enough fluids, having bad habits (smoking, alcohol abuse), predisposition to allergies, occupational hazards, as well as suffering from immunodeficiency.

    esophageal ulcer, leading to a narrowing of its lumen and stenosis.

    As the prevalence of chronic esophagitis process can be proximal (affecting the initial esophagus), distal (change capture the lower esophagus, located at the entrance to the stomach), total (all amazed mucous membrane).

    diverticula, tumors and esophageal stenosis);
  • allergic (Accompanied by another of allergy - food allergies, asthma and others.);
  • specific (Occurs in patients with tuberculosis, scleroderma, mycosis, syphilis);
  • dismetabolic (Formed on the background of severe anemia, hypoxia of any origin, lack of vitamins and iron, extensive burns, etc.);
  • traumatic (Chronic inflammation develops after trauma, esophageal foreign body contaminated wounds).


  • Separately, take out special forms of chronic esophagitis: idiopathic ulcerative regional and constrictive. The reasons for the formation of chronic ulcerative esophagitis has not been fully elucidated, but gastroenterologists note the similarity of this disease with ulcerative colitis. Perhaps these two diseases have common origins.

    The regional constrictive nonspecific esophagitis is characterized by granulomatous lesions total of all layers of the esophagus wall, on the morphological picture of changes in the tissues resemble those in Crohn's disease. However, unlike the intestinal lesion, stenosis in the esophagus with chronic esophagitis and eosinophils are not giant cell elements. The regional constrictive nonspecific esophagitis affects equally for young women and men of working age (onset of the disease usually occurs between the ages of about 30 years). Research in the field of gastroenterology, devoted to identify the causes of the disease are maintained to this day. Stenosing regional esophagitis should be differentiated from other etiologies stenosis, esophageal cancer. The disease progresses continuously for six months and can lead to complete obstruction of the esophagus.

    chronic gastritis, gastric and duodenal disease, syphilis, tuberculosis, bronchial asthma, etc.).; directly to the clinical picture of chronic inflammation in the esophagus; dyskinesia esophageal inflammation in the background.

    Usually the first signs of chronic esophagitis are dysphagia and chest pain. The disease is often accompanied by the development hypermotor dyskinesia, which is manifested paroxysmal course of dysphagia. Difficulties in swallowing described by the patient as a sensation of a lump in the throat, esophagus overflow, squeezing or compression of the throat. In a typical course of chronic esophagitis complexity usually occurs during the passage of the liquid food, while non-specific esophagitis stenosis and other diseases of the esophagus - on the contrary, a firm that helps to differentiate these states.

    Pain in chronic esophagitis clearly associated with eating, always accompanied by dysphagia. Usually localized pain behind the breastbone, but perhaps the beginning of a painful attack with interscapulum and then spread on the intercostal space of the sternum, neck and jaw. If chronic esophagitis developed against the background of gastroesophageal reflux disease, the highest intensity of pain is noted at a throw of acidic stomach contents into the esophagus (during trunk bending forward, belching, lying down); such pain is accompanied by heartburn. Usually pain is removed antacids.

    For chronic esophagitis is characterized by symptoms such as regurgitation, belching and vomiting. All these symptoms are manifestations of the same process - proceeds retrograde food from the esophagus or stomach in the oral cavity. Regurgitation usually occurs passively, without nausea, just eaten food enters the mouth, it can be aspirated into the respiratory tract. GERD belching characteristic, while in the mouth from the stomach large amount of air, sometimes with the gastric juice, food masses. Vomiting is most common in alcoholic genesis of chronic esophagitis, occurs in the morning, vomit large amounts of mucus. With frequent and persistent vomiting develops Mallory-Weiss syndrome (esophageal mucosal tears with bleeding).

    gastroenterologist and endoscopist doctor. If you suspect that chronic esophagitis necessarily performed esophageal radiography: mucosal folds thickened, swollen, rough contours of the esophageal tube, can be seen "niche" in the area of ​​localization of esophageal ulcers. At esophagoscopy rendered full-blooded mucosa (stage A), esophageal erosion and melkotochechnye hemorrhage (stage B), an inflammatory exudate. Esophageal manometry and daily intraesophageal pH monitoring can detect reflux of stomach contents into the esophagus. In order to avoid chronic bleeding esophageal ulcers in the background is shown holding a fecal occult blood test, blood count for all patients. For differentiation with anginal pain is recommended to perform an ECG.

    A specific test for the detection of chronic esophagitis is acid perfusion test Bernstein: the esophagus through a thin probe is slowly injected 0.1-molar solution of hydrochloric acid. The appearance of chest pain and heartburn after 20 minutes from the start of infusion favors chronic esophagitis.

    aspiration pneumonia) is shown surgical intervention; its kind and amount is determined depending on the clinical situation.

    The prognosis for a timely start of the treatment of chronic esophagitis favorable, but may develop severe complications. Once every six months is required to conduct inspection gastroenterologist esophagoscopy. In severe disease is established disability. Prevention is a timely treatment of the background pathology and exclusion of causal factors (bad habits, poor nutrition, occupational hazards, etc.).