Erosive Esophagitis

Erosive Esophagitis – General Information

Erosive Esophagitis is a common health problem which is determined by a gastro-esophageal reflux. There are some other problems which can lead to the appearance of the disease, but they are less frequent: an infectious esophagitis, a radiation esophagitis or a direct esophagitis caused by medications or other agents ingested by the patient. Erosive Esophagitis appears when the gastric substances are regurgitated in the esophagus. In most of the cases however, this reflux does not cause major problems, as the esophagus presents some substances which redirect the gastric contents back into the stomach. In more severe cases, the esophagus can not defend itself and it suffers some major macroscopic changes. The gastric nutriments contain pepsin, gastric acid and bile which excite the esophagus and lead to erosion, inflammation or even ulceration of its mucosa. About 15 % of the healthy people present minor symptoms like those described above each day; in what concerns those who experience such symptoms at least once a month, they represent more than a half of the population. In most of the cases, however, people get used to these symptoms and they start to ignore them. Although is seems quite a mild disease, Erosive Esophagitis can result in the patient’s death. If the symptoms worsen quickly, they can lead to anxiety and severe pain. If the patient is not treated fast and properly, he can experience death. The number of those who suffer from this disease is equal among women and men and there was noticed to predilection for a specific race.

Erosive Esophagitis – Symptoms

The most common signs and symptoms which were reported in the case of Erosive Esophagitis are: burning feelings in the chest when the acid from the stomach gets in touch with the inflamed mucosa, bitter taste (caused by the reflux of the gastric nutriments back to the esophagus), nausea, abdominal discomfort, fullness, bloating, cough, wheezing, and hoarseness. These symptoms can worsen if the patient is wearing tight clothes, if he bends over or if he usually eats large meals frequently. Another problem which can appear is the chest pain, usually associated with diaphoresis and shortness of breath. However, the chest pain can be associated with a lot of other diseases. In the case of young children who suffer from this disease, the symptoms are even more severe and they can include one or more of the following: backache, apnea, regurgitation, weight loss or respiratory problems. Even though the doctor you consult will perform a physical examination, this will not help him too much; he should, however, choose a rectal examination in order to determine the presence of excessive bleeding. There are some conditions which can increase the risk of developing Erosive Esophagitis: obesity, smoking, pregnancy, alcohol, coffee, spicy foods abuse, scleroderma, the administration or certain drugs (nitrates, beta-blockers), mental retardation, radiotherapy or some severe injuries of the spinal cord. Another aspect which should be considered is the excessive administration of chemical substances which irritate the esophageal mucosa: steroids, iron supplements, aspirin and potassium supplements. These drugs can be even more dangerous if they are taken with a small quantity of fluid. 

Erosive Esophagitis – Treatment

If you notice one of more of the symptoms presented above, you should seek for medical care as soon as possible. Even though your doctor will recommend you some laboratory tests, these will not help him to determine a sure diagnosis. A routine radiography is indicated only if the patient is suspect of developing severe complications, such as obstruction, perforation or bleeding; on the other hand, an esophageal study can provide information about possible tumors or other complications. An endoscopy can give information about the intensity of the damage of the esophageal mucosa; this procedure is highly indicated in the case of old sufferers or those who present one or more of the following symptoms: anemia, abdominal mass and vomiting. In what concerns the pre-hospital care for Erosive Esophagitis, the doctors can not recommend anything. The first purpose of the treatment is to reduce or even eliminate the complications and such procedures need immediate hospitalization and stabilization of the patient. In addition, the first intervention also focuses on the management of the chest pain.

The treatment of Erosive Esophagitis should not be performed in an emergency department, unless the patient experiences severe complications such as excessive bleeding, perforation, obstruction or dehydration. In this case, a surgery is absolutely necessary, especially if the patient does not respond to any other type of medical care. If the patient presents mild symptoms, he should first visit a gastroenterologist. After the condition of those who suffer from Erosive Esophagitis is stabilized, they will need to remain in the hospital for at least 2 or 3 days and then they will need follow-up care. They have to be permanently monitored by a specialist in order to observe the reaction to the drugs administrated and any minor problems which can appear. During the treatment for Erosive Esophagitis some complications can appear. The most common ones include: bleeding, perforation, Barrett esophagus, laryngitis, inability to swallow followed by weight loss, pneumonitis or bronchospasm.  

In most of the cases of those who suffer from this disease, the recurrence is a serious problem; this is the main reason why the sufferers need to maintain the therapy for a long period of time and they have to take some tests periodically. In order to reduce the risk of suffering from Erosive Esophagitis, the possible patients should be aware of some simple rules which they can follow: they should try to exercise, to move or at least to stand upright for at least an hour after they eat, they should reduce the size of their meals as well as the frequency of the meals, they should try to lose weight (if necessary), they should avoid fatty foods, chocolate, spicy foods and citrus, they should reduce the drugs they are taken (especially aspirin), they should try to quit smoking and keep of caffeine and alcohol. Another important thing the possible patients should change is their position while sleeping; they should renounce at the extra pillows. This way, they will reduce the abdominal pressure and the possibility of a gastric reflux.