Esophagitis

Esophagitis
Classification and external resources
Micrograph of herpes esophagitis. H&E stain.
ICD-10	K20
ICD-9	530.10
MeSH	D004941

Esophagitis (or oesophagitis) is inflammation of the esophagus. It may be acute or chronic. The acute esophagitis can be catarrhal or phlegmonous, whereas the chronic esophagitis may be hypertrophic or atrophic.

Causes

Infectious

Forms of infectious esophagitis are typically seen in immunocompromised people. Types include:

• candida (Esophageal candidiasis)
• Viral
  • herpes simplex (herpes esophagitis)
  • cytomegalovirus

Endoscopy can be used to distinguish among these conditions.^[1]

Other

• The most common cause is gastroesophageal reflux disease (GERD, or GORD in British English). If caused by GERD, the disease is also called reflux esophagitis.
• Chemical injury by alkaline or acid solutions may also cause esophagitis, and is usually seen in children, as well as in adults who attempt suicide by ingestion of caustic substances^[2]
• Physical injury resulting from radiation therapy or by nasogastric tubes may also be responsible.
• Hyperacidity.
• Alcohol abuse.
• Eosinophilic esophagitis is a little understood form of esophagitis, which is thought to be related to food allergies.

Grading of severity

The severity of esophagitis is commonly classified into four grades according to the Los Angeles Classification:^[3][4]

Grade A	One or more mucosal breaks < 5 mm in maximal length
Grade B	One or more mucosal breaks > 5mm, but without continuity across mucosal folds
Grade C	Mucosal breaks continuous between > 2 mucosal folds, but involving less than 75% of the esophageal circumference
Grade D	Mucosal breaks involving more than 75% of esophageal circumference

References

1. ^ Meinhard Classen; Guido N. J. Tytgat; M.D. Ph.D.; Charles J. Lightdale (2010). Gastroenterological Endoscopy. Thieme. pp. 490–. ISBN 9783131258526. http://books.google.com/books?id=Tb2Bnn_icI0C&pg=PA490. Retrieved 26 June 2010. 
2. ^ Lawrence M. Tierney, Jr., MD; Stephen J. McPhee, MD; Maxine A. Papadakis, MD. (2007). Current Medical Diagnosis & Treatment 2007 (46 ed.). The McGraw-Hill Companies. ISBN 0071472479. 
3. ^ webgerd.com > Los Angeles Classification of Esophagitis By M. Farivar; In turn citing: Lund ell L, Dent J, Bennett J, et al. Endoscopic assessment of esophagitis: clinical and functional correlates and further validation of Los Angeles classification. Gut 1999; 45:172-80
4. ^ Laparoscopic bariatric surgery , Volyme 1. William B. Inabnet, Eric J. DeMaria, Sayeed Ikramuddin. ISBN 0-7817-4874-7.