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Shakiba Hassanzadeh, MD[1]

Overview

Esophagitis is a disease characterized by inflammation of the esophagus.[2]

Historical Perspective

Classification

  • Esophagitis may be classified into 6 subtypes/groups:
    • Reflux esophagitis

For decades it has been assumed that inflammation from acid reflux was caused by the irritation of acid itself. A recent study, however, points toward a cause and effect relationship that is less clear, and demonstrated that inflammation may not be caused by acid reflux, but that both reflux and inflammation could be caused by an underlying third factor. It is a common misconception that reflux has been proven to cause inflammation in the esophagus.

    • Infectious esophagitis

Esophagitis that happens due to a viral, fungal, parasitic or bacterial infection. More likely to happen to people who have an immunodeficiency. Types include:

      • Fungal
      • Viral
        • Herpes simplex (Herpes esophagitis)
        • Cytomegalovirus
    • Drug-induced esophagitis

Damage to the esophagus due to medications. If the esophagus is not coated or if the medicine is not taken with enough liquid, it can damage the tissues.

    • Eosinophilic esophagitis

Eosinophilic esophagitis is caused by a high concentration of eosinophils in the esophagus. The presence of eosinophils in the esophagus may be due to an allergen, and is often correlated with GERD. The direction of cause and effect between inflammation and acid reflux is poorly established, with recent studies (in 2016) hinting that reflux does not cause inflammation. This esophagitis can be triggered by allergies to food or to inhaled allergens. This type is still poorly understood.

    • Lymphocytic esophagitis
    • Caustic esophagitis

Pathophysiology