Esophagitis : Most Common Infectious Cause is Candida Albicans

By | July 11, 2013
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Esophagitis is a generalized terms and usually refers to either infection or inflammation of Esophagus. The most common infectious cause of esophagitis is dues to infection from Candida Albicans. This fungal infection is most of the time seen in two types of patients:

HIV Positive : Patients who are HIV positive and their CD4 count is below 200/cubic mm
Diabetes Patients: Patients suffering from diabetes mellitus are prone if get infected from candida albicans.

Other causes of infectious esophagitis which are rarer in existence are

  • Cytomegalovirus (CMV) infection
  • Herpes Simplex Infections
  • Aphthous ulcers

Inflammation of esophagus resulting in esophagitis can also be caused by some medications and ingestion of caustic substance. “Pill esophagitis” is a term usually used when esophagitis occurs due to ingestion of some medications. The medication sticks to the surface of esophagus and thus causing local inflammation.

The pills that usually cause esophagitis are:

  • Alendronate
  • Quinine
  • Iron Sulfate
  • Vitamin C
  • Doxycycline

Pills taken for Acne are one of the most common cause of medication associated  esophagitis. So if a young patient comes with chief complaint of pain while swallowing (odynophagia) on pills for acne, pill esophagitis might be the reason for his discomfort.

Signs & Symptoms of Esophagitis

Most common symptom of esophagitis is pain while swallowing food also called as odynophagia. The pain usually occurs while swallowing food and is caused by mechanical rubbing of food on the walls of infected or inflamed esophagus. The pain of esophagitis can be differentiated from the pain in diffuse esophageal spasm from the fact that, in esophagitis pain occurs only while ingesting food unlike diffuse esophageal spasm where pain can occur anytime and intermittently. As the disease progresses in rare situation, obstruction of food might also occur along with pain while swallowing.

Diagnosis & Treatment of Esophagitis

If a person is known HIV positive patient and has chief complaint of pain while swallowing food, there is no need to diagnose the condition and  fluconazole therapy can be started. If the response is good, the diagnosis is confirmed for Candida Albicans esophagitis. If the patient does not respond to the treatment, then endoscopy is performed.

If esophagitis is suspected due to medication or ingestion of caustic substance, medication history is important. Pill esophagitis can easily be treated by proper counselling of the patient, asking him/her to take medication in upright position and drinking lots of water to flush the pill into the stomach.

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