Eosinophilic Esophagitis Research Paper

This condition is characterized by symptoms and complications that result from reflux or back of gastric content into the esophagus that extent also into the oral cavity or even the lungs. Common signs and symptoms of this condition include heartburn( burning/stinging), and does note that radiates to the back such as in the case of Peptic Ulcer Disease (PUD). Furthermore, other symptoms patients may experience are a chronic cough, bronchospasm, chest pain not related to a cardiomyopathy, hoarseness, early satiety, abdominal fullness, bloating with belching. Complications related to this disorder are closely linked to esophageal ulceration, hematemesis, melena, stricture development(Dains, Baumann, & Scheibel,

patient tested positive for H. pylori and wakes up at night due to cramping pain with bloating, so it is assumed to be peptic ulcer and the status of his condition is uncontrolled. Her symptoms were not improved with over the counter medication, Tums. Therefore, it is not GRED. However, Patient does not need a referral for endoscopy this time around because she does not hat the symptoms vomiting, nausea or dizziness.

Eosinophilic Esophagitis also known as EOE, Is a rare disease that is becoming more commonly found in children. Eosinophilic Esophagitis is a disease in which a large number of white blood cells called eosinophils are in the esophagus tissue. EOE is a very rare, yet very serious disease. It is considered a chronic condition. EOE is more commonly found in children and some adults. EOE is also known to affect Caucasians more than any other race, and also known to affect males more than females.

A relatively new diagnosis in the medical field is Eosinophilc Esophagitis. This disease has emerged all around the world and became a more common diagnosis beginning in the 2000’s. According to doctors at the Cincinnati Children’s Hospital Medical Center, 1-4 in 10,000 people live with this disease (Cincinnati, 2012, p. 1). Food allergies often accompany this disease, which may be why it is becoming better known. The pathophysiology behind Eosinophilic Esophagitis is extensive, and includes the parts of the body that are effected, normal function, symptoms and cause of symptoms, diagnosis, physiology, and treatment.

Ehlers-Danlos patients often have a high degree of gastrointestinal problems such as GERD (gastroesophageal reflux disease), IBS (Irritable bowel syndrome), Motility problems, hernias and intestinal obstructions. Although these issues are not usually life threatening they can be resistant to many treatment methods which in turn can affect the person’s quality of life [4,5].

• If you have no dysplasia or low-grade dysplasia, your health care provider may recommend no treatment or only taking medicines to treat GERD. Sometimes, taking acid-blocking drugs to treat GERD helps improve the tissue affected by Barrett esophagus. Your health care provider may also recommend periodic esophageal exams.

Eosinophilic esophagitis (EoE) generally has a male preponderance and is more common in adults [12,13]. The clinical presentation varies by age: younger children are more likely to present with nonspecific gastrointestinal symptoms, older children and adults more commonly present with food impaction and dysphagia with a history of allergy (including atopic disease) [12]. While the etiology remains unknown, the association with hypersensitivity makes allergy the most likely possibility [12,13]. The distinction of EoE from GERD is challenging and requires an integrative clinical and pathologic correlation. The endoscopic concentric rings and linear furrowing of the distal esophagus in this case suggests a diagnosis of EoE, but these findings are not specific and do not help differentiate EoE from GERD [12]. The diagnosis of EoE essentially requires the presence of an esophageal eosinophilic infiltrate on biopsy, normal pH monitoring, and persistence even with PPI therapy [12,13]. In the eight months of documented follow-up, however, there has been no documented pH monitoring and no additional notes since starting PPI therapy. Therefore, no distinction between the two entities can be made. The presence of a large trichobezoar occupying her entire stomach, however, would likely result in consumed food and beverage being propelled retrograde with peristaltic action. Thus, the case likely

Inhaled allergens, such as pollen, can also cause this form of esophagitis. Reflux esophagitis is usually due to a condition known as gastroesophageal reflux disease (GERD). GERD is when the stomach contents, including acids, frequently back up into the esophagus. This causes chronic inflammation and irritation of the esophagus. Drug-induced esophagitis can occur when you take certain medications with insufficient water. This causes them to linger in the esophagus too long. Medications may include pain relievers, antibiotics, potassium chloride, and bisphosphonates (drugs that prevent bone loss). Infectious esophagitis is rare and can be due to bacteria, viruses, fungi, or parasites. You are at increased risk for this type of esophagitis if you have a weakened immune system due to disease and/or medications. This type of inflammation is common in people with HIV or AIDS, cancer, and diabetes.

Gastroesophageal reflux disease is a digestive disorder in which the stomach contents back into the esophagus” (MedlinePlus, n.d.). It affects the muscle between the stomach and esophagus. It’s also known as GERD or reflux.

Patients who experience “frequent heartburn or acid regurgitation are considered to have gastroesophageal reflux disease (GERD), unless proven otherwise”. (Tindall, Sedrak, & Boltri, 2014, p. 181). The stomach acid or reflux causes irritation to the esophagus, which leads to GERD. (Mayo Foundation for Medical Education and Research, 2014, para. 1). Frequent signs and symptoms of GERD include difficulty swallowing, chest pain that radiates to the back, heartburn, sour taste in mouth, hoarseness or sore throat, sensation of a lump in your throat, or a dry cough. (Mayo Foundation for Medical Education and Research, 2014, para. 1). GERD can be worse or aggravated by meals and by lying down. (Tindall et al., 2014, p. 181).

Among the most common symptoms of gastrointestinal reflux, heartburn comes to the fore, because it is a sharp pain that quickly radiates from the epigastrium to the throat, then rolling in different body parts such as the legs and arms. Many patients suffer from these symptoms that are often intermittent and develop within one hour after the lunch was served. Regurgitation and vomiting are also been recorded in many cases. Other symptoms may also be part of gastrointestinal reflux, such as dysphagia, cough reflex, and respiratory disease. The severity of injuries caused by gastrointestinal reflux is determined primarily by the disease process, when the patients have been subject to repeated attacks.

Symptoms must be chronic, occurring at least weekly and over a period of at least 6 months, in the absence of an organic explanation(nejm). The rome III criteria has divided functional dyspepsia into two subgroups: postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Patients with PDS typically report postprandial fullness and early satiation. Whereas those with EPS are more likely to experience epigastric pain and burning differently (nature). Functional dyspepsia may be confused with other gastrointestinal conditions outside the gastroduodenal region including other functional disorders such as GERD or Irritable bowel syndrome but there are some symptoms which helps the physician to discriminate between these diseases (nejm). Patients who report alarm symptoms should be referred urgently for upper GI endoscopy. For patients with simple dyspepsia who do not have alarm symptoms the requirement for any further diagnostic test depends on the background prevalence of helicobacter pylori infection

Dysphagia is the sensation of food being hindered during the passage from the mouth through the esophagus into the stomach (1), and is considered a serious red flag or alarm symptom (2, 3). There are many causes of dysphagia classified into oropharyngeal or esophageal etiologies (4-6). Oropharyngeal dysphagia may arise from neurologic diseases including stroke, Parkinson’s disease, or amyotrophic lateral sclerosis, or a Zenker’s diverticula (4). Causes of esophageal dysphagia (5) include esophageal dysmotility (e.g. achalasia, diffuse esophageal spasm, nutcracker esophagus, or scleroderma), inflammation (e.g. eosinophilic esophagitis, radiation esophagitis), and structural abnormalities (e.g. malignancy, peptic strictures, esophageal rings,

In 1961, Ureles, Alschibaja, Lodico, & Stabins (1961) classified EGE’s depending on presentation for the first time, class I a diffuse EGE and class II a EGE with well-defined edges. In 1970, Klein, Hargrove, Sleisenger, & Jeffries (1970) classified EGE by the anatomical location of the eosinophilic infiltration within the three layers of the intestinal tract: the mucosal, muscularis and subserosal layers. In 1990, Talley, Shorter, Phillips, & Zinsmeister (1990) proposed three diagnostic criteria: presence of gastrointestinal symptoms, biopsies showing eosinophilic infiltration of the gastrointestinal tract in one or more areas, and characteristic radiological findings of eosinophilia with no evidence of parasites or intestinal disease. In 1993, a longitudinal study on eight adult patients was published which provided information on the relapsing nature of EGE as 50% of the individuals in the study needed continuous low does steroid therapy to stay in remission (Lee, Changchien, Chen, Lin, Sheen, Wang, . . . Wu,

First the study was done on healthy volunteers which are themselves capsule endoscopists. Subsequently study was done of patients with suspected esophageal disease to compare the feasibility, efficacy, quality and patient discomfort between the two methods. Feasibility and the quality of the test has been compares in al the four main diagnostic indications of EGD and this has been shown the table format as well as compared with the pictures.