Esophageal mucosal edema and congestion

Introduction Esophageal mucosal edema congestion is caused by esophagitis. Esophagitis is an inflammation caused by edema and congestion of the esophageal mucosa due to abnormal stimulation of the superficial or deep tissue of the esophageal mucosa. These stimuli include stomach acid, bile, vomiting, bile, spirits, peppers, too hot soup, too hot tea, and so on. Can be divided into primary and secondary esophagitis. There are many reasons for inflammation of the esophagus; for example, after severe vomiting, long-term placement of nasogastric tubes or taking aspirin, strong acid and alkali, non-steroidal anti-inflammatory drugs or patients receiving chemotherapy or radiation therapy or the patient's own resistance Decreased and infected with tuberculosis or Candida or virus causes esophagitis.

Cause

(1) Lower sphincter function of the lower esophagus: There is a high pressure area in the lower esophageal forebrain in normal people to prevent the reflux of stomach contents to the esophagus. There are many reasons for the weakening of the lower esophageal sphincter function, including hiatal hernia, which can easily cause the stomach and intestinal contents to flow back into the esophagus, which is the main cause of inflammatory lesions in the esophagus.

(2) increased abdominal pressure: such as a large amount of ascites, pregnancy, resulting in increased abdominal pressure, easy to form reflux.

(3) Esophageal motility disorder: Under normal circumstances, when the contents of the stomach flow back into the esophagus, the secondary peristaltic waves of the esophagus are caused by the tension, and the reflux is returned to the stomach. Esophagitis can slow the esophageal peristalsis, prolong the residence time of the reflux in the esophagus, aggravate the original esophagitis, and esophagitis weakens the function of the lower esophageal sphincter, aggravates reflux, and forms a vicious circle.

(4) swallowing hot food, sharp foreign bodies or chewed bones, ingesting corrosive agents and other direct damage to the esophageal mucosa causing inflammation. When veterinarians use a gastric catheter to inject drugs into dogs and cats, the gastric catheter is used violently, which often damages the esophageal mucosa.

an examination

Related inspection

White blood cell count esophagography

an examination

1. Loss of appetite at the beginning of the disease, followed by difficulty swallowing, salivation and vomiting, often occurs after food refusal or swallowing. In dogs with acute esophagitis, the dog snoring due to countercurrent flow of gastric juice, and the mouth of the mouth adheres to the mucus. The palpation of the esophagus was a chord-like swelling.

2. Esophageal barium meal imaging. The mucosal surface of the esophagus is not smooth and has a banded shadow.

3. Esophageal endoscopy can directly check the inflammatory state of the esophageal mucosa.

Clinical manifestation

The symptoms of esophagitis are mainly pain, difficulty, heartburn and post-sternal pain. When the esophagitis is severe, it can cause esophageal fistula and esophageal stricture. When the lower end of the esophagus is caused by inflammation and mucosal degeneration and then the columnar epithelial cells of the stomach grow out, it is called the Barlow's esophagus. This is the predecessor of esophageal cancer and must be tracked for a long time. Generally, bleeding from esophagitis is mild, but it may also cause vomiting or dissolving asphalt.

Under normal circumstances, stomach acid will not flow back to the esophagus. There is a high pressure area in the lower half of the esophagus, which blocks gastric acid from flowing back to the esophagus. If the door is loosened, the pressure in the high pressure area will drop or even disappear. The stomach acid and bile will be Will reflux to the esophagus, strong stimulation of the esophageal mucosa, causing esophagitis. Lying flat after a meal, eating too much, too much to eat sweet food or greasy food will cause the stomach to reflux to the esophagus.

When you feel "burning heart", or "heartache", drinking hot water or eating irritating food, the pain in the back of the sternum is obvious, and it is a symptom of esophagitis. There is also a whimper when swallowing food, which is caused by edema of the esophagus, narrowing of the esophagus, or spastic contraction of the esophageal wall due to inflammation. Esophagitis should be diagnosed and treated promptly, otherwise it will worsen and cause esophageal mucosal ulcers, and hematemesis or blood in the stool.

Differential diagnosis

Differential diagnosis:

Suppurative esophagitis

Suppurative esophagitis is the most common mechanical damage caused by foreign bodies. Bacteria multiply in the esophageal wall, causing local inflammatory exudation, varying degrees of tissue necrosis and pus formation, and may also be a wide range of cellulitis.

2. Esophageal tube

Patients with esophageal tuberculosis generally have pioneering symptoms of tuberculosis in other organs, especially tuberculosis. The symptoms of the esophagus itself are often confused or concealed by other organ symptoms, so that they cannot be discovered in time. According to the pathological process of tuberculosis, the early stage of infiltration may have symptoms of fatigue such as fatigue, hypothermia, and increased erythrocyte sedimentation rate, but there are also symptoms that are not obvious. Following swallowing discomfort and progressive dysphagia, often accompanied by persistent throat and retrosternal pain, increased when swallowed. Ulcer-type lesions are often characterized by pain during swallowing. Food spillage into the trachea should take into account the formation of tracheoesophageal fistula. Dysphagia suggests that lesion fibrosis causes scarring.

3. Fungal esophagitis

The clinical symptoms of fungal esophagitis are mostly atypical, and some patients may have no clinical symptoms. Common symptoms are swallowing pain, difficulty swallowing, upper abdominal discomfort, post-sternal pain, and burning sensation. In the severe sternum, there is a knife-like colic, which can radiate to the back like angina. Candida esophagitis can cause severe bleeding but is not common. Untreated patients may have epithelial shedding, perforation, or even disseminated candidiasis. Perforation of the esophagus can cause mediastinal inflammation, esophageal fistula, and esophageal stricture. Patients with persistent high fever neutropenia should be examined for the presence of disseminated acute candidiasis such as skin, liver, spleen and lung.

4. Viral esophagitis

HSV infection of the esophagus often has nasal and herpes. The main symptom is swallowing pain. Pain often worsens when ingesting food, and the patient descends slowly in the esophagus after swallowing. A small number of patients with dysphagia as the main symptom, mild infection can be asymptomatic.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.