How to Diagnose Esophagitis

Esophagitis is any inflammation of the esophagus. It is usually caused by gastroesophageal reflux disease but may also result from infection, medication, radiotherapy, disease and trauma. Infective esophagitis is common in immunosuppressed patients; fungal esophagitis may be caused by illnesses that disrupt esophageal peristalsis, such as achlasia, esophageal neoplasia and systemic sclerosis. Medication can cause esophagitis by suppressing immune functions or by local injury. Here's how to diagnose esophagitis.

Instructions

1. Observe the presenting symptoms of esophagitis. These usually consist of difficulty and pain in swallowing with malnutrition in severe cases. Life-threatening bleeding also can occur in rare cases.

2. Obtain the patient history. Recent antibiotic use, immunosuppressive therapy, steroid therapy and systemic disease all support a diagnosis of esophagitis.

3. Conduct a physical examination to find symptoms of advanced esophagitis. These may include abdominal and epigastric pain, heartburn, nausea, retrosternal discomfort and pain. Vomiting of blood also may occur.

4. Perform laboratory tests when esophagitis is suspected. Laboratory studies are normally limited to a complete blood cell and CD4 count in immunosuppressed patients to determine the extent of the immunosuppression.

5. Run barium studies as the first imaging test if the pain and difficulty of swallowing are not too severe.

6. Use an upper endoscopy as the primary diagnostic tool in cases of severely painful swallowing because this is a specific symptom of esophagitis. An endoscopy provides more diagnostic information than a barium study and is more accurate for mucosal detail.