OESOPHAGITIS

It is one of the complications of gastro oesophageal reflux disease. The inflammation of oesophagus is called as oesophagatis.

It is mainly reflux oesophagitis.

Causes of oesophagitis

Infection – oesophageal candidiasis occurs in debilitated patients and those taking broad spectrum antibiotics and cytotoxic drugs. It is a particular problem in AIDS patient.

Corrosives – Suicide attempt by strong household bleach or battery acids is followed by painful burns of mouth and pharynx and by extensive erosive oseophagitis.

Drugs – Potassium supplements and NSAIDS may cause oesophageal ulcer, when the tablets are trapped above on oesophageal stricture.

Pathology –

In this lower end of oesophagus is affected. There is loss of epithelium due to injury and is replaced by bleeding granulation tissue. Due to inflammation there is vagal hyperactivity and so there is spasm of longitudinal muscle which draws the cardia more and more in thorax and so there is increased hyperactivity and so there is the vicious cycle.

                                                         oesophagitis

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                                               longitudinal muscle spasm

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                                          upward displacement of cardia

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                                                     Acid regurgitation

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.                                                        oesophagitis

                                               

Clinical features –

1) Pain – Retrosternal pain which may radiates between the shoulder blades and then to the arm or up to ear. This pain occurs when the patient lies down and better by sitting upright.

2) Heart burn with regurgitation.

3) Dysphagia – It is constant and increases as stenosis develops. Sometimes patient presents with secondary anaemia.

Investigations –

1) Stool examination –

Occult blood in stool is found called as melaena.

2) Barrium swallow –

It will reveal the cause i.e. sliding hiatus hernia. It will also show stenosis.

3) Oesophagoscopy –

Velvety red oesophagus which bleeds easily.

Treatment –

Antacids are given for control of the hyperacidity and also treat the cause.

Complication –

- Stricture of oesophagus

- Carcinoma of oesophagus.

HOMEOPATHIC MEDICINES

Arsenicum Album

Has characteristic burning pains, these pains are like burning coal of fire is associated with diarrhea. The stools are indigested slimy and bloody. The exciting causes are sudden chilling of the stomach with ice water or ice-cream. The inflammation in the Arsenic stomach is aggravated by milk.

Phosphorous

Pain in the stomach, better by cold drinks. Regurgitates ingesta by mouthful. Empty all gone sensation in stomach. The vomited matter is sour and mixed with clear mucus. Flatulent colic worse by hot drinks. Sharp cutting pain in abdomen.

Argenticum Nitricum

Will give history of pain developing immediately after meal, particularly after excessive drinking of beer. Those patients have strong desire for cold, ice-cold sweetened drinks.

Carbo Vegitabilis

Patient develop definite epigastric pains burning that come on after sometime after partaking of faced and develop colicky attacks. There is great discomfort and distension of stomach.

Iris versicolor

Burning in throat, profuse flow of saliva, ropy saliva. Tongue burns or feels cold. Greasy and sweetish taste. Burning of whole alimentary canal. Vomiting is bloody bilious. Constant nausea. Vomiting of bitter, sweetish and acrid water. Vomiting of sour milk in children.

Laurocerasus

Spasmodic contractions of throat and oesophagus with dysphagia, dull pain in throat, extending to the right scapula, burning pain in throat, with the accumulation of tenacious mucus.

Pulsatilla Nigricans Nigricans

Is thirstless in almost all complaints and is aggravated by rich food, fats, pork, pastries, dessests and ice-cream.

Ptelea

There is chronic state of the stomach and is aggravated by lying on left side. On awaking there is hunger and headache.

Natrum Carbonicum

Has weak digestion and it get aggravated with slightest errors of diet. Gastric pain are better by eating, fats aggravate.

Nux Vomica

Has habit of taking stimulants, rich food and late hours of eating therefore develops irritable digestive system.

Natrum Phosphoricum

Has complaints with excess of acidity, desire strong tasting things eggs, fried fish, beer, which ameliorates. Aversion to bread and butter.

Lycopodium Clavatum

Complains of sour stomach and suffer from water brash, acute acidity and recurring attacks of hiccups cold food aggravates.