Fast Five Quiz: Esophagitis

B.S. Anand, MD

Disclosures

July 14, 2020

The most common complaint in patients with esophagitis is heartburn (dyspepsia), a burning sensation in the mid-chest caused by contact of stomach acid with the esophageal mucosa. Symptoms often are maximal while the person is supine, bending over, or wearing tight clothing or after the person has eaten a large meal. The patient may complain of water brash, a bitter taste of refluxed gastric contents often associated with heartburn.

The American College of Gastroenterology (ACG) published updated guidelines for the diagnosis and treatment of GERD in 2013. According to the ACG guidelines, regurgitation and heartburn, separately or in conjunction, are the symptoms most specific for GERD. Other common symptoms of esophagitis include upper abdominal discomfort, nausea, bloating, and fullness. Less common symptoms of esophagitis include dysphagia, odynophagia, cough, hoarseness, wheezing, and hematemesis. Patients may experience chest pain indistinguishable from that of coronary artery disease. Pain is often mid-sternal, with radiation to the neck or arm, and may be associated with shortness of breath and diaphoresis. Chest pain may be relieved with nitrates if esophageal spasm is involved, further confounding the diagnostic evaluation.

Read more about the presentation of GERD.

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