Fast Five Quiz: Esophagitis

B.S. Anand, MD


July 14, 2020

Laboratory tests are usually unhelpful in patients with esophagitis unless complications are present (eg, upper gastrointestinal hemorrhage). Routine radiography is not indicated unless complications (eg, perforation, obstruction, bleeding) are suspected. Electrocardiography and measurement of troponin or other cardiac markers are needed when acute coronary syndrome is in the differential diagnosis.

A double-contrast esophageal barium study (esophagography) is recommended as the initial imaging study in patients presenting with dysphagia. However, a case can be made for initial upper endoscopy (esophagogastroduodenoscopy), because this approach reveals more diagnostic information (eg, inflammatory characteristics, ability to obtain samples for pathologic examination, cytologic examination, and viral and bacterial cultures). Blind brush cytology has been used in the past; however, with the availability of esophagogastroduodenoscopy, its use has diminished.

Barium studies are not routinely recommended for patients with absolute dysphagia or odynophagia. Upper endoscopy is indicated under these circumstances.

Read more about the workup of esophagitis.


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