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Oesophagitis
Inflammation of the oesophagus is usually due to reflux of acid from the stomach. The squamous epithelium is not resistant to low pH and inflammation develops. Other factors which can results in oesophagitis include alcohol, bile and drugs, particularly if their passage is slowed by a stricture. Infection may affect the oesophagus, the commonest being due to herpes simplex and Candida. This latter is commoner in immunosuppressed patients due to drug therapy such as steroids, or AIDS. Predisposing factors include pregnancy, obesity and smoking.
Clinical features:
Symptoms: Heart burn, a dull retrosternal ache, is the commonest symptom and is often triggered by food, sometimes particular factors such as coffee or alcohol. This symptom may be indistinguishable from angina pectoris. Less common symptoms include dysphagia or lethargy due to anaemia.
Signs: pallor due to anaemia caused by occult bleeding, haematemesis may complicate ulcerative oesophagitis. Severe reflux may be associated with aspiration accompanied by coarse crepitations at the lung bases.
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