What is Oesophagitis

Oesophagitis is often caused by ingestion of chemical irritants, burns caused by overheated food, gastroesophageal reflux secondary to anesthetic, persistent vomiting, and retention of highly acidic medications such as doxycycline.

Clinical signs of oesophagitis are similar to other oesophageal diseases, including dysphagia, regurgitation, odynophagia, repeated swallowing, and excessive salivation. With mild oesophagitis, signs may be absent. Vomiting and regurgitation can be observed concurrently when oesophagitis is associated with a hiatal hernia or secondary to persistent vomiting. When oesophagitis occurs secondary to anesthesia, signs usually begin two to 14 days post-anesthesia. Concomitant stomatitis and oral ulcerations may suggest ingestion of a caustic chemical as the cause.

Endoscopy is the most sensitive method for detecting oesophagitis. Findings include mucosal erythema, hemorrhage, increased friability, erosions or ulcers.

Mild oesophagitis may resolve on its own without therapy, however An intramural oesophageal stricture results when severe oesophagitis involving the submucosa and muscularis heals by fibrosis. Strictures can be single or multiple. Although esophageal stricture can occur after any severe mucosal injury, it is most commonly a complication of reflux oesophagitis after anesthesia and oesophageal foreign bodies. Strictures may also occur after oesophageal surgery, ingestion of caustic substances (including medications such as doxycycline), vomiting of large hairballs, and secondary reflux oesophagitis associated with a hiatal hernia. Clinical signs of oesophageal stricture usually include progressively worsening dysphagia of solid foods, regurgitation immediately after eating, and weight loss in spite of a ravenous appetite. Clinical signs from a stricture usually occur within five to 14 days after onset of oesophageal injury.

Oesophageal stricture can be diagnosed by either barium contrast radiography or endoscopy.

Conservative management of oesophageal strictures by endoscopically guided balloon dilation is effective in most cases. Mechanical dilation of the stricture is performed under general anesthesia with endoscopic visualization. Balloon catheters with a balloon size (when inflated) of 10 or 15 mm in diameter and 6 to 8 cm in length are used. The procedure is repeated at 3 - 5 day intervals for a minimum of three treatments. Serious complications (perforation, hemorrhage) are rare. In some cases this management fails and the strictures re-occur.