Sandbox esophagitis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment of esophagitis should be directed against the specific etiology. Reflux esophagitis
Medical Therapy
Treatment depends on the specific cause. Reflux disease may require medications to reduce acid. Infections will require antibiotics.
- Medications that block acid production, like heartburn drugs.
- Antibiotics, antifungals, or antivirals to treat an infection.
- Pain medications that can be gargled or swallowed.
- Corticosteroid medication to reduce inflammation.
- Intravenous (by vein) nutrition to allow the esophagus to heal and to reduce the likelihood of malnourishment or dehydration.
- Endoscopy to remove any lodged pill fragments.
- Surgery to remove the damaged part of the esophagus.
While being treated for esophagitis, there are certain steps you can take to help limit discomfort.
- Avoid spicy foods such as those with pepper, chili powder, curry, and nutmeg.
- Avoid hard foods such as nuts, crackers, and raw vegetables.
- Avoid acidic foods and beverages such as tomatoes, oranges, grapefruits and their juices. Instead, try imitation fruit drinks with vitamin C.
- Add more soft foods such as applesauce, cooked cereals, mashed potatoes, custards, puddings, and high protein shakes to your diet.
- Take small bites and chew food thoroughly.
- If swallowing becomes increasingly difficult, try tilting your head upward so the food flows to the back of the throat before swallowing.
- Drink liquids through a straw to make swallowing easier.
- Avoid alcohol and tobacco.
Esophagitis of Infectious Etiology
Eosinophilic Esophagitis
The optimal treatment of eosinophilic esophagitis remains uncertain. Evaluation by an allergist for coexisting atopic disorders and food and environmental allergens is advisable. Allergen elimination typically leads to improvement in dysphagia and reduction of eosinophil infiltration in the majority of cases. Corticosteroids such as budesonide suspension or fluticasone inhalation may be considered in adult patients. Graduated dilation of esophageal strictures should be performed cautiously in patients with dysphagia and strictures to minimize the risk of iatrogenic perforation.
Contraindicated medications
Reflux esophagitis is considered an absolute contraindication to the use of the following medications: