Causes of chronic esophagitis

The following etiological groups of chronic esophagitis are distinguished (VM Nechaev, 1995).

[1], [2], [3], [4], [5], [6], [7], [8]

Alimentary chronic esophagitis

Occur due to constant traumatization of the mucous membrane of the esophagus hot, acute, too cold, rough food, as well as alcohol abuse.

[9], [10], [11], [12], [13]

Professional chronic esophagitis

Develop due to the constant effect on the mucous membrane of the esophagus of harmful production factors (vapors of concentrated acids, alkalis, salts of heavy metals, etc.).

Congestive chronic esophagitis

Due to the constant and prolonged stagnation and decomposition of food in the esophagus. This is observed with diverticula, benign and malignant stenosis of the esophagus and achalasia of the cardia.

[14], [15], [16], [17], [18]

Allergic chronic esophagitis

Due to the changed reactivity of the body, especially in children, and develop with food allergies, sometimes bronchial asthma, cardiac achalasia, esophageal diverticula.

[19], [20], [21], [22]

Dysmetabolic chronic esophagitis

Occur during polyhypovitaminosis; deficiency of iron in the body (sideropenic dysphagia or Plummer-Vinson syndrome); tissue hypoxia of any genesis (congestive heart failure, chronic respiratory failure); extensive skin burns (Batga-Vinson syndrome); at a portal hypertension (in connection with disturbance of a trophism of a mucosa of an esophagus).

[23], [24], [25], [26], [27]

Peptic chronic esophagitis or reflux esophagitis

Develop due to the constant casting into the esophagus of gastric or duodenal contents .

Special forms of esophagitis

This group includes "idiopathic ulcerative esophagitis" (it has some common morphological features with ulcerative colitis) and nonspecific regional stenosing esophagitis.

Nonspecific regional stenosing esophagitis ( chronic fibrotic esophagitis ) is a special form of chronic esophagitis, characterized by transmural nonspecific granulomatous inflammation of the esophagus, thickening of its wall and almost complete obliteration of the lumen. The defeat of the esophagus at the same time resembles Crohn's disease, but unlike the latter, in the cellular composition of the granuloma there are no eosinophils and giant cells. The etiology of the disease is unknown.

The disease develops mainly in young people (up to 25-30 years), equally often in women and men.

The onset of the disease is gradual.

The main symptoms of chronic fibrotic esophagitis:

• gradually increasing dystrophy when taking predominantly solid food;
• chest pain that usually accompanies dysphagia;
• vomiting and regurgitation of food. The volume of vomiting depends to a certain extent on the level of stenosis of the esophagus. When the narrowing in the upper third of the esophagus is localized, vomiting occurs immediately after eating, and the vomiting volume is relatively small. In distal stenoses, the vomit mass is larger, since they contain food taken recently, as well as the day before.

X-ray examination of the esophagus reveals a sharply expressed circular narrowing of the lumen. Due to the high degree of stenosis, the barium enters the distal part of the esophagus very thinly, or (in the most severe cases) does not arrive at all. Characteristic is also the suprastenotic expansion of the esophagus.

When esophagoscopy is defined as stagnant esophagitis, manifested by hyperemia and looseness of the mucous membrane, contact bleeding, erosions, and more rarely - granulations.

The disease progresses quite rapidly. After 3-7 months from the onset of the disease, complete obstruction of the esophagus occurs.

Nonspecific regional stenosing esophagitis must be differentiated from esophageal cancer. This is possible only on the basis of a histological study of sight taken biopsy specimens of the mucosa of the esophagus.

Specific chronic esophagitis

The cause of the development of specific esophagitis can be tuberculosis, syphilis, candidomycosis. This group of esophagitis is rare. A group of specific esophagitis can include a lesion of the esophagus with systemic scleroderma, although this is somewhat arbitrary, since changes in the esophagus with this disease do not correspond to the completely accepted concept of esophagitis.

Traumatic chronic esophagitis

Trauma and foreign bodies can cause the development of chronic esophagitis, since usually the consequences of injury are associated with an infectious and inflammatory process.