Esophagitis

• Esophagitis

- Inflammation of the esophagus

- Also called heartburn (pyrosis)

- Risk factor

- Smoking

- obesity

- pregnancy

- Mechanical trauma (prolonged ngt)

- Reflux of gastric contents (GERD)

- Infection

- Irritants (smoking)

- Clinical Manifestations:

- Localized pain

- Belching

- Difficulty in swallowing

- Diagnostics:

- History – lifestyle

- Measure weight, and pt’s swallowing

- Esophagoscopy

- Barium swallow

- Bernstein acid perfusion test – instillation of acid through tube. Produces sudden pain in esophagitis. Helps differenciate esophagitis from cardiac pain

- Management:

- Antacids (Maalox) – given 1hr before meals, 2-3hrs after meals and at bedtime

- H2 receptor antagonist (ranitidine) – taken with meals or at bedtime. 1hr should elapse between antacid and H2 receptor antagonist

- Nursing Intervention:

- Give bland, low fat, non irritating diet

- Drink fluids while eating to aid swallowing

- Keep head of the bed elevated 2-3 hrs after meal and at bedtime(6-8in)

- Limit food and fluid intake 2-4 hrs before bedtime

- Avoid precipitating factors – coffee, alcohol, smoking, chocolate, acid rich foods