An inflammatory reaction in the esophageal mucosa can be initiated by contact with allergenic foods, toxins and infectious agents as well as peristaltic interruption, interference and neuropathy. Regardless of cause, the inflammatory state results in mucosa edema, peristaltic dysfunction, dysphagia and pain.
Gastric acid (pH< 4.0) has been shown to play a crucial role in the development of esophagitis, but regurgitated bile could also be linked to various detrimental mucosal reactions.
- Esophageal foreign body
- Oral infections extending into the esophagus - e.g. periodontitis
- Ingestion of cytotoxins - e.g. tetracyclines, chemotherapy drugs, household chemicals
- Helicobacter spp-associated gastroesophageal reflux
- Chronic vomiting
- Intra-operative gastro-oesophageal reflux
- Percutaneous endoscopic gastrostomy
- Esophageal neoplasia - e.g.adenocarcinoma
- Structural abnormalities - e.g. persistent aortic arch, hiatal hernia
- Spirocerca lupi infection
Clinical signs in affected dogs include regurgitation, coughing, dysphagia and weight loss, often associated with recent general anesthesia.
Diagnosis usually requires clinical signs supported with evidence of inflammatory and delayed esophageal transit using barium-meal radiographs. Definitive diagnosis usually requires visual confirmation using endoscopy and forceps biopsy for histological analysis.
A differential diagnosis would include megaesophagus and Spirocerca lupi infection.
In cases of esophageal foreign body obstruction, immediate surgical removal is imperative in order to minimize scarring of the esophageal mucosa and cicatrization, leading to long-term esophageal motility problems.
If esophageal stricture has occurred, esophageal bougienage is usually required to mechanically dilate the muscle.
A bland protein diet (e.g. chicken and rice) may also be required until inflammation has resolved.
A good outcome with esophagitis is defined as tolerance of solid food with regurgitation less than once a week. Complete resolution of symptoms may required 1 - 2 months, depending on severity.
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