Acute necrotizing esophagitis: role of nonsteroidal anti-inflammatory drugs

Yasuda, Hiroshi; Yamada, Masaya; Endo, Yutaka; Inoue, Kazuaki; Yoshiba, Makoto

doi:10.1007/s00535-005-1741-6

Cited by 41 publications

(35 citation statements)

References 14 publications

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“…[1][2][3][4][5][6][7][8][9] Some of these injuries produce endoscopic white plaques or membranes. There is one form of superficial esophageal necrosis that produces extensive, sometimes spectacular endoscopic membranes for which a specific cause has not been established, called 'sloughing esophagitis.'…”

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confidence: 99%

Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa

2012

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Sloughing esophagitis is characterized by superficial necrotic squamous epithelium and endoscopic plaques or membranes. According to abstract reports SE affects older, debilitated patients on multiple medications. This study seeks to evaluate the clinical findings in patients with SE. Thirty-one patients with necrotic superficial squamous epithelium, with endoscopic white plaques or membranes, but without fungi, were compared with 34 patients having esophageal biopsies done for any purpose other than Barrett's surveillance. Sloughing esophagits patients were older than controls (56 vs 43.5 years) and were more likely to be taking five or more medications (77 vs 32%), especially central nervous system depressants (65 vs 32%) and medications associated with esophageal injury (55 vs 18%). In 69% the plaques were in the distal and/or mid-esophagus; 23% involved the entire esophagus; 8% were limited to the proximal esophagus. There was no correlation between medication history and site. Sloughing esophagitis patients were likely to be debilitated based on evidence such as being on home oxygen, in nursing homes, bedridden, hospitalized, or malnourished, having metastatic cancer, organ transplantation, and/or being immunosuppressed. Sloughing esophagitis patients were more likely to have died since the biopsy (23 vs 3%), have peptic ulcer disease (55 vs 24%), or renal insufficiency (16% vs none), but no more likely to have dysmotility disorders, irritable bowel disease, or atherosclerosis. SE patients were less likely to have gastroesophageal reflux disease (45 vs 74%). No specific cause for sloughing esophagitis was identified, but the association with multiple drugs and conditions that may lead to esophageal stasis and/or injury, suggest that this is a local, perhaps contact injury, rather than an ischemic injury.

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Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa

2012

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“…ANE could be characterized as an acute esophageal mucosal lesion, particularly in aged patients with hiatal hernia and among those who consume NSAIDs. 27) We therefore examined the potential benefits of eupatilin as a novel therapeutic approach to prevent esophageal injury induced by administration of the NSAID, indomethacin.…”

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confidence: 99%

Eupatilin with Heme Oxygenase-1-Inducing Ability Protects Cultured Feline Esophageal Epithelial Cells from Cell Damage Caused by Indomethacin

Song

Shin

et al. 2009

Biological & Pharmaceutical Bulletin

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We previously reported that eupatilin (5,7-dihydroxy-3,4,6-trimethoxyflavone) extracted from Artemisia asiaitica, augmented the cellular antioxidant defense capacity through induction of the antioxidant protein heme oxygenase-1 (HO-1), thereby protecting ileal smooth muscle cells from nonsteroidal anti-inflammatory drug (NSAID)-induced intestinal toxicity. In the present study, we used cultured feline esophageal epithelial cells (

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“…Since then, fewer than 80 cases of AEN have been described so far 1 2. This is a rare event,5 6 a severe form of acute oesophagitis in which the oesophagus shows a dark, black-appearing colour, with friable mucosa in the two-thirds of the distal oesophagus 1 3…”

Section: Discussionmentioning

confidence: 99%

“…There is no standard treatment, but there is consensual use of the proton pump inhibitor and parenteric nutrition 2 5 6. The current recommendation is to also treat the patient's comorbidities, to optimise vascular perfusion and to treat oesophageal infection, if present 3.…”

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confidence: 99%

Black Oesophagus

Pereira¹,

Figueira-Coelho

Picado

et al. 2013

BMJ Case Reports

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Acute oesophageal necrosis, also known as 'Black Oesophagus', is a rare endoscopic finding since its first description by Goldenberg in 1990. In endoscopic studies, the frequency ranged from 0.01% to 0.2%. The aetiology is undefined and is probably multifactorial. A 62-year-old woman, with chronic alcoholism, was admitted to the internal medicine department for dehydration and marked malnutrition problems. Melaena was detected, and oesophagogastroduodenoscopy showed black mucosa of the lower two-thirds of the oesophagus and candidiasis. The patient gradually recovered after conservative treatments (intravenous proton pump inhibitor and total parental nutrition) and fluconazole. Oesophagus stricture was developed after 1 month, and balloon dilatation was performed successfully.

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Acute necrotizing esophagitis: role of nonsteroidal anti-inflammatory drugs

Abstract: ANE is more common than has been previously reported, and it should be included in the differential diagnosis of UGI bleeding. ANE could be characterized as an "acute esophageal mucosal lesion," particularly in aged patients with hiatal hernia and among those who consume NSAIDs.

Cited by 41 publications

References 14 publications

Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa

Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa

Eupatilin with Heme Oxygenase-1-Inducing Ability Protects Cultured Feline Esophageal Epithelial Cells from Cell Damage Caused by Indomethacin

Black Oesophagus

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