Real world management of esophageal ulcers : analysis of their presentation, etiology, and outcomes

Abstract

Background and study aims : Esophageal ulcers are a rare cause of upper gastrointestinal morbidity and may be due to different etiologies. We sought to systematically evaluate patients with esophageal ulcers and describe their presentations, endoscopic findings, etiologies, treatments, and outcomes. Patients and methods : Patients diagnosed with esophageal ulcers over an 11-year period were retrospectively identified from our institution’s electronic medical records. Results : We identified 100 patients with esophageal ulcers (0.49% of patients undergoing upper endoscopy). Half of them presented due to gastrointestinal bleeding and three-quarters were admitted to the hospital. The majority were in the lower esophagus. Twenty-two unique etiologies, including multiple iatrogenic causes, were diagnosed in 91 of the cases. The most common etiology was gastroesophageal reflux disease (57%), followed by non-steroidal anti-inflammatory drug use (7%), malignancies (3%), vomiting (3%), caustic ingestion (2%), pill esophagitis (2%) and radiation (2%). Many etiologies showed a predilection for specific segments of the esophagus. Nine ulcers required endoscopic intervention and all were treated successfully. Repeat endoscopies were performed 5 times for diagnostic or “second look” reasons, none of which changed the patients’ diagnosis or treatment. No patients required surgery or stricture dilation. One patient’s ulcer was complicated by perforation and he subsequently died. Four other patients died from non-ulcer related causes. Conclusions : While the majority of ulcers were due to gastro-esophageal reflux disease, 22 different etiologies were identified. Many were due to medication or iatrogenic causes. Repeat endoscopy did not appear to be helpful. While the incidence was low, they were frequently associated with significant morbidity.

Esophageal ulcer associated with mild hemophilia A: case report

“…We present a very rare case of patient with digestive bleeding from esophageal ulcer and an associated coagulopathy with unknown origin, which was later proved to be mild hemophilia A. Esophageal ulcer is a relatively rare cause of bleeding among GI diseases. The most common cause of esophageal ulcer is duodenogastric reflux (DGR) disease [ 18 ]. GERD is present in about 13% of the world’s population [ 19 , 20 ].…”

“…Esophageal ulcer is a relatively rare cause of bleeding among GI diseases. The most common cause of esophageal ulcer is duodenogastric reflux (DGR) disease [18]. GERD is present in about 13% of the world's population [19,20].…”

Promoting Activity of Terpenes on Skin Permeation of Famotidine

“…1) Some of the most common symptoms were trouble swallowing or painful swallowing, a feeling of food stuck in the throat, abdominal or chest pain, and blood in the vomit or black and tarry stools. 2) Histamine-2 (H2) receptor blockers are also frequently used to relieve the symptoms of GERD. 3) The frequent exposure to stomach acid can irritate the esophagus and lead to uncomfortable symptoms as described.…”