IJBPAS, May, 2013, 2(5): 1151-1159
ISSN: 2277–4998
Faculty of Pharmacy, Naraina Vidya Peeth Group of Institutions, Panki, Kanpur *Corresponding Author: E Mail: [email protected]; Ph.: 08574688230
The term esophagitis is any inflammation of the squamous esophageal epithelium, irritation, or swelling in the lining of the esophagus also known food pipe and body canal tube (the tube that carries food from the throat to the stomach). Esophagitis is the most common caused by the Gastrooesophageal reflux disease (GERD) is also known gastric reflux or acid reflux disease. GERD is delineated as a condition that spring up due to reflux of gastric contents into the esophagus leading to mucosal damage and oxidative stress; the condition may be asymptomatic or result in symptoms. The commonness of GERD is estimated to be 10- 20% in western countries, making it one of the most predominant gastrointestinal disorders. It may be acute or chronic. The GERD has three unique phenotypic presentations:  Non erosive reflux disease (NERD) 50-70% - Presence of troublesome symptoms in  Erosive esophagitis 15% - endoscopically visible breaks of distal esophageal mucosa.  Barrett’s esophagus 20-40% - replacement of squamous epithelium by columnar Researchers used various model randomly for new antiulcer drug screening. Corrosive esophagitis was formed without general anesthesia & laparotomy. Keywords: Esophagitis, Gastroo Esophageal Reflux Disease (GERD), Non Erosive Reflux
Disease (NERD), Erosive Esophagitis, Barrett’s Esophagus 1151
IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
Esophagitis was first reported by Quinke in be hypertrophic or atrophic with replacement 1879. Whereas peptic ulcer of esophagus was described by Jackson in 1927. Simillarly epithelium in distal esophagus lead to VCD attacks, aspiration pneumonia esophageal esophagitis as a new clinical entity in 1935, stricture and dysfunction of esophagus like he proposed associated with duodenal ulcer symptomps [5] and may also cause of
and suggested it as a part of ulcer diathesis as adenocarcinoma [6].
in the duodenitis and antral gastritis seen in association with a peptic ulcer [1]. The term
eosinophilic esophagitis also causes this squamous esophageal epithelium, irritation, or According to their causes and factors there swelling in the lining of the esophagus also are various types of esophagitis named (Table
known food pipe and body canal tube (the 1). The infection or irritation may cause the
tube that carries food from the throat to the esophagus to become inflamed & may also stomach) [2]. Esophagitis is the most
reflux disease (GERD) is also known gastric reflux or acid reflux disease which is caused columnar epithelium in distal esophagus. It happened when the lining of the esophagus (the long muscular tube of the gut that leads spontaneously for varying period of time or from the back of the mouth to the stomach) is damaged by stomach acid and changed to a contents & acid coming up from the stomach lining similar to that of the stomach, it can to esophagus [3]. If esophagitis caused by
GERD, the disease is also called reflux
reflux. Sometime, this type of conditon may esophagitis.
also cause of cancer of the esophagus [9].
It may be acute or chronic [4].The acute
esophagitis can be catarrhal or phlegmonous with hoarseness, dysphagia, odynophagia like gastroesophageal junction incompetence are: symtomps while the chronic esophagitis may 1152
IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
1) Transient lower esophageal sphincter
1) Non erosive reflux disease (NERD)
2) A hypotensive lower esophageal
3) Anatomic
2) Erosive
associated with a hiatal hernia [10].
3) Barrett’s
relaxations (tLESRs) constituent the major machanism of acid reflux [11].
esophagus [13].
presentations [12]:
adenocarcinoma [14 ].
Table 1: Causes and Factors there are Various Types of Esophagitis
Reflux Esophagitis
Alcohol abuse, Cigarette smoking, Hiatal Hernia, obesity and
pragnancy Vomiting, hyperacidity.

Drug-Induced Esophagitis
Alendronate (in ostoporosis), tetracycline, doxycycline, and
vitamin C, NSAIDS and above medicine is taken with plenty of

Erosive Esophagitis
Esophagitis due to Detergents Pesticides Mechanical lubricants
and industrial additives.
Esophagitis due to Chemical injury caustic, or alkaline, acid
solutions for example (persons who attempt suicide by
ingestion of any alkaline or caustic, acid solutions
substances). [7]

Eosinophilic Esophagitis
Chronic cough and asthma, food allergies, atopic dermatitis,

Infectious Esophagitis
Fungi Candida species (esophageal candidiasis), mucomycosis,
aspergillosis, Bacteria like Mycobacteriium tuberculosis
Mycobacterium avium-intracellulare
, yeast (especially Candida
infections), or viruses such as herpes or cytomegalovirus
HIV Persons with weakened immune systems and some
medications (such as carticosteroids and testosteron) may
develop infections that lead to esophagitis [8].

IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
Machanism of Esophagitis [15]
GERD is examined by mucosal response in the presence of Hcl in esophageal lumen. Epithelial cells have TRPV1 receptor mRNA and protein and capsaicin is the against of the When mucosa is exposoure to HCl, inflamation occur 1. IL-8, (Released From Non Neuronlly Pathway)
(Released From Neuronlly) is inhibited
Induce migration of peripheral blood leukocytes Induce prduction of H2O2 with the activation of peripheral blood leukocytes by PAF ,SP NOTE; PAF cause the production Of IL-6 in circular muscle
These H2O2 Cause Dysfunction of Esophagus and Cause Esophagitis
IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
The Mechanism of Map Kinase Activation Under Acidic Condition in Feline Esophageal
Smooth Muscle Cells [16]
GERD (occur due to repeated exposure of esophagus to gastric acid) In the condition of Barrett’s adenocarcinoma Acid (at PH4) Increase proliferaton via ERK, P-38MAPK activation Acidic medium Increase pasphorylation of ERK and MAPK Inhibited by pertusis toxins DEDA, PCMB, Protien kinase Not effected by genistein, forskplin U73122 There are various models are used to induced enzyme [17]. Researchers used this
1) NaOH Induced Esophagitis
fibroblastic activity inhibition stricture development [19]. Ibuprofen [20] and
CAPE (caffeic acid phenethyl ester) is
IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
stricture development [21].
2) Alcohol Induced Esophagitis
and cancer [25].
3) Pills Induced Esophagitis
(i.e., hemorrhagic) gastric lesions that [22]. Alcohol induced also cause ANE
achalasia [23]. Black esophagus is
community [24] alcoholism revealed
IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
hyperplasia, and papillomatosis [29].
esophagitis [26]
damage [30].
5) Esophagitis Induced by Pylorous
4) Esophagitis Induced by Acid and
near the pylorus ring [31].
6) Esophagitis Induced by Pancreatic
2RA [28]. 25 to 50 µ
vitro [32].
[1] Frederick S, et al., The Treatment of
IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
No Demonstrable Hiatal Hernia Dis [11] Iwakiri K, Mechanisms of Excessive
[2] http://www.health24.com/medical/Co
[12] Fry LC, et al., “Functional heartburn,
[3] Devault KR and Castle DO, Updated
esophagitis are all distinct conditions: [4] Orlando RC, Scand J., Gastroenterol.
[13] Jeurnink
[5] Rao CV, Effect of quercetin, flavonids
[14] Varannes Des SB, et al., “Short and
esophagitis in rats, Eur. J. Pharmacol., [6] Charles J, et al., Gastroenterological
secretory drugs?” Best Pract. & Res. [7] Lawrence M, et al., Current Medical
[15] Harnett
[8] http://www.healthhype.com/types-of-
[16] Park SY, et al., The mechanism of
[9] Orlando R, Diseases of the esophagus,
[10] http://www.uptodate.com/contents/pa
[17] Ocakci A, Beneficial effects of
IJBPAS, May, 2013, 2(5)
Arya E* and Joshi H Review Article
[26] Castell
[18] Senturk
[27] http://www.gihealth.com/html/educat
[19] Senturk
[28] Bardhan KD et al., Int. J. of
[20] Herek O, Protective effects of
[29] Lanas A, et al., Experimental
[21] Ocakci A, Role of caffeic acid
[30] Lanas A, et al., Superoxide Anion
[22] Bode
gastrointestinal tract disorder, 21 (1), [31] Omura N, et al., Establishment of
[23] Jeffrey K and Lee A, Alcohol-Stasis,
[32] Naito Y, et al., Role of pancreatic
[24] Altenburger DL, A case of black
[25] Chizhov
IJBPAS, May, 2013, 2(5)

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