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Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.
Question Title: EROSIVE ESOPHAGITISForum: The Gastroenterology and Liver Diseases Forum
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I WAS WONDERING IF YOU COULD PLEASE TELL ME WHAT THESE 4 THINGS MEAN, 1) ESOPHAGITIS 2) EROSIONS 3) ERETHEMA 4) PATULOUS LES I RECENTLY HAD AN ENDOSCOPY AND THESE WERE MY RESULTS. I WAS STILL GROGGY WHEN MY DR. CAME TO SEE ME SO I HAVE NO CLUE WHAT THIS MEANS. HE PLACED ME ON 300 ML OF ZANTAC AND 40 ML OF PRILOSEC. WHAT ARE THE RESULTS OF THESE 2 MEDS MIXED TOGETHER? I STILL HAVE HAD HEARTBURN WITH THESE 2 MEDS. WHAT IS THE LIKELIHOOD THAT I COULD HAVE SURGERY? I DONT WANT TO STAY ON MEDS FOR EVER. IS ANY OF THE THINGS HE FOUND THROUGH MY ENDOSCOPY SERIOUS OR CLOSE TO BARRETTS? ANY ANSWERS YOU HAVE WOULD BE GREATLY APPRECIATED. THANK YOU. Dear Jodi, Esophagitis means inflammation of the foodpipe. This is often characterized by redness of the lining of the foodpipe (erythema)and breaks in the lining of the foodpipe (erosions). One of the causes for the development of esophagitis is gastroesophageal reflux disease (GERD). GERD is a term to describe a mechanism where acid in the stomach is refluxed back into the esophagus (foodpipe). The acid can then damage the lining of the foodpipe and cause esophagitis. The most important mechanism leading to the development of gastroesophageal reflux is a weakening of a muscle that exists between the food pipe and the stomach called the lower esophageal sphincter (LES). The LES functions as a barrier to prevent the acid in the stomach from refluxing back into the stomach. A patulous LES refers to an open LES. Zantac and Prilosec are both medications used in the treatment of GERD. Zantac is a histamine receptor antagonist and Prilosec is a proton pump inhibitor. Both work to decrease acid production in the stomach. Prilosec is more potent than Zantac. They are usually prescribed separately and should not be taken together. Prilosec requires an acid medium to be effective. If Zantac is already suppressing acid secretion, Prilosec will not be as effective. If your symptoms are truly refractory to medical therapy surgery can be considered an option. It is also important to adhere to dietary and lifestyle modifications called anti-reflux measures. Barrett's esophagus is a complication of GERD where the lining of the foodpipe looks more like the lining of the stomach or small intestine. Barrett's esophagus is best diagnosed on tissue biopsy specimens taken from the lower esophagus. I hope you find this information helpful. This response is being provided for general informational purposes only and should not be considered medical advice or If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an HFHSM.D.-ym
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