Esophagitis in the context of "Ipecac"

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👉 Esophagitis in the context of Ipecac

Syrup of ipecac (/ˈɪpɪkæk/ IP-ih-kak), or simply ipecac, is a drug that was once widely used as an expectorant (in low doses) and a rapid-acting emetic (in higher doses). It is obtained from the dried rhizome and roots of the ipecacuanha plant (Carapichea ipecacuanha), from which it derives its name. It is no longer regularly used in medicine.

In particular, the rapidly induced forceful vomiting produced by ipecac was considered for many years to be an important front-line treatment for orally ingested poisons. However, subsequent studies (including a comprehensive 2005 meta-study) revealed the stomach purging produced by ipecac to be far less effective at lowering total body poison concentrations than the adsorption effect of oral activated charcoal (which is effective through the entire gastrointestinal tract and is often coupled with whole bowel irrigation). Ipecac also presents a small risk of overdose (being a mild poison itself) and a major risk of esophagitis and aspiration pneumonia if used to purge corrosive poisons. Having long been replaced (even in the emetic role) by more effective medications, the American Society of Health-System Pharmacists (ASHP) now advises that "Ipecac syrup is no longer recommended for routine management of outpatient ingestions of medications or other chemicals."

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Esophagitis in the context of GORD

Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a chronic upper gastrointestinal disease in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications. Symptoms include dental corrosion, dysphagia, heartburn, odynophagia, regurgitation, non-cardiac chest pain, extraesophageal symptoms such as chronic cough, hoarseness, reflux-induced laryngitis, or asthma. In the long term, and when not treated, complications such as esophagitis, esophageal stricture, and Barrett's esophagus may arise.

Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications. Medications that may cause or worsen the disease include benzodiazepines, calcium channel blockers, tricyclic antidepressants, NSAIDs, and certain asthma medicines. Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus. Diagnosis among those who do not improve with simpler measures may involve gastroscopy, upper GI series, esophageal pH monitoring, or esophageal manometry.

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Esophagitis in the context of Heartburn

Heartburn is a burning sensation felt behind the breastbone. It is a symptom that is commonly linked to acid reflux and is often triggered by food. Lying down, bending, lifting, and performing certain exercises can exacerbate heartburn. Causes include acid reflux, gastroesophageal reflux disease (GERD), damage to the esophageal lining, bile acid, mechanical stimulation to the esophagus, and esophageal hypersensitivity. Heartburn affects 25% of the population at least once a month.

Endoscopy and esophageal pH monitoring can be used to evaluate heartburn. Some causes of heartburn, such as GERD, may be diagnosed based on symptoms alone. Potential differential diagnoses for heartburn include motility disorders, ulcers, inflammation of the esophagus, and medication side effects. Lifestyle changes, such as losing weight and avoiding fatty foods, can improve heartburn. Over-the-counter alginates or antacids can help with mild or occasional heartburn. Heartburn treatment primarily involves antisecretory medications like H2 receptor antagonists (H2RAs) and proton-pump inhibitors (PPIs).

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Esophagitis in the context of Esophageal rupture

Esophageal rupture, also known as Boerhaave syndrome, is a rupture of the esophageal wall. Iatrogenic causes account for approximately 56% of esophageal perforations, usually due to medical instrumentation such as an endoscopy or paraesophageal surgery. The 10% of esophageal perforations caused specifically by vomiting are termed Boerhaave syndrome.

Spontaneous perforation of the esophagus is most commonly a full-thickness tear in the esophageal wall due to a sudden increase in intraesophageal pressure combined with relatively negative intrathoracic pressure caused by straining or vomiting (effort rupture of the esophagus or Boerhaave syndrome). Other causes of spontaneous perforation include caustic ingestion, pill esophagitis, Barrett's esophagus, infectious ulcers in patients with AIDS, and following dilation of esophageal strictures.

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