Changes

==Description==  

==Description==  

[[Image:Oesophagitis.jpg|thumb|right|250px|Oesophagitis - Copyright David Walker RVC]]

[[Image:Oesophagitis.jpg|thumb|right|250px|Endoscopic image showing marked inflammation of the oesophageal mucosa<br><small> Copyright David Walker 2007 RVC]]</small>

Oesophagitis refers to [[Inflammation - Pathology|inflammation]] of the oesophagus.  This usually involves the '''mucosa''' but can involve the deeper layers of the submucosa and muscularis and it may follow an '''acute''' or '''chronic''' course.  The oesophagus is usually protected from physical or chemical damage by mucus (produced by simple tubuloacinar glands along its whole length in dogs and in the rostral portion in cats) and by peristaltic waves and the upper and lower oesophageal sphincters which prevent ingesta or regurgitated material from remaining in contact with the oesophageal wall.  Oesophagitis is a serious condition and, if not treated, it may progress to ulceration, rupture, [[Oesophageal Stricture|stricture formation]] or derangement of normal motility ([[Megaoesophagus|megaoesophagus]]).  The most common causes are:

Oesophagitis refers to [[Inflammation - Pathology|inflammation]] of the oesophagus.  This usually involves the '''mucosa''' but can involve the deeper layers of the submucosa and muscularis and it may follow an '''acute''' or '''chronic''' course.  The oesophagus is usually protected from physical or chemical damage by mucus (produced by simple tubuloacinar glands along its whole length in dogs and in the rostral portion in cats), by peristaltic waves and by the upper and lower oesophageal sphincters which together prevent ingesta or regurgitated material from remaining in contact with the oesophageal wall.  Oesophagitis is a serious condition and, if not treated, it may progress to ulceration, [[Rupture of the Oesophagus|rupture]], [[Oesophageal Stricture|stricture formation]] or derangement of normal motility ([[Megaoesophagus|megaoesophagus]]).  The most common causes are:

*'''Physical Injury'''

*'''Physical Injury'''

**Ingestion of [[Oesophageal Foreign Body|'''foreign bodies''']] which lodge in the oesophagus.

**Ingestion of [[Oesophageal Foreign Body|'''foreign bodies''']] which lodge in the oesophagus.

**'''Gastro-oesophageal reflux''', which may occur with '''general anaesthesia''' or [[Hiatal Hernia|'''hiatal hernias''']].

**'''Gastro-oesophageal reflux''', which may occur with '''general anaesthesia''' or [[Hiatal Hernia|'''hiatal hernias''']].

**'''Chronic vomiting'''

**'''Chronic vomiting'''

**Ingestion of '''caustic''' or '''irritant substances''', including '''doxycycline''' in cats.

**Ingestion of '''caustic''' or '''irritant substances''', including '''[[Tetracyclines|doxycycline]]''' in cats.

==Signalment==

==Signalment==

Any age group can be affected and there is usually a history suggestive of a particular cause, such as a recent general anaesthetic or administration of doxycylcine to a cat.

Any age group can be affected and there is usually a history suggestive of a particular cause, such as a recent general anaesthetic or administration of doxycycline to a cat.

==Diagnosis==

==Diagnosis==

===Diagnostic Imaging===

===Diagnostic Imaging===

'''Plain radiographs''' of the chest usually show little inidcation of disease but signs of aspiration pneumonia (an alveolar pattern) may be seen in cranio-ventral lung lobes.  

'''Plain radiographs''' of the chest usually show little inidcation of disease but signs of aspiration pneumonia (an alveolar pattern) may be seen in cranio-ventral lung lobes.  

'''Barium contrast studies''' could be performed and these may show:

'''Barium contrast studies''' could be performed and these may show an '''irregular mucosal surface''' and '''narrowing''' or '''dilation''' of the oesophagus due to stricture formation or megaoesophagus, respectively. Barium should not be administered if an oesophageal rupture is suspected as it may escape into the mediastinum and initiate a foreign body reaction.

*An '''irregular mucosal surface'''

*'''Narrowing''' or '''dilation''' of the oesophagus due to stricture formation or megaoesophagus, respectively.

Barium should not be administered if an oesophageal rupture is suspected as it may escape into the mediastinum and initiate a foreign body reaction.

'''Endoscopy''' is the gold standard technique for diagnosis of oeosphagitis but it requires a general anaesthetic (which may be the cause of the problem) and, if a large endoscope is used, there is the potential to cause further traumatic damage.  Since medical management of oesophagitis is generally inexpensive, it is rarely advisable to perform this technique in an animal suspected of having active inflammation.  If it is performed, the oesophagus may be seen to have an oedematous mucosa that is hyperaemic, ulcerated and actively bleeding, whilst less severe cases may require several mucosal biopsies to diagnose the condition.

'''Endoscopy''' is the gold standard technique for diagnosis of oeosphagitis but it requires a general anaesthetic (which may be the cause of the problem) and, if a large endoscope is used, there is the potential to cause further traumatic damage.  Since medical management of oesophagitis is generally inexpensive, it is rarely advisable to perform this technique in an animal suspected of having active inflammation.  If it is performed, the oesophagus may be seen to have an oedematous mucosa that is hyperaemic, ulcerated and actively bleeding, whilst less severe cases may require several mucosal biopsies to diagnose the condition definitively.

==Treatment==

==Treatment==

Mild oesophagitis has a good prognosis if treated aggressively but animals which develop ulceration, strictures or aspiration pneumonia have a much more guarded prognosis.  

Mild oesophagitis has a good prognosis if treated aggressively but animals which develop ulceration, strictures or aspiration pneumonia have a much more guarded prognosis.  

==References==

==References==

Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''

Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''

 

Merck & Co (2008) '''The Merck Veterinary Manual'''

Merck & Co (2008) '''The Merck Veterinary Manual'''

[[Category:Oesophagus_-_Pathology]]

[[Category:Oesophagus_-_Pathology]]

[[Category:To_Do_-_James]]

[[Category:To_Do_-_James]]