Tag Archives: esophagitis

Vaping-Induced Esophagitis

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L Pace, K McGoogan. JPGN Reports 4(3):p e327, August 2023. Open Access! Vaping Induced Severe Erosive Esophagitis

This case report describes a 17 yo with sore throat, odynophagia chest pain, and dysphagia associated with vaping. His symptoms resulted in hospitalization and he underwent an EGD on day 4 after symptoms had not improved with multiple empiric therapies.

EGD findings included .

  1. Circumferential erosive or exudative lesions) esophagitis with bleeding found throughout the entire esophagus. Given the lack of infectious etiologies, the authors made a diagnosis of vaping-associated esophagitis
  2. H pylori gastritis

My take: When adolescent patients present with esophageal symptoms, inquiring about exposure to vaping along with medications known to cause pill-esophagitis, is worthwhile.

Related blog post: Review: Infectious Esophagitis

More Often Than Not Esophagitis in Children with Esophageal Atresia is NOT due to Reflux

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A long time ago in a galaxy far far away, I was taught that children with esophageal atresia would have reflux for life due to dysmotility following repair. Thus, these children presumably should remain on acid blockers indefinitely. It turns out that this was fiction (just like Star Wars).

R Tambucci et al J Pediatrics 2021; 228: 155-165. Full text: Evaluation of Gastroesophageal Reflux Disease 1 Year after Esophageal Atresia Repair: Paradigms Lost from a Single Snapshot?

In this retrospective study with 48 children, the authors had the following key points:

  • Microscopic esophagitis was found in 33 (69%)
  • Pathological esophageal acid exposure on MII-pH was detected in 12 (25%)
  • The presence of long-gap esophageal atresia was associated with abnormal MII-pH.

The authors conclude that “histological esophagitis is highly prevalent at 1 year after esophageal atresia repair, but our results do not support a definitive causative role of acid-induced GERD. Instead, they support the hypothesis that chronic stasis in the dysmotile esophagus might lead to histological changes.”

My take: Along with endoscopy, pH probe testing can be helpful in selecting which children with esophageal atresia should continue with PPI therapy.

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