Zusammenfassung
Allein durch ihre Häufigkeit steht die gastroösophageale Refluxkrankheit (GERD) im Vordergrund der ärztlichen Aufmerksamkeit. Die Vigilanz für seltene Ösophagusentzündungen wie Herpesösophagitis, Strahlenösophagitis, eosinophile Ösophagitis, Pseudodivertikulose oder Morbus Crohn ist vergleichsweise gering. Zudem lassen sich diese Entitäten klinisch kaum von der GERD unterscheiden. Bei allen untypisch verlaufenden oder therapierefraktären vermeintlichen Refluxkrankheiten sollte daher die Diagnose hinterfragt und endoskopisch reevaluiert werden. Bei nicht eindeutigen makroskopischen Befunden in der Ösophagoskopie können Biopsien erfolgen und die Diagnose histologisch gesichert werden. Diese Diagnosesicherung ist gerade bei seltenen Ösophagitiden wichtig, da sich ihre Therapien teilweise erheblich von denen der GERD unterscheiden.
Abstract
Because of its high incidence gastroesophageal reflux disease (GERD) is at the forefront of medical attention. On the other hand, vigilance for rare inflammatory diseases of the esophagus, such as herpes esophagitis, radiation-induced esophagitis, eosinophilic esophagitis, pseudodiverticulosis and Crohn’s disease is low. Moreover, these entities are rarely distinguishable from GERD by clinical features alone. For all atypical and treatment refractory supposedly reflux diseases, the diagnosis should therefore be questioned and re-evaluated by endoscopy. When the macroscopic findings of esophagoscopy are ambiguous biopsies can be performed and histological examination then often leads to a definitive diagnosis. This is particularly important because the required treatment of rare forms of esophagitis often significantly differs from that of GERD.
Abbreviations
- AEN:
-
„Acute esophageal necrosis“ (akute Ösophagusnekrose)
- CD:
-
„Crohn’s disease“ (Morbus Crohn)
- DEGRO:
-
Deutsche Gesellschaft für Radioonkologie
- EIPD:
-
„Esophageal intramural pseudodiverticulosis“
- EoE:
-
„Eosinophilic esophagitis“ (eosinophile Ösophagitis)
- EORTC:
-
European Organisation for Research and Treatment of Cancer
- EREFS:
-
„Exudates, rings, edema, furrows, and strictures“
- GERD:
-
„Gastroesophageal reflux disease“ (gastroösophageale Refluxkrankheit)
- GIT:
-
Gastrointestinaltrakt
- HSV:
-
Herpes-simplex-Virus
- ISDE:
-
International Society for Diseases of the Esophagus
- NSAR:
-
Nichtsteroidales Antirheumatikum
- ÖGD:
-
Ösophagogastroduodenoskopie
- PPI:
-
Protonenpumpeninhibitor
- UEG:
-
United European Gastroenterology
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Hentschel, F., Lüth, S. Seltene Entzündungen des Ösophagus. Internist 60, 533–539 (2019). https://doi.org/10.1007/s00108-019-0586-7
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DOI: https://doi.org/10.1007/s00108-019-0586-7
Schlüsselwörter
- Eosinophile Ösophagitis
- Pseudodivertikulose
- Akute Ösophagusnekrose
- Strahlenösophagitis
- Herpesösophagitis