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Esophagitis (cont.)

Esophagitis Medications

Treatment of esophagitis with medication depends upon the cause.

  • Pain medications and medications that decrease inflammation such as corticosteroids can be used as adjuncts in the treatment of any inflammatory cause of esophagitis.

  • Candida esophagitis is treated with antifungals (such as fluconazole [Diflucan] or nystatin [Bio-Statin, Mycostatin, Mycostatin Pastilles, Nilstat]), which can be administered IV or orally.

  • Herpes esophagitis is treated with antiviral medications (such as acyclovir [Zovirax]), which can be administered IV or orally.

  • Acid reflux is treated with over-the-counter antacids (for example, calcium carbonate [Tums, Maalox, etc.] and Gaviscon).

  • Barrett's esophagus is initially treated with proton pump inhibitors. If these do not help, patients are often given metoclopramide (Reglan) which can strengthen the lower esophageal sphincter, decreasing reflux.

  • Eosinophilic esophagitis is treated with proton pump inhibitors and fluticasone propionate (Flovent), which is an inhaled steroid that reduces the proliferation of the white blood cells (eosinophils) and decreases inflammation.

  • Achalasia is treated with nitrates (isosorbide dinitrate [Isordil]) and calcium channel blockers, (nifedipine [Procardia] and verapamil [Calan]). It may also be treated by injecting muscle-relaxing drugs such as botulinum toxin directly into the esophagus.

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