Nongastroesophageal reflux disease-related infectious, inflammatory and injurious disorders of the esophagus.
OBJECTIVE
To review recently published studies presenting novel and relevant information on some esophageal infectious, inflammatory and injurious diseases.


RESULTS
In the treatment of Candida esophagitis, fluconazole remains the treatment of choice, but clinical failures indicate new therapeutic opportunities, like two new echinocandins, micafungin and anidulafungin. Eosinophilic esophagitis is an increasingly recognized entity. New therapeutic insights come from a six-food elimination diet in children and from fluticasone propionate in adults; humanized monoclonal IgG antibody anti-interlukin-5, mepolizumab, has been shown to decrease eosinophilia and ameliorate symptoms. There has been some advance in microscopic characterization of lymphocytic esophagitis. Esophagitis is found to be present in 67% of patients with pemphigo vulgaris, in 32.3% of patients with systemic sclerosis and to be associated with thoracic neoplasias. In the case of caustic ingestion, endoscopic ultrasound with miniprobes has proven not to be better than videoendoscopy. Recent evidence shows that systemic steroids might even be harmful. Mitomycin C applied on fresh wounds is currently being evaluated. Stenting of the stricture has been proposed for contrasting esophageal remodeling.


CONCLUSIONS
These recent findings, together with a better understanding of diseases such as eosinophilic or lymphocytic esophagitis, allow new diagnostic and therapeutic approaches.
Pace
Fabio
F
Division of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan, Italy. fabio.pace@unimi.it
Pallotta
Stefano
S
Antinori
Spinello
S
D000730:Androstadienes / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000935:Antifungal Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D015415:Biomarkers / Q000032:analysis; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy; D002424:Caustics / Q000009:adverse effects; D004032:Diet; D004802:Eosinophilia / Q000209:etiology / Q000628:therapy; D004941:Esophagitis / Q000209:etiology* / Q000628:therapy*; D004947:Esophagus / Q000187:drug effects / Q000293:injuries* / Q000528:radiation effects; D000068298:Fluticasone; D006801:Humans; D011878:Radiotherapy / Q000009:adverse effects
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000935:Antifungal Agents; D000970:Antineoplastic Agents; D015415:Biomarkers; D002424:Caustics; C434107:mepolizumab; D000068298:Fluticasone