From the Research
Neutrophilic esophagitis is a rare inflammatory condition of the esophagus characterized by an increased presence of neutrophils in the esophageal tissue, which can cause symptoms such as difficulty swallowing, chest pain, and heartburn, and its diagnosis and management may differ from other forms of esophageal inflammation. This condition is distinct from more common forms of esophagitis, such as eosinophilic esophagitis or reflux esophagitis. In neutrophilic esophagitis, the predominant inflammatory cells are neutrophils, which are a type of white blood cell typically associated with acute inflammation and bacterial infections. The condition is diagnosed through endoscopy and biopsy of the esophageal tissue, which shows a significant infiltration of neutrophils in the esophageal epithelium. While the exact cause is often unclear, it may be associated with certain medications, infections, or systemic inflammatory conditions, as suggested by studies such as 1, which discusses various inflammatory disorders of the esophagus, including lymphocytic esophagitis and eosinophilic esophagitis. Understanding this specific type of esophagitis is important for proper diagnosis and management, as its treatment may differ from other forms of esophageal inflammation, and recent studies such as 2 emphasize the importance of pathologic interpretation of endoscopic mucosal biopsy specimens in guiding clinical management. Some studies, such as 3, describe multinucleated epithelial giant cell changes in esophagitis, which may be seen in patients with esophagitis of varying etiology and probably represent a regenerative response to injury. However, the most recent and highest quality study, 1, provides the most relevant information for the diagnosis and management of neutrophilic esophagitis. Key points to consider in the diagnosis and management of neutrophilic esophagitis include:
- The condition is rare and distinct from other forms of esophagitis
- Neutrophils are the predominant inflammatory cells
- Diagnosis is through endoscopy and biopsy
- Symptoms include difficulty swallowing, chest pain, and heartburn
- Treatment may differ from other forms of esophageal inflammation
- Recent studies emphasize the importance of pathologic interpretation of endoscopic mucosal biopsy specimens in guiding clinical management.