The primary goals in treating esophagitis are to identify and treat the primary cause, decrease or prevent further exposure of the esophagus to gastric acid, provide adequate nutrition, and treat any complications. Although most animals with esophagitis are treated as outpatients, certain individuals with extremely severe cases do warrant hospitalization for intensive therapy and support. Therapy for esophagitis includes:
Gastric acid inhibitors are recommended to block acid secretion, and therefore diminish the volume of acid that can be refluxed (leaked backwards) into the esophagus. Examples include a group called H2 receptor antagonists (cimetidine (Tagamet®), ranitidine (Zantac®), famotidine (Pepcid®)), or proton pump inhibitors such as omeprazole (Prilosec®).
Sucralfate (Carafate®) suspension (liquid) helps soothe and coat an inflamed stomach and esophagus.
Motility modifying drugs are drugs that promote movement within the gastrointestinal tract, such as metoclopramide (Reglan®), and can be used to stimulate movement within the esophagus and help to tighten the lower esophageal sphincter, the band of tissue that separates the stomach from the esophagus. In turn, this decreases the amount of reflux into the esophagus.
Dietary modification should include small, frequent feedings of an easily digestible product. In addition, it is preferable not to feed these animals late at night, as they will be more apt to reflux with a full stomach while sleeping.
Antibiotic therapy may be recommended in some cases where there is extreme inflammation and especially in cases where secondary pneumonia has been documented.
Nutritional support may be indicated in those cases where feeding the individual orally will worsen and perpetuate esophageal inflammation. Placing a stomach tube using an endoscope or surgery may be necessary to bypass the esophagus and deliver nutritional support. Intravenous nutrition may be of benefit if the individual is not a good candidate for anesthesia. Both are temporary means of delivering support until the esophagitis has resolved.
Endoscopic removal of a foreign body may be indicated in cases where a foreign body is present.
Surgery may be indicated in certain situations to include removal of an esophageal foreign body where endoscopy was unsuccessful.
