Anamnesis – Requesting the medical history
With the large number of causes for esophagitis, the person affected must be asked in particular detail about the nature of his or her complaints and the time of their occurrence (anamnesis). This can explain thermal and cauterization-related esophagitis. The medications taken and the manner in which they are taken must also be questioned. In this way, some causes can be excluded or confirmed even before the examinations and invasive diagnostics.
Physical examination
Physical examination can often reveal groundbreaking findings that suggest certain forms of esophagitis. In the case of thrush esophagitis, 75% of cases also show an infestation of the oral cavity by the yeast fungus (oral thrush), which facilitates the diagnosis of esophagitis. In herpes esophagitis, the lips and the oral mucosa are often also affected with the typical herpes blisters. If cytomegalovirus esophagitis is suspected, in many cases other organs may be affected, and special attention should be paid to the retina.
Endoscopy – Oesophagogastroscopy
The “endoscopy” (endoscopy) of the oesophagus for direct assessment and classification of mucous membrane damage is the means of choice for securing the diagnosis and direct assessment of the damage caused. Images are transmitted to a monitor via a tube camera (endoscope). During the endoscopy, tissue samples (biopsy) can be taken from suspicious mucosal areas.
In the case of esophagitis of unknown origin, esophagoscopy can often reveal specific findings that indicate a concrete cause of the disease. In the case of a threroesophagitis, the endoscopic findings show typical white-yellowish, firmly adhering coatings (so-called striations). In CMV esophagitis, there are few but large, superficial, flat ulcers (ulcerations).
Herpes esophagitis tends to show many smaller but deep ulcers. In mechanical-irritative esophagitis, a localized swelling is usually seen, accompanied by redness or even bleeding. The cauterized esophagus is characterized by scattered whitish coatings on the mucous membrane.