3.出血性食道炎

Haemorrhagic Esophagitis

要旨　出血性食道炎は消化管出血の鑑別診断の1つに挙げられる疾患であり，近年その頻度は増加しつつある．特に，高齢者の原因不明の貧血や吐血症例では念頭に置く必要がある．食道炎の主な原因は胃酸の食道への逆流で，プロトンポンプ阻害薬が治療に奏功する．逆流性食道炎からの出血はロサンゼルス分類でgrade C，Dの重症型が多く，再発の防止のためにはプロトンポンプ阻害薬による維持療法が必要である．

　Haemorrhagic esophagitis is one of the diseases that causes gastrointestinal bleeding and its incidence has been increasing recently. Haemorrhagic esophagitis should be considered in cases of elder patients with unknown origin of anemia or haematotemesis. The main cause of reflux esophagiits is acid reflux from the stomach to the esophagus and proton pump inhibitors (PPI) are effective for therapy. Haemorrhage is usually associated with severe esophagitis (Los Angeles classification grade C or D) and long-term maintenance therapy with PPI is required to prevent the development of haemorrhgic esophagitis.