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World J Gastroenterol. May 7, 2017; 23(17): 3011-3016
Published online May 7, 2017. doi: 10.3748/wjg.v23.i17.3011
Esophagitis and its causes: Who is “guilty” when acid is found “not guilty”?
Laurino Grossi, Antonio Francesco Ciccaglione, Leonardo Marzio
Laurino Grossi, Antonio Francesco Ciccaglione, Leonardo Marzio, G. d’Annunzio University of Chieti-Pescara, School of Gastroenterology, Digestive Sciences c/o Ospedale Spirito Santo, 65124 Pescara, Italy
Author contributions: Grossi L was responsible for the conception of the manuscript; Grossi L and Ciccaglione AF performed the literature search; Marzio L supervised the work and gave final approval of the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Laurino Grossi, MD, Associate Professor, Gastroenterology, G. d’Annunzio University Chieti-Pescara, School of Gastroenterology c/o Digestive Sciences - Ospedale Spirito Santo, Via Fonte Romana, 8 65124 Pescara, Italy. l.grossi@unich.it
Telephone: +39-085-4252460
Received: January 25, 2017
Peer-review started: February 1, 2017
First decision: March 3, 2017
Revised: March 14, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: May 7, 2017
Core Tip

Core tip: This manuscript analyzes the esophageal diseases whose etiology is not directly related to abnormal gastro-esophageal reflux episodes. These conditions occur less frequently than gastroesophageal reflux disease, but their diagnosis should always be considered when managing patients with unexplained upper gastrointestinal symptoms. Some of these diseases are immune-mediated inflammatory processes, either limited to the esophageal wall such as eosinophilic esophagitis or part of systemic diseases such as Crohn’s disease. Other possible etiologies include viral or fungal infections in immunocompromised patients, and corrosive agents causing direct damage to the esophageal mucosa as well as therapeutic regimen used for neoplasms. All these possibilities should be taken into consideration when Reflux esophagitis cannot be diagnosed.