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Buchholz's esophagitis a common problem

Buchholz's esophagitis a common problem
For the first two and a half months of the season, opening the morning paper (yes, I still do that) for a look at the American League East standings was a gut-wrenching experience. For a while there was some comfort in knowing that the boys from the Bronx weren't in much better shape, but there's no denying the fact that seeing the Red Sox as cellar-dwellers was hard to swallow.

It had to bother the players themselves, though it is likely not the cause of the esophagitis that kept Clay Buchholz out of the rotation and in the hospital recently. It's actually a common problem across the nation -- and we're not just talking Red Sox Nation.

"Esophagitis is an inflammation of your esophagus, and is most often caused by acid from the stomach that flows back up into the esophagus," explained Dr. Douglas Pleskow, co-director of endoscopy at the Digestive Disease Center at Beth Israel Deaconess Medical Center. "You might have heard the term 'acid reflux' or 'GERD' which is an acronym for Gastro Esophageal Reflux Disease. GERD affects about 60 million Americans and in chronic cases -- about 10 to 20 percent of the time -- it leads to esophagitis."

Symptoms of esophagitis include heartburn, nausea and sometimes vomiting. Because Buchholz noticed the presence of blood he spent some time in the intensive care unit. It's almost certain the diagnosis was confirmed by an endoscopic examination where a hi-def camera is threaded from the mouth through the esophagus.

"It's pretty easy to spot, even in what we would grade a mild case," said Pleskow. "Normally the lining of the esophagus is whitish-pink and very smooth. When it's inflamed it looks red and raw. A severe case might show an ulcer, or break in the lining -- that would be the source of the bleeding."

Pleskow also mentioned that some medications are known to cause "pill induced" esophagitis if not administered properly. The antibiotic doxycycline, which is a common treatment for acne, should always be taken with a lot of water because of the risk of irritation. Also, some bisphosphonate drugs that are used to treat osteoporosis fall into that category. Most often the culprit is acid and with treatment and prevention the prognosis for relief is very good.

For some sufferers a couple of Tums or a dose of Maalox will neutralize enough acid to address the issue. Others might need the intervention of drugs that actually cut down the amount of acid the body produces. Then there is the approach that is sometimes less popular among patients, but undeniably effective.

"We would always prefer to prevent first, so we look at common food triggers," Pleskow said. "Quite often tomato based foods like pizza or pasta sauce will cause problems. Spicy, greasy or fatty foods will do it too. Overeating, smoking or too much alcohol can trigger GERD, so lifestyle changes can be key."

So it might be a good idea to cut back on the peanuts and Cracker Jack, limit the number of hot dogs, and hold the ketchup and onions. Oh, and adding a few more Sox wins to the menu wouldn't hurt either.

Gary Gillis is a contributor to The BID Injury Report is a regular column on Beth Israel Deaconess Medical Center is the official hospital of The Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.

Boston Red Sox, Clay Buchholz