Evolving Diagnostic and Therapeutic Methods in Corrosive Esophagitis: Evaluation of a Diagnostic and Therapeutic Algorithm for Corrosive Esophagitis Based on 26 Years of Experience

Abstract

Background: This study aims to present a diagnostic and treatment algorithm developed from 26 years of clinical experience and to evaluate current management approaches. Methods: In this retrospective study, 601 patients (362 males, 239 females; mean age: 44.9 +/- 17.1 years; range, 18 to 86 years) diagnosed with corrosive esophagitis between January 1998 and December 2024 were analyzed. Demographic data, ingested substance type and intent (accidental or suicidal), clinical presentation, diagnostic methods, treatment strategies, and outcomes were evaluated. Endoscopic injury severity was classified using the Zargar system. Results: Commonly ingested substances were bleach, limescale removers, and detergents. Rigid esophagoscopy was performed in 248 (49.5%) patients. Oral intake was initiated in a mean duration of 4.5 +/- 5.23 days. All patients received intravenous proton pump inhibitors and antibiotics; corticosteroids were selectively used. Surgery was required in three patients, and eight underwent dilatation. Four (0.8%) patients died. Conclusion: A symptom-and imaging-based triage approach may be safe in the diagnosis and management of corrosive esophagitis. Routine corticosteroid use appears unnecessary. The proposed algorithm, based on 26 years of clinical experience, may serve as a practical tool to streamline management and improve patient outcomes.