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Question

Following endowcopy my son's report said irregular z-line 44cm from incisors, also monilial esophagitis ? this was biopsied, gastric mucosal abnormality characterized by erythema, biopsied, lower third of the esophagus and upper gastrointestinal tract both showed candidiasis. What does this all mean??

Submitted: 24 days and 15 hours ago.
Category: Health
Value: $14
Status: CLOSED
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Posted by Julia Kizhner 24 days and 15 hours ago.

Answer

Hello,

Thank you for your question and for writing in.

 

Candidiasis means Yeast infection. There are cases when you can get yeast infection in your esophagus. It is very treatable with antifungal medication.

Minimal esophagitis means inflammation in the esophagus. In your son's case, it is most likely caused by the yeast infection. Sounds like he also has the same inflammation in the stomach since he has redness (erythema).

Z-line is just a term used to describe the area where esophagus meets the stomach. Irregular z-line does not something is wrong but the area was biopsied and tissue sent to be looked at under the microscope.

 

Hope this was helpful.

Please let me know if you have any other questions.

 

Thanks,

Julia

24 days and 14 hours ago.

Reply

What would cause the yeast infection in the esophagus, and why did the MD not give him anything to treat it? Also, he is to return to this MD in 4 weeks, seems like a long time to leave a yeast infection untreated?

Posted by Julia Kizhner 24 days and 13 hours ago.

Answer

I am not sure as to why MD didn't give him anything but usually it can be treated with Diflucan 200 mg as first dose followed by 100 mg daily for 2 weeks. He needs to have it treated especially if he is having sympomts of difficulty swallowing or painful swallowing. Sometimes there is no specific answer to why someone got yeast infection, but occasionally it can be associated with several conditions which lower immune system. You need to discuss that further with your doctor. I am assuming the doctor is waiting for the pathology reports which take 3-4 days to come back following endoscopy before he initiates treatment. I definitely suggest you calling the doctor sooner then 44 weeks to discuss the results and treatment.

24 days and 13 hours ago.

Reply

So I recommended that my son call the MD back and ask why he did not offer treatment, since recommendation was to return in 4 weeks. Son is symptomatic, which is why he had this endo done, plus he is scheduled for an abdominal US next week. Is it wrong to expect immediate treatment for the yeast infection, especially considering he is symptomatic?

Posted by Julia Kizhner 24 days and 13 hours ago.

Answer

No, it is not wrong at all. He should have received immediate treatment. Was he recently on any antibiotics?

24 days and 13 hours ago.

Reply

No, he has not been on any treatment. I told him I felt he should call MD back today and ask why he was not given treatment for the yeast, regardless of biopsy results pending. Did not make sense to me, but had not heard of this z-line issue, was not sure of the implications, but his endoscopy photos clearly show white patchy yeast in the lower esophagus.

Posted by Julia Kizhner 24 days and 13 hours ago.

Answer

Z-line simply implies to the anatomical site where esophagus meets stomach. If the endoscopy report says "irregular z-line" that just means they did a biopsy in that area. This does not have to have any implication at all. Good luck with your son and hope he feels better soon. Julia

24 days and 13 hours ago.

Reply

So, how did this answer my question?

Posted by Julia Kizhner 24 days and 13 hours ago.

Info Request

I am sorry, I thought I answered your question. You were asking what the results of endoscopy mean. Did I misunderstand? Do you have an additional question. I will be glad to answer.

24 days and 13 hours ago.

Reply

OK. Thought I just responded to this, getting the same question again. I asked the following question:

No, he has not been on any treatment. I told him I felt he should call MD back today and ask why he was not given treatment for the yeast, regardless of biopsy results pending. Did not make sense to me, but had not heard of this z-line issue, was not sure of the implications, but his endoscopy photos clearly show white patchy yeast in the lower esophagus.

The response I keep getting from you relates back to my first query about the endoscopy results r/t to z-line statement. Seems that we are recycling answers??? Why was he not given treatment for the yeast - is there a medical rationale behind this?

Accepted Answer

I have written before that I dont know why MD did not give him immediate treatment. Unfortunately I cannot answer for the decisions of other providers. The only possible explanation to me was that he was waiting for the biopsy report before putting your son on any medication. Otherwise, I dont see any medical rationale behind the decision. I agree with the fact that you asked your son to call the doctor and find out why treatment wasn't started.

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Expert: Julia Kizhner
Pos. Feedback: 100.0 %
Accepts: 
Answered: 10/30/2009

Physician Assistant

7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss

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