[ XXXX as complication of inhaled steroid therapy].

@entity1 @entity748 @entity565 @entity2910 @entity5023
Gastrointestinal endoscopy was performed in two @entity565 @entity1 using inhaled corticosteroid who complained of odynophagia. The endoscopic finding was high grade with white moss (Grade III) in both @entity1 . @entity2910 is often recognized in bronchial @entity748 @entity1 receiving long-term @entity5023 (FP) dry powder (Diskhaler) inhalation. We therefore examined the complicated context of @entity2910 in @entity1 with long-term FP inhalation. Out of 20 bronchial @entity748 @entity1 who had been using FP inhalation long-term, seven showed signs of @entity2910 . Three @entity1 had mild grade (Grade I), one middle grade (Grade II) and three high grade (Grade III) candidiasis, with a frequency of 35%. This rate is higher than the usual spontaneous occurrence rate of @entity2910 , and it is suggested that inhalation of corticosteroid medication can penetrate into the esophagus after deep inhalation. We tested this hypothesis in two studies. 1) To measure the esophageal concentration of FP, four healthy adults inhaled 200 microg FP once. Right after inhalation, FP concentration in the esophageal washing fluid was 3.3 microg. On another day, 30 minutes after the same dose of inhaled FP, one FP concentration in the esophageal washing fluid was 0.67 microg (immediately laydown), and another was 0.11 microg (remained standing). This indicates that even though FP dissipates quickly, it remains in the esophagus 30 minutes after inhalation. 2) We observed the process in one @entity1 with high grade (Grade III) @entity2910 . The time of inhalation was changed from just after getting up and just before going to bed to before breakfast and before dinner. Under this regimen, the signs of @entity2910 improved from high to middle grade. CONCLUSION: If @entity748 @entity1 do not go to sleep immediately after FP inhalation, the remaining FP in the esophagus decreases rapidly, thereby decreasing the risk of @entity2910 . In addition, by changing the FP inhalation times to before breakfast and dinner, the remaining FP in the esophagus is washed away and does not remain in the esophagus. Therefore, this study, which avoided inhalation before going to bed, provides useful information for the prevention and improvement of @entity2910 .
