Rev. Chim. ♦ 71 ♦ no. 2 ♦ 2020 ♦ https://revistadechimie.ro 35 https://doi.org/10.37358/RC.20.2.7888 Impact of Corrosive Substances on the Mucosa of the Digestive Tract RODICA DANIELA BIRLA 1 *, PETRE ANGEL HOARA 1 , VALERIU-GABI DINCA 2 , ALEXANDRA-LIGIA DINCA 3 , SILVIU CONSTANTINOIU 1 ¹Carol Davila University Bucharest, Faculty of Medicine, 8 Eroii Sanitari, 050474, Bucharest, Romania 2 Titu Maiorescu University Bucharest, Faculty of Medicine, 22 Dambovnicului Str., 040441, Bucharest, Romania 3 Medicover Hospital Bucharest, 24 Preciziei, 062202, Bucharest, Romania Caustic ingestion is a major health concern in both developed and developing countries, that may lead to serious esophageal and gastric injury.Initially, the ingestion of a caustic substance produces post- caustic esophagitis, this being the acute phase, which in time by chronicization and by the methods of tissue remodeling, by fibrosis determines the post-caustic esophageal stenosis. Key words:caustic ingestion, esophageal lesions, gastric injury Ingestion of caustic substances often leads to severe morbidity and, frequently, death. Eymologic, the term corrosive is used for the action of acidic substances on the tissues and for the effect of the alkaline substances the term caustic is used. Currently, for both types of substances the term caustic is used [1]. For a long time, many authors agreed that the acids cause more damage to the gastric mucosa, whereas alkalis have a tendency for greater damage to the esophageal mucosa [2]. However, it is now known that these agents cause mucosal injuries in both the organs with no selective preference [3,4]. The symptomatology differs depending on the digestive segment predominantly affected. Thus, if the patient has dysphonia, dyspnoea then the lesion is in the epiglottis and larynx and represents a medical emergency that endangers the patient's life, causing acute respiratory failure [3]. If the corrosive substance has particularly damaged the esophagus, then the main symptoms of the patient are dysphagia and odynophagia. Stomach involvement causes epigastric pain or hematemesis [5,6]. Caustic agents can be acidic or alkaline in nature. Common alkali-containing caustic agents are household bleaches, drain openers, toilet bowel cleaners, dishwashing agents and detergents. Strong alkalis sold in liquid and granular forms are the principal causes of severe damage. Household bleach, dishwasher detergents, and other cleaning agents, all of which are mildly alkaline, are the most common caustic substances ingested. Alkalis commonly used are hydroxides of sodium and potassium. Acidic agents, frequently responsible, are the ones that are commonly available such as cleaning agents (hydrochloric acid) and a gold solvent, which is a mixture of hydrochloric and nitric acid (aqua regia) [7]. Alkaline substances are tasteless, colorless, odorless and have a viscous consistency, so their ingestion tends to be mostly accidental and in large quantities. [8] The most commonly used alkaline substance is sodium hydroxide. The acids have a pungent odor and an unpleasant taste, which is why the amount of the substance ingested is small and most often suicidal. The slightly alkaline pH of the saliva buffers the acidity of the substance, thus the lesions being milder in the esophagus. [1]. Acid-containing agents implicated in caustic ingestion include toilet bowl cleaners, anti-rust compound, swimming pool cleaners, vinegar, formic acid used in the rubber tanning industry and other similar acids [9,10]. The type of caustic agent most commonly implicated in poisonings varies from country to country. In a report, the most commonly implicated caustic agent was the alkali-sodium hypochlorite, which was found in bleaches, toilet bowl cleaners, drain cleaners and household disinfectants. Local experiences from some contries - Denmark, Israel, United Kingdom, Peru, Spain, Australia, Saudi Arabia and Turkey also showed that alkaline agents were more commonly involved in caustic injury[10]. Indian data, on the other hand, showed that majority of ingestions in their country were due to acids since these were cheaper and more readily available[9,10]. Some authors reported that bleach seems to constitute approximately 30% of all caustic substances ingested by children; drain or grease cleaners make up 30% of the total and various acid or alkali cleaners and detergents such as oven, toilet, tile, and drain cleaners, lye solvents, and battery acids make up 40% [11–13]. *email:gaby_uk30@yahoo.com