A 40-year-old woman, with no relevant pathological history. She attended the primary care clinic for dyspepsia with epigastralgia and retrosternal pyrosis of 10 days' evolution. The anamnesis ruled out dietary transgressions, intake of drugs or gastrolesive substances, and the presence of organic symptoms or clinical alarm data. Physical examination was normal. The patient was diagnosed with dyspepsia that was not investigated. Treatment was started with hygienic-dietary measures and omeprazole 20 mg/day for 4 weeks, and the patient was scheduled for a check-up.
The patient reported a slight clinical improvement. The dose of omeprazole was increased to full doses and a prokinetic drug was added. The patient was recalled in 4 weeks for a further review, where the presence of mechanical oropharyngeal dysphagia was noted as an alarm sign. An EDA was requested as a matter of preference, which revealed the presence of an oesophageal exudate in the proximal 2/3 of the esophagus. Samples of the lesions were taken by brushing for pathological examination and culture, which confirmed the diagnosis: candidal oesophagitis.

The patient was treated with fluconazole 100 mg/day for 21 days and pantoprazole 40 mg/day orally, achieving complete remission.
Given the diagnosis of CD, the study of its possible causes and associated entities (neurological, neoplastic, metabolic, systemic, immunosuppression, etc.) was completed by means of anamnesis, physical examination, complete blood tests (with thyroid, hepatic and renal function, diabetic profile, immunological status of the patient, serological study, etc.) and chest and abdominal X-rays. The results of all the complementary tests were negative. After completing the study, the only risk factor found was treatment with proton pump inhibitors (PPIs).
The patient was finally diagnosed with CD in an immunocompetent patient. In the literature reviewed, patients with CD related to taking PPIs had taken this treatment for at least 2 months6-8 (like our patient). We decided to discontinue such treatment after clinical resolution, and subsequently performed a follow-up EDA, which was normal.