Esophagitis is any inflammation or irritation of the esophagus. The esophagus is the tube that sends food from your throat down to your stomach. Common causes include acid reflux, side effects of certain medications, and bacterial or viral infections. Reflux is when the stomach contents and acids back up into the esophagus.
This disorder can cause a wide variety of symptoms, including trouble swallowing, sore throat, and heartburn. Untreated esophagitis can lead to ulcers or even to a severe narrowing of the esophagus, which can be a medical emergency.
Your treatment options and outlook depend on the exact cause of your condition. Most healthy people improve, with proper treatment, within two to four weeks. Recovery may take longer for people with a weakened immune system or infection.
Eosinophilic esophagitis is the result of too many white blood cells in the esophagus. This is the result of your body over-responding to an allergen. In children, this allergic reaction can make it difficult to eat. According to the Boston Children’s Hospital, 1 in every 10,000 children has this form of esophagitis. Common triggers include milk, soy, eggs, rye, wheat, peanuts, beans, and beef. Inhaled allergens, such as pollen, can also cause this form of esophagitis.
Reflux esophagitis is usually due to a condition known as gastroesophageal reflux disease (GERD). GERD is when the stomach contents, including acids, frequently back up into the esophagus. This causes chronic inflammation and irritation of the esophagus.
Drug-induced esophagitis can occur when you take certain medications with insufficient water. This causes them to linger in the esophagus too long. Medications may include pain relievers, antibiotics, potassium chloride, and bisphosphonates (drugs that prevent bone loss).
Infectious esophagitis is rare and can be due to bacteria, viruses, fungi, or parasites. You are at increased risk for this type of esophagitis if you have a weakened immune system due to disease and/or medications. This type of inflammation is common in people with HIV or AIDS, cancer, and diabetes.
Symptoms of esophagitis include:
- difficulty swallowing (dysphagia)
- pain when you swallow (odynophagia)
- sore throat
- hoarse voice
- acid reflux
- chest pain (worse with eating)
- abdominal pain
- decrease in appetite
Very young children may have difficulty feeding.
Contact your doctor if you or your child experience this, and:
- you also have shortness of breath or chest pain, especially if it does not occur while eating
- symptoms continue for more than a few days
- symptoms are severe enough to interfere with your ability to eat properly
- you also have headache, muscle aches, or fever
Seek immediate medical attention if:
- you have chest pain lasting more than a few minutes, especially if you have a history of heart problems, elevated blood pressure, or diabetes
- you think you may have food stuck in your esophagus
- you are unable to consume even small sips of water
Risk factors for developing esophagitis include:
- weakened immune system due to HIV or AIDS, diabetes, leukemia, lymphoma, or other autoimmune diseases
- hiatal hernia (when the stomach pushes through the opening in the diaphragm between the esophagus and stomach)
- radiation therapy of the chest
- surgery in the chest area
- medications to prevent organ transplant rejection
- aspirin and anti-inflammatory medications
- chronic vomiting
- alcohol and cigarette use
- a family history of allergies or esophagitis
Your chance of developing an infection of the esophagus is low if you have a healthy immune system.
Untreated esophagitis can lead to other, more serious health complications related to the function and structure of the esophagus. Complications include:
- Barrett’s esophagus, damage to your esophagus
- stricture, or narrowing, of the esophagus that can lead to problems swallowing
- holes or ulcers in the esophagus (esophageal perforation)
Make an appointment to see your doctor if you have signs of esophagitis. Be prepared to provide a full medical history, including any previously diagnosed conditions. List all of the prescription and over-the-counter medications you take.
Your doctor will likely perform a physical examination. They may also order diagnostic tests, including:
- barium X-ray, also called an upper GI series
- allergy testing, which may include skin tests and eliminating certain foods from your diet
Treatment depends on the specific cause of your symptoms. Medications may include:
- antiviral medications
- antifungal medications
- pain relievers
- oral steroids
- proton pump inhibitors (these medications block stomach acid production)
If food allergies cause your condition, you must identify trigger foods and eliminate them from your diet. Common food triggers include tomatoes, citrus fruits, spicy food, alcohol, caffeine, onions, garlic, mint, and chocolate.
You can also ease your symptoms by avoiding spicy foods, acidic foods and drinks, and raw or hard foods. Take smaller bites and chew your food well. You should avoid tobacco and alcohol, which increase inflammation and suppress the immune system. Ask your doctor for dietary guidelines.
Surgery to dilate the esophagus may be necessary if the esophagus has become too narrow and causes food to lodge.
If your symptoms are due to medication, you may need to drink more water, take a liquid version of the medication, or try a different medication. You may need to refrain from lying down for 30 minutes after taking medication in pill form.
Chronic esophagitis can cause narrowing of the esophagus or tissue damage without treatment. Your chances of developing esophageal cancer are higher if the cells lining your esophagus have changed.
You can lower your risk of future bouts of esophagitis by avoiding identified triggers.
Your individual outlook depends on the cause and on your overall health. Most people improve with treatment. Healthy people often recover within three to five days, even without treatment. Recovery may take longer if you have a weakened immune system.