Herpes Esophagitis

Written by Erica Roth | Published on July 11, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Herpes Esophagitis?

Esophagitis is inflammation of the esophagus. The esophagus is the tube that carries food and drink from your mouth to your stomach.

Herpes esophagitis is a viral infection of the esophagus. The herpes simplex virus type 1 (HSV-1) causes herpes esophagitis. This is the same virus that causes cold sores and eye infections such as conjunctivitis. The inflammation and open sores of herpes esophagitis can cause pain and can damage the throat tissues. Herpes simplex virus type 2 (HSV-2) is another form of the virus, which causes genital herpes but does not cause herpes esophagitis.

Herpes esophagitis is not very common in healthy people. Up to 90 percent of healthy adults have developed antibodies to the herpes simplex virus, according to the University of Tennessee Medical Center (UT, 2009). Antibodies help your body fight off viruses and other invaders so you do not get sick.

How Is Herpes Esophagitis Spread?

The herpes simplex type 1 virus that causes esophagitis is spread through infected saliva. You can develop a throat infection through close contact with someone who has mouth ulcers, cold sores, or eye infections. Wash your hands with warm water and soap to avoid spreading the virus to others. Avoid contact with those who have an active infection.

Cross contact with the herpes simplex virus type 2 can also cause infection in some cases. Engaging in oral sex with someone who has an active herpes outbreak could lead to herpes esophagitis in some people.

Most people with strong immune systems will not develop herpes esophagitis, even after being infected by the virus. Your risk increases if you have:

  • HIV or AIDS
  • leukemia or other cancers
  • organ transplants
  • diabetes

These conditions either weaken your immune system or are treated with medications that suppress your immune system. Any illness that could compromise your immune system can increase your risk of contracting herpes esophagitis.

Symptoms of Herpes Esophagitis

Symptoms of herpes esophagitis involve both the mouth and other areas of the body. The primary symptoms include difficulty swallowing and open sores in the mouth. These moth sores are called “herpes labialis.” Swallowing may also be painful due to the inflammation and ulceration of the throat tissues. Other signs of infection may include:

  • joint pain
  • chills
  • fever
  • general malaise (not feeling well)

Diagnosing Herpes Esophagitis

Your doctor will take a medical history and look into your esophagus to determine the cause of your symptoms. Bacteria, fungi, and a range of other viruses can also cause infectious esophagitis. Other conditions such as strep throat may mimic the symptoms of herpes esophagitis. Throat cultures, mouth swabs, blood tests, and urine tests are all diagnostic tools used to confirm herpes esophagitis. These tests can identify the source of the infection. If the HSV-1 virus is found, then your doctor will know that you have herpes esophagitis.

Treatment for Herpes Esophagitis

Medication can be used to treat esophagitis caused by the herpes virus. Your healthcare provider will likely prescribe one of three anti-viral drugs:

  • acyclovir (Zovirax)
  • famciclovir (Famvir)
  • valacyclovir (Valtrex)

Over-the-counter (OTC) or prescription-strength pain relievers may also be used to ease the pain of herpes esophagitis. Your doctor might prescribe medication on a long-term basis to prevent you from developing recurring infections.

What Is the Outlook for Herpes Esophagitis?

Recovery times vary depending on your individual state of health. People with healthy immune systems usually respond quickly to treatment and improve within a few days. Those with more complicated medical conditions may be slower to heal due to an impaired immune system.

Residual scarring from the inflammation can cause swallowing difficulties. A more serious, life-threatening complication is esophageal perforation, which is a medical emergency. Esophageal perforation is only very rarely caused by herpes esophagitis. Most people with herpes esophagitis will not have serious long-term health issues.

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