Herpes esophagitis is a viral infection of the esophagus caused by the herpes simplex virus type 1 (HSV-1). The esophagus is the tube that carries food and drink from your mouth to your stomach. Esophagitis is inflammation of the esophagus. It can cause damage to the esophagus and throat tissues, as well as difficulty swallowing and chest pain.
Esophagitis can be caused by a variety of factors, including bacteria, fungi, or even acid reflux. Herpes esophagitis isn’t very common in healthy people. People who have weakened immune systems, such as those who have cancer, HIV, or AIDS, are at an increased risk of developing herpes esophagitis if they’re infected with HSV-1.
If you have developed herpes esophagitis, your doctor will watch you very closely and check for other illnesses or health problems.
There are several types of the herpes simplex virus. HSV-1, the cause of most cases of herpes esophagitis, is the same virus that causes cold sores. It’s generally passed through mouth-to-mouth contact.
HSV-1 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. If you’re infected, it’s very important that you wash your hands with warm water and soap to avoid spreading the virus to others. You should avoid contact with those who have an active infection. If you know or suspect that you’re infected, immediately contact your doctor and inform anyone that you’ve had close contact with.
Herpes simplex virus type 2 (HSV-2) is another form of the virus and is considered a sexually transmitted disease (STD). It’s spread through skin-to-skin contact and causes genital herpes. HSV-2 very rarely causes herpes esophagitis.
Cross-contact with HSV-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. If you’re having a herpes outbreak, make sure to practice safe sex and to inform your partner. The key to preventing it from being spread is catching it early on and beginning treatment.
Most people with strong immune systems won’t develop herpes esophagitis, even after being infected by HSV-1. Your risk increases if you have:
- HIV or AIDS
- leukemia or other cancers
- organ transplants
- any illness that compromises your immune system
People who abuse alcohol or take a long-term antibiotic are also at greater risk. Taking oral medications that can affect your esophageal lining or cause your esophagus to become inflamed can also increase your risk.
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 mouth 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
- general malaise (not feeling well)
Your doctor will ask you your 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. Your doctor will know that you have herpes esophagitis specifically if the HSV-1 virus is found.
Medication can be used to treat esophagitis caused by the herpes virus. Your healthcare provider will likely prescribe one of three antiviral drugs:
- acyclovir (Zovirax)
- famciclovir (Famvir)
- valacyclovir (Valtrex)
Over-the-counter or prescription pain relievers may also be used to help ease the pain of herpes esophagitis. Your doctor might prescribe medication on a long-term basis to prevent you from developing recurring infections.
Recovery times vary depending on your state of health. People with healthy immune systems usually respond quickly to treatment and improve within a few days. People who have more complicated medical conditions may need more time to heal because of their impaired immune system.
Scarring from the inflammation can sometimes make it difficult to swallow. A more serious, life-threatening complication is esophageal perforation, which is a medical emergency. Herpes esophagitis rarely causes esophageal perforation. Most people with herpes esophagitis won’t have serious long-term health issues.