Esophagitis

Medically reviewed by Michele Cho-Dorado, MD on December 11, 2017Written by Ann Pietrangelo

What is esophagitis?

Esophagitis is any inflammation or irritation of the esophagus. The esophagus is the tube that sends food from your mouth 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 variety of symptoms that include:

Untreated esophagitis can lead to ulcers, scarring, and severe narrowing of the esophagus, which can be a medical emergency.

Your treatment options and outlook depend on the cause of your condition. Most healthy people improve within two to four weeks with proper treatment. Recovery may take longer for people with a weakened immune system or infection.

Types of esophagitis

Eosinophilic esophagitis

Eosinophilic esophagitis is caused by too many eosinophils in the esophagus. This happened when your body overrespond to an allergen. In children, this can make eating difficult. According to the Boston Children’s Hospital, 1 in 10,000 children has this form of esophagitis. Common triggers include:

  • milk
  • soy
  • eggs
  • wheat
  • peanuts
  • tree nuts
  • shellfish

Inhaled allergens, such as pollen, can also contribute to this form of esophagitis.

Reflux esophagitis

Reflux esophagitis is usually due to a condition known as gastroesophageal reflux disease (GERD). GERD occurs when stomach contents like acids, frequently back up into the esophagus. This causes chronic inflammation and irritation of the esophagus.

Drug-induced esophagitis

Drug-induced esophagitis can occur when you take certain medications without enough water. This causes medications to linger in the esophagus too long. These medications include:

  • pain relievers
  • antibiotics
  • potassium chloride
  • bisphosphonates (drugs that prevent bone loss)

Infectious esophagitis

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 or medications. This type is common in people with HIV or AIDS, cancer, and diabetes.

Symptoms of esophagitis

Symptoms of esophagitis include:

Very young children may have difficulty feeding. Contact your doctor if you or your child experience and the following symptoms and:

  • 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
  • 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 esophagitis

Risk factors for developing esophagitis include:

  • weakened immune system due to HIV or AIDS, diabetes, leukemia, or lymphoma
  • hiatal hernia (when the stomach pushes through the opening in the diaphragm between the esophagus and stomach)
  • chemotherapy
  • radiation therapy of the chest
  • surgery in the chest area
  • medications to prevent organ transplant rejection
  • immunosuppressive medications used to treat autoimmune diseases
  • aspirin and anti-inflammatory medications
  • chronic vomiting
  • obesity
  • 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.

Potential long-term health complications

Untreated esophagitis can lead to serious health complications related to the function and structure of the esophagus. Complications include:

  • Barrett’s esophagus, damage to the lining of your esophagus, which can lead to a precancerous change in the tissue
  • stricture, or narrowing, of the esophagus that can lead to obstruction and problems swallowing
  • holes or ulcers in the esophagus (esophageal perforation)

How is esophagitis diagnosed?

Make an appointment to see your doctor if you have symptoms esophagitis. Be prepared to provide a full medical history, including any other diagnosed conditions. List all the prescription and over-the-counter medications you take.

Your doctor will likely perform a physical examination. They may also order diagnostic tests including:

  • endoscopy with biopsies
  • barium X-ray, also called an upper GI series
  • allergy testing, which may include skin tests. Food elimination may be discussed after a diagnostic endoscopy.

Treatment for esophagitis

Treatment depends on the cause of your symptoms. Medications may include:

  • antiviral medications
  • antifungal medications
  • antacids
  • 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. The top 6 food allergens include:

  • milk
  • soy
  • eggs
  • wheat
  • peanuts
  • tree nuts
  • shellfish

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. And ask your doctor for dietary guidelines. You should avoid tobacco and alcohol.

A procedure to dilate the esophagus may be necessary if the esophagus becomes 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. And you may need to refrain from lying down for 30 minutes after taking medication in pill form.

What is the long-term outlook?

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 due to chronic acid exposure.

You can lower your risk of future bouts of esophagitis by avoiding identified triggers.

Your 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.

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