- Gastroesophageal reflux disease – The most common cause, with symptoms resulting from a combination of refluxed gastric acid and pepsin leading to inflammation and ultimately necrosis of the esophageal wall, causing ulcers and erosions.
- Infectious esophagitis – Common in patients with immunodeficiency or those on immunosuppressive medications. Common infections include Candida spp., herpes simplex virus type 1 or 2, varicella zoster virus, and cytomegalovirus, especially in organ-transplant recipients.
- Radiation esophagitis – Develops after treatment for thoracic cancers, especially breast cancer, with the risk proportional to the radiation dosage. Symptoms may last weeks to months after the completion of therapy. Stricture is a common consequence.
- Corrosive esophagitis – Follows ingestion of alkali or acidic materials. Stricture is a common consequence of this time of injury and may require dilation.
K20.90 – Esophagitis, unspecified without bleeding
16761005 – Esophagitis
Differential Diagnosis & Pitfalls
- Peptic ulcer disease
- Acute coronary syndrome
- Coronary artery disease
- Achalasia (see esophageal motility disorder)
- Esophageal web / esophageal ring
- Esophageal spasm (see esophageal motility disorder)
- Nutcracker esophagus (see esophageal motility disorder)
- Gingivostomatitis (eg, herpetic)
- Zenker diverticulum
- Hiatal hernia
- Inflammatory bowel disease (eg, Crohn disease)
- Malignancy (particularly esophageal, gastric, small bowel, pancreatic)
- Biliary colic (see cholelithiasis)
- Acute cholecystitis
- Zollinger-Ellison syndrome
- Chronic pancreatitis
- Drug side effects (NSAIDs, alcohol, caffeine, antibiotics, corticosteroids, opiates, digoxin)