Esophagitis is an acute or chronic inflammatory process affecting the esophageal wall that can cause chest pain, dyspepsia, odynophagia, or dysphagia and lead to complications such as strictures, food impactions, gastrointestinal bleeding, and even esophageal perforation. There are many causes of esophagitis, including:
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.
Esophagitis is an acute (rapid onset) or chronic (long-lasting) inflammation of the lining of the esophagus. The esophagus is the passageway for food between the mouth and the stomach. Irritation and swelling of the esophagus can be caused by stomach acid, allergies, oral medications, chemical irritants, radiation treatments, or infection. If not treated, esophagitis can damage the lining of the esophagus.
Who’s At Risk
Risk factors for esophagitis:
Habitually eating before going to bed
Consuming large, fatty meals
Consuming acidic or spicy foods including tomatoes, citrus, caffeine, alcohol, garlic, onions, and chocolate
Personal history or family history of allergic reactions or asthma
Incomplete swallowing of pills
Diabetes, immune deficiency, certain drug therapies (immunosuppressants), and certain infections
Using steroids or antibiotics to treat other infections
Signs & Symptoms
Common symptoms of esophagitis include:
Difficult or painful swallowing
Indigestion or heartburn
Stomach or chest pain
Acid reflux / regurgitation
Symptoms in infants and very young children:
Failure to thrive
These measures can be taken to alleviate the symptoms of esophagitis:
Avoid foods that induce acid reflux
Take pills with plenty of water and do not lie down until 30 minutes after taking the pill
Contact a health care professional about your use of pain relievers
Avoid lying down after eating
Elevate your head in bed
When to Seek Medical Care
Contact your health care provider if you have symptoms that last for more than a few days and don't improve after using antacids, or if your symptoms are severe and you have difficulty eating.
Call 911 if you have food lodged in your esophagus.
Chest pain caused by a heart problem is an emergency. Call 911 if your chest pain is crushing or squeezing, comes with a fast or irregular pulse, radiates to the shoulder or jaw, or comes with shortness of breath. If you have a personal or family history of heart disease, treat chest pain as an emergency.
Your health care provider may recommend treatments to reduce symptoms for acid reflux esophagitis:
Over-the-counter antacids to neutralize stomach acid
Medication to reduce acid production, such as cimetidine (Tagamet HB) and famotidine (Zantac)
Medication to block acid production, such as Iansoprazole (Prevacid) and omeprazole (Prilosec)
Surgery to strengthen the sphincter between the stomach and esophagus can reduce acid reflux
If your esophagitis is induced by allergies, your health care provider may recommend the following:
Proton pump inhibitors such as lansoprazole (Prevacid), omeprazole (Prilosec), or pantoprazole (Protonix)
Eliminating consumption of food that causes reaction