HealthSheets™


Esophagitis

Outline of human figure showing digestive system and pointing out esophagus and stomach. Detail of closeup of lower esophagus where it connects to stomach. Lining of esophagus is inflamed.
With esophagitis, the lining of the esophagus is inflamed.

Do you often have burning pain in your chest? You may have esophagitis. This is when the lining of the esophagus becomes red and swollen (inflamed). The esophagus is the tube that links your throat to your stomach. This sheet tells you more about esophagitis. It also talks about treatment.

Main types of esophagitis

Reflux esophagitis. This is the more common type. It is caused by GERD (gastroesophageal reflux disease). Stomach contents and acid flow back up into the esophagus. This happens over and over. It leads to inflammation. You are more likely to get this type if you:

  • Are overweight

  • Have asthma

  • Smoke

  • Are pregnant

  • Vomit a lot

  • Take certain medicines, such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Have a hiatal hernia

Infectious esophagitis. This is caused by an infection. You are more at risk for this kind if you have a weakened immune system and poor nutrition. Using antibiotics can also raise your risk. The infection is often due to:

  • A type of fungus (often candida)

  • A virus, such as herpes simplex virus 1 (HSV-1) or cytomegalovirus (CMV)

Eosinophilic esophagitis. Foods or other things around you can give you an allergic reaction. This causes an immune response. It may lead to this type of esophagitis.

Pill-induced esophagitis. Certain types of medicines can cause inflammation and ulcers in the esophagus. Some of these are:

  • Doxycycline

  • Aspirin

  • NSAIDs

  • Alendronate

  • Potassium

  • Quinidine

  • Iron

 

Symptoms of esophagitis

These symptoms can occur with esophagitis:

  • Pain when swallowing, or trouble swallowing

  • Pain behind your breastbone (heartburn)

  • Acid regurgitation

  • Chronic sore throat

  • Gum inflammation

  • Cavities

  • Bad breath

  • Nausea

  • Pain in your upper belly (abdomen)

  • Bleeding (indicated by bright red vomit or black, tarry stool)

These symptoms occur more often with reflux esophagitis:

  • Coughing, wheezing, or asthma

  • Hoarseness or laryngitis

Diagnosis of esophagitis

Your healthcare provider will ask about your past health and your symptoms. You’ll also be examined. Sometimes certain tests are needed, such as:

  • Upper endoscopy. A thin, flexible tube with a tiny light and camera is used. It is put into the mouth down into the esophagus. This lets the provider look for damage. A small sample of tissue (biopsy) may also be taken. The sample is sent to a lab for testing.

  • Upper gastrointestinal (GI) X-ray with barium. An X-ray is done after you drink a substance called barium. Barium may make problems in the esophagus easier to see on an X-ray.

  • Esophageal pH. A soft, thin tube is passed into the esophagus through the nose or mouth for 24 hours. It measures the acid level in the esophagus.

  • Esophageal manometry. A soft, thin tube is passed into the esophagus through the nose or mouth. It measures muscle contractions in the esophagus.

Treatment of esophagitis

Medicines. Different medicines can help treat esophagitis. The medicine used will depend on the type of esophagitis you have. Talk with your healthcare provider.

Lifestyle changes. Making these changes can help reduce irritation and ease your symptoms:

  • Limit or don't eat:

    • Spicy foods (pepper, chili powder, curry)

    • Hard foods (nuts, crackers, raw vegetables)

    • Acidic foods and drinks (tomatoes, citrus fruits and juices)

    • High-fat foods

    • Chocolate

    • Peppermint

    • Nutmeg

     

  • Until you can swallow without pain, stick to a combined liquid and soft diet. Try foods such as cooked cereals, mashed potatoes, and soups.

  • Take small bites and chew your food well.

  • Don't eat large meals or heavy meals at night. Don't lie down within 2 to 3 hours of eating.

  • Get to or stay at a healthy weight.

  • Stay away from alcohol, caffeine, and smoking or tobacco products.

  • Brush and floss your teeth

  • Raise your upper body by 4 to 6 inches when lying in bed. This can be done using a foam wedge. Or put blocks or bed risers under the legs at the head of your bed.

Surgery. This may be needed for severe reflux esophagitis. Other noninvasive procedures to treat GERD and esophagitis are being studied. Your provider can tell you more.

Why treatment is important

Without treatment, esophagitis can get worse, especially if you have severe reflux esophagitis. Ongoing symptoms can cause scarring of the esophagus. Over time, scarring can lead to a narrowing of the esophagus (stricture). This can make it hard to pass food down to the stomach. As symptoms go on, they can also cause changes in the lining of the esophagus. These changes can put you at a slightly higher risk of cancer of the esophagus.

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