Understanding Esophagitis

Esophagitis is the inflammation of the lining of the esophagus (lower end). This condition can be extremely uncomfortable if left untreated, causing ulcers, scarring of the esophagus, and problems with swallowing. In some cases, esophagitis can lead to a condition called "Barrett’s Esophagus," a risk factor for esophageal cancer.

Causes of esophagitis

The following are the underlying conditions that could cause esophagitis: gastroesophageal reflux disease (GERD) or reflux esophagitis, swallowing corrosive chemicals such as alkaline, muscle failure between the esophagus and stomach, and certain infections (candidiasis, cytomegalovirus, herpes simplex) that affect immunocompromised people like those with HIV.

Esophagitis could also be caused by a physical injury that results from radiation therapy or by ingesting a medication tablet that lodges and slowly dissolves in the esophagus.

Symptoms of esophagitis

The primary symptom of esophagitis is heartburn that worsens when you bend over.

This symptom may or may not involve regurgitation of gastric acids into your mouth. Heartburn may last for days, weeks, several months, or even longer if left untreated. It can also re-occur.

Other symptoms include: mouth sores, nausea, vomiting, painful and/or difficulty swallowing, and a feeling of something being stuck in your throat.

How esophagitis is diagnosed?

How is esophagitis diagnosed? This condition is first suspected by visually examining the esophagus on endoscopy.

Esophagitis is suspected if there are constrictions or multiple rings that make the esophagus look like a cat’s esophagus (ringed esophagus or felinization of the esophagus).

Other signs may be long furrows, whitish spots, or a lining resembling a crepe paper. The definitive diagnosis of this condition is made by examining the presence of eosinophils in the esophageal biopsy tissue.

How to treat esophagitis?

The treatment used in esophagitis is the same as the recommended treatment for GERD without esophagitis. These treatments include: proton pump inhibitors, acid suppressants like histamine2-receptor antagonists, and prokinetic agents.

Usually, drug treatment is only required for a short period of time, although medications often need to be re-prescribed. Medication that enhances normal swallowing movements are also prescribed and are helpful in most cases.

Other possible treatments include: pain medications, corticosteroid medication for reducing inflammation, intravenous nutrition, and antibiotics, antivirals, or antifungals to control an infection. In rare cases, surgery is needed.

How to prevent esophagitis?

You can prevent esophagitis by slightly elevating your head when you sleep, avoiding substances that strongly stimulate acid secretions (e.g., alcohol, coffee), and avoiding drugs like anticholinergics, foods rich in fats and sugar, and cigarette smoking. You can also take an antacid to balance gastric acidity.