Infectious Esophagitis

What is infectious esophagitis?

Esophagitis is when the lining of your esophagus becomes irritated and inflamed. The esophagus is the tube that connects the back of your throat to your stomach. Food and liquid go down the tube when you swallow. The lining of the esophagus is sensitive. Because of this, many things can cause irritation. The most common cause is acid from the stomach. But an infection from fungi, yeast, a virus, or bacteria can also cause irritation. This is called infectious esophagitis. You are more likely to develop it if your immune system is weakened.

What causes infectious esophagitis?

The condition can be caused by fungi, yeast, viruses, or bacteria.

Who is at risk for infectious esophagitis?

People with a normal immune system are not likely to get infectious esophagitis. If you have a health problem or are having treatment that weakens your immune system, you could be at risk. These conditions put you at risk:

• HIV/AIDS

• Cancer treatments such as chemotherapy and radiation therapy

• Diabetes

• Bone marrow or stem-cell transplant

• Medicines that depress the immune system, such as steroids or medicines taken after an organ transplant

• Long-term antibiotic use

• Medicines that limit how much stomach acid you make

• Alcohol abuse

• Older age

What are the symptoms of infectious esophagitis?

Symptoms can occur a bit differently in each person. They can include:

• Pain when swallowing

• Trouble swallowing

• Mouth pain

• Chest pain or heartburn

• Abdominal (belly) pain

• Nausea or vomiting

• Loss of appetite

• Chills or fever

The symptoms of infectious esophagitis may look like other health conditions. See your healthcare provider for a diagnosis.

How is infectious esophagitis diagnosed?

You may see a healthcare provider called a gastroenterologist. This is a doctor who specializes in conditions linked to digestive tract health. They may think you have infectious esophagitis if you have symptoms of esophagitis along with a condition that weakens the immune system. Your healthcare provider will ask about your symptoms and health history and give you a physical exam. You may also have tests, such as:

• Endoscopy. Your healthcare provider uses a tiny camera on a thin, flexible tube to look inside your esophagus for signs of irritation. They might take swabs and scrapings of any white patches, fluid-filled blisters, or sores in your esophagus. These will be tested to find the cause of the infection. Tissue samples (biopsies) are taken and looked at under a microscope to diagnose the cause of the infection.

• Blood tests. Your blood may be tested for viruses, such as herpes simplex virus.

How is infectious esophagitis treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. If you have a healthy immune system, your infection may go away on its own without treatment.

If you need treatment with medicine, the type of medicine depends on the cause. For example:

• Fungal esophagitis. This is caused by a fungus called Candida. It may be treated with an antifungal medicine called fluconazole or other similar medicines.

• Viral esophagitis. This may be treated with antiviral medicines, such as acyclovir.

• Bacterial esophagitis. This may be treated with broad-spectrum antibiotics. These are medicines that work to kill many types of bacteria.

You may also be given acid blocker medicine along with other treatments.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all medicines.

What are possible complications of infectious esophagitis?

Complications are not common, unless you have a condition that weakens your immune system. Complications may include:

• Infection that spreads to other parts of your body

• Scar tissue that forms in the esophagus and causes it to narrow

• Sores (ulcers) in the esophagus that lead to bleeding

• A hole in the esophagus called a perforation or fistula

How do I manage infectious esophagitis?

While you are recovering from infectious esophagitis, work with your healthcare provider and keep all your follow-up appointments.

If you have ongoing painful or difficult swallowing, your healthcare provider may advise that you:

• Stop smoking.

• Not drink alcohol or caffeine.

• Not take over-the-counter medicines that may irritate your esophagus, such as aspirin or ibuprofen.

• Not eat foods or have drinks that give you heartburn.

• Lose weight if you are overweight.

• Eat smaller meals more often.

• Not eat within 3 hours before you go to bed.

• Not sleep in a flat position. Raise the head of your bed several inches.

When should I call my healthcare provider?

Call your healthcare provider right away if any of the following occur:

• Trouble swallowing that gets worse

• Pain when swallowing

• Symptoms of infection, such as chills or fever

• Chest pain or trouble breathing ( Call 911)

• Vomiting that persists

Key points about infectious esophagitis

• Esophagitis is when the lining of your esophagus becomes irritated and inflamed. An infection from fungi, yeast, a virus, or bacteria can cause it. This is called infectious esophagitis.

• People with a normal immune system are not likely to get infectious esophagitis. You are more likely to develop it if your immune system is weakened.

• Symptoms can include pain when swallowing and trouble swallowing.

• You may have an endoscopy and blood tests.

• If you have a healthy immune system, your infection may go away on its own without treatment. If you need medicine, the type of medicine depends on the cause of the infection.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.