Esophagitis

What is 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.

What causes esophagitis?

Causes of esophagitis can include:

• Stomach acid often leaking up into your esophagus (gastroesophageal reflux disease, or GERD)

• Chronic vomiting

• Medicines, such as aspirin or other anti-inflammatory medicines

• Medical procedures, such as radiation therapy

• Infections that weaken your immune system

• Allergies, often to foods

Who is at risk for esophagitis?

You may be at risk for esophagitis if you:

• Are pregnant

• Smoke

• Are obese

• Are an older adult

• Use certain medicines, such as NSAID pain relievers (nonsteroidal anti-inflammatory medicines), nitrates, beta blockers, certain antibiotics, or potassium

• Have a spinal cord injury

• Have had radiation therapy for chest tumors

• Swallow medicine with too little water or get a pill stuck in your throat

• Have scleroderma or other autoimmune diseases

• Have many allergies, especially to certain foods

What are the symptoms of esophagitis?

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

• Sore throat

• Feeling that something is stuck in your throat

• Sores in your mouth

• Nausea or vomiting

• Trouble swallowing

• Pain when swallowing

• Heartburn

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

How is esophagitis diagnosed?

You may see a healthcare provider called a gastroenterologist. This is a doctor who specializes in the digestive system. They will ask about your symptoms and health history and will also give you a physical exam. You may also have tests. These include:

• Upper GI series. This test takes X-ray images of your esophagus and stomach as you swallow a barium fluid. The test shows any problem areas.

• Endoscopy. Your healthcare provider uses a tiny camera on a thin, flexible tube to look inside your esophagus for signs of irritation. Sometimes a tiny sample is taken (biopsy) to examine it under the microscope to find the cause of esophagitis.

• Esophageal pH test for stomach acid. Your provider will put sensors or thin wires into your esophagus either while you're awake or with an endoscopy. These sensors or wires are left in place to gather information over 1 to 3 days. This can show if stomach acid backs up in the esophagus. Some backup is normal, but too much backup causes gastroesophageal reflux disease, which can lead to esophagitis.

How is esophagitis treated?

Treatment depends on the cause. It will also depend on how severe the condition is. Treatments include:

• Taking medicines. Acid-blocking medicine causes your stomach to make less acid. Other medicines can sometimes help make the valve between the esophagus and stomach stronger. This valve is called the lower esophageal sphincter (LES). It keeps stomach acid in your stomach. Other medicines may include infection-fighting medicines (such as antibiotics). You may take steroids to reduce swelling (inflammation) in certain kinds of esophagitis.

• Not taking certain medicines. Don’t take aspirin or ibuprofen and similar NSAIDs unless your healthcare provider tells you to.

• Not eating certain foods. If food allergies cause your condition, you will need to not eat those foods.

• Dilation. This is stretching of the esophagus. It is done during an endoscopy.

• Surgery or endoscopic treatment. Your healthcare provider may advise this treatment if you have bleeding or narrowing of the esophagus. It also might be advised to control the spread of precancerous cells.

Your healthcare provider may advise these lifestyle changes if your condition is caused by GERD:

• Raise the head of your bed. This will help prevent reflux when you sleep.

• Change your eating habits. You may need to switch to a bland diet for a while. This means not having spicy foods, citrus, chocolate, fatty foods, or caffeine.

• Stop smoking.

• Don’t drink alcohol or limit how much you drink.

• Keep a healthy weight.

• Be more active.

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

What are possible complications of esophagitis?

Esophagitis can affect your quality of life. If left untreated, it may also develop into a condition called Barrett’s esophagus. This may increase your risk for esophageal cancer.

Other problems that can happen include:

• Trouble swallowing or eating

• Bleeding

• Narrowing of the esophagus

What can I do to prevent esophagitis?

Esophagitis can come back. You will need to follow your healthcare provider’s advice about lifestyle changes and medicine use.

When should I call my healthcare provider?

Call the healthcare provider if you have:

• Symptoms that don’t get better, or get worse

• New symptoms

Key points about esophagitis

• Esophagitis is when the lining of your esophagus becomes irritated and inflamed.

• Causes of esophagitis can include GERD, vomiting, and medicines. You may be at risk for esophagitis if you are pregnant, smoke, or are obese.

• Symptoms can include sore throat and a feeling that something is stuck in your throat.

• Treatments can include lifestyle changes, medicines, dilation, and surgery.

• If left untreated, the condition may also develop into a condition called Barrett’s esophagus. This may increase your risk for esophageal cancer.

• Esophagitis can come back. You will need to follow your healthcare provider’s advice about lifestyle changes and medicine use.

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 directions 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.