What Is Esophagitis?
Esophagitis is an inflammation of the lining of the esophagus, the tube that carries food from the throat to the stomach. If left untreated, this condition can become very uncomfortable, causing problems with swallowing, ulcers, and scarring of the esophagus.
Symptoms of esophagitis include:
- Difficult or painful swallowing
- Acid reflux
- A feeling of something of being stuck in the throat
- Chest pain
If you have any of these symptoms, you should contact your doctor as soon as possible.
Esophagitis Causes and Risk Factors
Esophagitis is caused by an infection or irritation in the esophagus. An infection can be caused by bacteria, viruses, fungi, or diseases that weaken the immune system. Infections that cause esophagitis include:
Candida. This is a yeast infection of the esophagus caused by the same fungus that causes vaginal yeast infections. The infection develops in the esophagus when the body's immune system is weak, such as in people with diabetes or HIV. It is usually very treatable with antifungal drugs.
Irritation leading to esophagitis can come from any of the following:
- GERD, or gastroesophageal reflux disease
- Medications such as aspirin and other anti-inflammatory drugs
- Taking a large pill with too little water or just before bedtime
- Swallowing a toxic substance
- Radiation treatment for cancer
Some lifestyle choices can make esophagitis more likely, including:
- Eating right before you go to sleep
- Too many large meals with high-fat foods
- Heavy alcohol use
- Carrying extra weight, including when you're pregnant
Some foods can also give you a higher chance of esophagitis if you eat them. These include:
- Spicy foods
Once your doctor has performed a thorough physical examination and reviewed your medical history, there are several tests that can be used to diagnose esophagitis. These include:
Biopsy. During this test, a small sample of the esophageal tissue is removed and then sent to a laboratory to be examined under a microscope.
Upper GI series (or barium swallow). During this procedure, X-rays are taken of the esophagus after drinking a barium solution. Barium coats the lining of the esophagus and shows up white on an X-ray. This characteristic enables doctors to view certain abnormalities of the esophagus.
Treatment for esophagitis depends on the type of esophagitis you have.
Reflux esophagitis is when the contents of your stomach back up into your esophagus. If it happens a lot, your doctor may tell you that you have a condition called GERD (gastroesophageal reflux disease). To treat this, you might use:
- Over-the-counter drugs like antacids, or medications that block acid production like lansoprazole (Prevacid) and omeprazole (Prilosec).
- Prescription drugs that can block acid production or help clear your stomach
- Surgery to strengthen the valve that separates your stomach and your esophagus
Eosinophilic esophagitis is when a large number of white blood cells called eosinophils come together in your esophagus. Usually, this happens because of an allergy. It can be triggered by pollen or some foods.
To treat this, you might take:
- Prescription medicines to block acid production
- Steroids like budesonide (Pulmicort) and fluticasone (Flovent)
Your doctor may also suggest an elimination diet. This is where you stop eating common food allergens for a while, then slowly add them back in. This can help you and your doctor figure out which foods might cause your esophagitis.
Drug-induced esophagitis happens when medicines touch the lining of your esophagus for too long. For this, your doctor might:
- Change your medication
- Give it to you in liquid form, if possible
They might also advise you to take your medicine with a full glass of water or ask that you stand or sit for at least 30 minutes after you take it.
Infectious esophagitis happens when the tissues of your esophagus are infected. This can happen if you have cancer or HIV. To treat it, you'll take a medication to clear up your infection.
If your esophagus is very narrow or food is stuck in it, your doctor may perform a procedure called esophageal dilation, which will expand your esophagus.
Some people turn to alternative treatments to ease symptoms. These aren't used in place of medical treatments, but in addition to them.
They can include:
- Herbal remedies like licorice, chamomile, and marshmallow
- Relaxation practices like progressive muscle relaxation or guided imagery
Make sure you talk with your doctor before you start any alternative treatments.
While you have treatment for esophagitis, there are certain steps you can take to help yourself feel better:
- Avoid spicy foods such as those with pepper, chili powder, curry, and nutmeg.
- Stay away from hard foods such as nuts, crackers, and raw vegetables.
- Try not to eat right before bedtime.
- Avoid acidic foods and beverages such as tomatoes, oranges, grapefruits, and their juices. Instead, try imitation fruit drinks with vitamin C.
- Add more soft foods to your diet such as applesauce, cooked cereals, mashed potatoes, custards, puddings, and high protein shakes.
- Try to stay clear of meals with a lot of fatty foods.
- Keep caffeine, chocolate, and mint-flavored foods to a minimum.
- Take small bites and chew food thoroughly.
- Drink liquids through a straw to make swallowing easier.
- Avoid alcohol and tobacco.
- When you take medication, take it with plenty of water.
- Don't take medicine lying down, or right before you go to sleep.
It's very important that you follow your doctor's treatment plan for your esophagitis. If you do, you should get relief.
However, if esophagitis goes untreated, it can lead to:
- Scarring of your esophagus. Your doctor might call this "stricture." It can make swallowing very difficult.
- Something doctors call "esophageal perforation." It's tearing on the tissue that lines your esophagus. It can come from gagging when food gets stuck there or when you have an upper endoscopy. This can also make swallowing difficult. It can also make it hard to breathe.