What is esophagitis?
Esophagitis is irritation or inflammation of the esophagus . The esophagus is the tube that carries food from your throat to your stomach. Esophagitis can be painful and can make it hard to swallow.
Symptoms of esophagitis
Common signs and symptoms of esophagitis include:
- Difficult swallowing
- Painful swallowing
- Chest pain, particularly behind the breastbone, that occurs with eating
- Swallowed food becoming stuck in the esophagus (food impaction)
- Acid regurgitation
In young children, particularly those too young to explain their discomfort or pain, signs of esophagitis may include:
- Feeding difficulties
- Failure to thrive
Causes of esophagitis
Esophagitis is often caused by fluid that contains acid flowing back from the stomach to the esophagus, a condition called gastroesophageal reflux. An autoimmune disorder called eosinophilic esophagitis also causes this condition.
The following increase your risk of esophagitis:
- Alcohol use
- Cigarette smoking
- Surgery or radiation to the chest (for example, treatment for lung cancer)
- Taking certain medications without plenty of water, especially alendronate, doxycycline, ibandronate, risedronate, tetracycline, and vitamin C
Persons with weakened immune systems due to HIV and certain medications (such as corticosteroids) may develop infections that lead to esophagitis.
Esophageal infection may be due to fungi, yeast (especially Candida infections), or viruses such as herpes or cytomegalovirus.
How is esophagitis diagnosed?
A gastroenterologist (a doctor who specializes in treatment of disorders of the gastrointestinal tract) may order specialized tests to look for the cause and extent of the esophagitis. These tests include:
- Esophagogastroduodenoscopy (EGD): An endoscope is used to directly examine the esophagus, stomach and first part of the intestines. In addition, tissue samples can be obtained (biopsy) to assess the severity of the damage to the esophagus.
- Esophageal manometry: this test is used to measure the pressure inside the lower part of the esophagus. A thin, pressure-sensitive tube is passed through the mouth or nose and into the stomach, which is then pulled slowly back into the esophagus. Patients are asked to swallow, and the pressure of the muscle contractions is measured along several sections of the tube.
- Upper GI series or barium swallow is a test where X-rays are taken of the esophagus after drinking a barium solution. Barium coats the lining of the esophagus and appears white on an X-ray, and can show the location and extent of damage to the esophagus.
Esophagitis Medical Treatment
- If esophagitis is diagnosed early enough, medications and dietary or lifestyle changes are often enough to allow the body to heal.
- If the damage from esophagitis is severe or leads to scar tissue causing difficulty swallowing, more invasive treatment may be necessary.
- Endoscopy can be used to remove any lodged pill fragments, food or foreign bodies stuck in the esophagus. Stretching (dilatation) of the esophagus can also be done as part of the endoscopy procedure.
- Surgery may be necessary to remove any damaged portions of the esophagus. In the case of Barrett’s esophagus, where the risk of cancer is increased, surgery might be the treatment of choice.
- Eosinophilic esophagitis is treated with gentle stretching of the esophagus (dilatation) and medications to decrease white blood cells in the lining of the esophagus.
- Achalasia may be treated with stretching of the esophagus (dilatation) when oral medications fail to improve symptoms.