Esophagitis

Do you often have burning pain in your chest? You may have esophagitis. This is an inflammation of the lining of the esophagus. The esophagus is the tube that connects the throat to the stomach. This sheet tells you more about esophagitis. It also explains your treatment options.

Two Main Types of Esophagitis

With esophagitis, the lining of the esophagus is inflamed.

• Reflux esophagitis. This is the more common type. It's also called GERD (gastroesophageal reflux disease). It occurs when acid from the stomach flows back into the esophagus. This happens repeatedly and leads to irritation. Causes include:

  • Being overweight

  • Pregnancy

  • Frequent vomiting

  • Certain medications (such as aspirin and other anti-inflammatories)

  • Hiatal hernia, which is when the upper part of the stomach pushes upward through the diaphragm (the muscle between the chest and the abdomen)

• Infectious esophagitis. This condition is caused by an infection. Certain factors can make this more likely. These include a weakened immune system and poor nutrition. Antibiotic use can also be a factor. The infection is often due to the following:

  • A type of fungus (typically candida)

  • A virus, such as herpes simplex virus 1 or cytomegalovirus (CMV)

Symptoms of Esophagitis

The following symptoms can occur for both types of esophagitis:

• Pain when swallowing, or trouble swallowing

• Heartburn (pain behind the breastbone)

• Nausea

• Bleeding (indicated by bright red vomit or black, tarry stool)

These symptoms occur more often with reflux esophagitis:

• Coughing

• Hoarseness

Diagnosis of Esophagitis

Your healthcare provider will ask about your health history and symptoms. You'll also be examined. Sometimes certain tests are needed. These may include:

• Upper endoscopy. A thin, flexible tube with a tiny light and camera is used. It is inserted through the mouth down into the esophagus. This allows the doctor to look for damage. A biopsy may also be done. This is when a small sample of tissue is removed. The sample is sent to a lab for testing.

• Upper GI x-ray with barium. An x-ray is done after the patient drinks a substance called barium. This substance makes problems in the esophagus easier to see on an x-ray.

Treatment of Esophagitis

• Medications can help treat either type. For infectious esophagitis, medications can help clear the infection. For reflux esophagitis, medications are prescribed based on symptoms. For instance, minor symptoms can be treated with antacids. These are taken after meals and at bedtime. For more severe symptoms, certain medications can help reduce the amount of acid the stomach makes. Other medications can help food move through the stomach more quickly.

• Lifestyle changes can help reduce irritation and ease symptoms:

  • Avoid spicy foods (pepper, chili powder, curry). Also avoid hard foods (nuts, crackers, raw vegetables) and acidic foods and drinks (tomatoes, citrus fruits and juices). Other problem foods include chocolate, peppermint, nutmeg, and foods high in fat.

  • Until you can swallow without pain, follow a combined liquid and soft diet. Try foods such as cooked cereals, mashed potatoes, and soups.

  • Take small bites and chew your food thoroughly.

  • Avoid large meals. And don't eat right before lying down.

  • Get to or maintain a healthy weight.

  • Avoid alcohol, caffeine, and smoking.

  • Practice good oral hygiene.

  • Raise your upper body by 4 to 6 inches when lying in bed. This can be done using a foam wedge. Or put blocks under the legs at the head of your bed.

• Surgery may be needed for severe reflux esophagitis. Your doctor can tell you more.