Causes of esophagitis

These are some possible causes of irritation and inflammation:

• Stomach acid in the food pipe. If you have gastroesophageal reflux disease (GERD), stomach acid leaks backward into your esophagus. If this happens on a regular basis, it may cause esophagitis.

• 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

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

Symptoms

You may experience these symptoms with esophagitis:

• Sore throat

• Feeling that something is stuck in your throat

• Sores in your mouth

• Nausea or vomiting

• Difficulty or painful swallowing

• Heartburn

Risk factors

You may be at risk for esophagitis unrelated to an infection if you:

• Are pregnant

• Smoke

• Are obese

• Are an elderly adult

• Consume a lot of alcohol, coffee, chocolate, fatty foods, or spicy foods

• Use certain medicines, including NSAID pain relievers, nitrates, and beta blockers 

• 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, an autoimmune disease

• Have many allergies, especially to certain foods 

Diagnosis

To make a diagnosis, your healthcare provider may do these things:

• Take a medical history and do a physical exam.

• Order an upper GI series. This test consists of X-ray images of your esophagus and stomach as you swallow a barium fluid that shows any problem areas.

• Order an endoscopy. This is an outpatient procedure in which the gastroenterologist uses a tiny camera on a thin, flexible tube to look inside your esophagus for signs of esophagitis.

• Do an esophageal pH test for stomach acid. The gastroenterologist will insert sensors or thin wires during an endoscopy to gather information over 1 to 3 days. This may help your healthcare provider find out about stomach acid that may be appearing in the esophagus.

Treatment 

Treatment for esophagitis depends on the cause. These are possible treatments:

• Therapy. This is to find the cause of your esophagitis.

• Acid-blocking medicines

• Additional medicines. Your healthcare provider may prescribe medicines to strengthen the lower esophageal sphincter. This keeps stomach acid in your stomach.

• Avoidance of certain foods. This is necessary if you have an allergic cause to your esophagitis.

• Dilation. Stretching of the esophagus is done during an endoscopy. 

• Lifestyle changes. If your esophagitis is caused by GERD, your healthcare provider might offer these recommendations:

  • Raise the head of your bed so that you sleep with your head slightly above your feet.

  • Change your eating habits to limit acid or irritation of the esophagus. This might mean switching to a bland diet for a while and avoiding spicy foods, citrus foods, chocolate, fatty foods, and caffeine.

  • Stop smoking.

  • Avoid or limit alcohol.

  • Maintain a healthy weight.

  • Become more active.

• Surgery. Your healthcare provider may recommend surgery if you have bleeding or narrowing of the esophagus. It also might be recommended if it is needed to control the spread of precancerous cells.

Complications

Problems that can happen with esophagitis include:

• Difficulty swallowing or eating

• Bleeding

• Narrowing of the esophagus

Living with esophagitis

Esophagitis can return if you do not make some changes in the way you live. Living with this condition means following your healthcare provider’s recommendations on lifestyle changes and medicine use.

When to call the healthcare provider

Contact your healthcare provider if your symptoms return.