
Esophagitis is an inflammation of the lining of the esophagus. The esophagus is the tube that carries food from the mouth to the stomach.
The lining of the esophagus becomes inflamed because of an infection or an irritation of the lining. Esophagitis is called acute when it occurs suddenly. It is called chronic when it lasts for a long time.
Symptoms of esophagitis include: difficulty swallowingpain that can range from mild to severea feeling that something is stuck in the throatnausea or vomitingloss of appetitereluctance to eat because of pain while swallowingfast breathingchest painblood in the stools, usually black increased salivation or drooling
Causes of esophagitis include: infections by organisms such as Candida (yeast), cytomegalovirus (CMV), or herpes simplex (HSV)diseases and conditions that weaken the immune system, such as HIV, poorly controlled diabetes, immunodeficiency disorders, chemotherapy, chronic steroid use, or malnutritionchemicals that are swallowedpills that become stuck in the esophagusgastroesophageal reflux disease (GERD), a condition in which stomach acid splashes back up into the esophagusmedications and supplements such as nonsteroidal anti-inflammatory drugs (NSAIDs); bisphosphonates (that are used to treat osteoporosis, like alendronate
Maintaining a healthy weight, avoiding smoking, and limiting alcohol intake may decrease the risk of esophagitis. Other ways to decrease the risk include: eating a nutritious diet based on the food guide pyramidgetting adequate restpracticing safer sexgetting proper treatment for GERD
Esophagitis caused by toxic substances can be avoided by: storing chemicals in properly labeled containers and keeping them out of the reach of childrenalways taking pills with adequate amounts of liquid and at least 15 minutes before lying down
Prevention of esophagitis is not always possible.
After a complete history and physical, tests ordered may include the following:: endoscopy, which uses a scope, or long tube, to see the esophagus and look for possible causes of symptoms. Biopsies may also be done with the endoscope.upper GI series, in which the person swallows liquid barium, and X-rays are taken to follow the course of the barium through the esophagus and into the stomach.blood tests, including a complete blood count (CBC), to check for infectionesophageal motility tests, to evaluate the movement of food through the esophaguspH tests, to measure the acid content of the esophagus
If the cause of the esophagitis is an infection, and the infection is treated, the inflammation may improve. If a toxic chemical, such as lye, bleach, or gasoline is ingested, the esophagus can perforate, or rupture. This esophageal perforation can be fatal.
Conditions such as GERD can irritate and narrow the esophagus causing an esophageal stricture.
Chronic GERD can result in Barrett's esophagus. In Barrett's esophagus, a condition in which the lining of the esophagus is so badly damaged that a new lining is formed. The changes in the cells lining the esophagus pose an increased risk for esophageal cancer.
Esophagitis itself is not contagious and poses no risk to others. If the cause is an infection, such as herpes simplex, the infection may be contagious.
Treatment of esophagitis is directed at the cause. Treatment may include: antibiotics, antiviral, or antifungal medications for infectionsmedications to treat underlying conditions, such as GERD or diabetesmaintaining a healthy lifestylesurgery to repair the esophagus
Medications used to treat infections may cause allergic reactions, stomach upset, and headache. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.
Treatment with antacids, diet changes, and activity recommendations may control mild, intermittent symptoms. Recovery from surgery may be a few days to several weeks depending on the procedure used.
Any new or worsening symptoms should be reported to the healthcare provider. Careful attention to symptoms that recur is important so that early treatment can begin.
Harrison's Principles of Internal Medicine, 1998, Fauci et al. The Merck Manual of Medical Information, 1997.