Esophagitis

Condition Basics

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.

What causes it?

Gastroesophageal reflux disease, or GERD, is the most common cause of esophagitis. When you have GERD, stomach acid and juices flow backward into your esophagus. This can irritate the esophagus.

Other causes include:

• A hiatal hernia.
• Medicines that irritate the esophagus, such as:
  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen.
  • Medicines for osteoporosis (bisphosphonates), such as alendronate, ibandronate, or risedronate.
  • Antibiotics, such as clindamycin or tetracycline.
• Natural health products, such as vitamin C, iron, and potassium pills.
• Infection. People who have a weak immune system are more likely to get esophagitis. This includes people with HIV, diabetes, or kidney problems, as well as older adults and people who take steroid medicine.
• Radiation therapy.
• Certain diseases that make it hard to swallow, such as scleroderma.
• Allergies, often food allergies, especially to seafood, milk, nuts, soy, or eggs.

What are the symptoms?

Common symptoms of esophagitis include:

• Heartburn.
• Pain when you swallow.
• Trouble swallowing food or liquids.
• Chest pain (may be similar to the pain of a heart attack).
• A cough.

Sometimes it also causes:

• Nausea or vomiting.
• Fever.
• Belly pain.

How is it diagnosed?

Your doctor will ask about your symptoms and past health. The doctor may do tests such as:

• An endoscopy. During this test, the doctor puts a thin, flexible tube down your throat to look at your esophagus. This test also lets the doctor get a sample of the cells to test for infection. Sometimes a small piece of tissue is removed for a biopsy. A biopsy is a test that checks for inflammation or cancer cells.
• A barium swallow. This is an X-ray of the throat and esophagus. Before the X-ray, you will drink a chalky liquid called barium. Barium coats the inside of your esophagus so that it shows up better on an X-ray.

How is esophagitis treated?

Treatment depends on what is causing the esophagitis. If it's caused by acid reflux or gastroesophageal reflux disease (GERD), your doctor will likely suggest that you change your diet, lose weight if needed, and make other lifestyle changes.

If lifestyle changes aren't enough to help, your doctor may suggest trying medicines that reduce stomach acid. Reducing the reflux gives the esophagus a chance to heal. Over-the-counter medicines include:

• Antacids, such as Gaviscon or Tums. Be careful when you take over-the-counter antacid medicines. Many of these medicines have aspirin in them. Read the label to make sure that you aren't taking more than the recommended dose. Too much aspirin can be harmful.
• Stronger acid reducers, such as famotidine (for example, Pepcid) and omeprazole. Your doctor may also prescribe acid reducers for you.

If esophagitis is caused by an infection, you may need to take antibiotics or other medicines to treat the infection. If it's caused by a food allergy, your doctor may prescribe corticosteroids.

You might need surgery if you have a tear in your esophagus or if something is blocking it, such as a tumour.

How can you care for yourself?

There are things you can do that might help. Try eating several smaller meals instead of two or three larger ones. Avoid foods that can make symptoms worse, like chocolate, mint, alcohol, and spicy foods. If you smoke, try to quit. Try an over-the-counter antacid or acid reducer. Take medicines as instructed.