Esophagitis

What is Esophagitis?
Esophagitis is inflammation that damages the tissues of the esophagus, the muscular tube that delivers food from your mouth to your stomach.

It often causes painful, difficult swallowing and chest pain. If left untreated, it can change the structure of the esophagus, leading to narrowing or scarring.

Symptoms

Common signs include:

• Dysphagia: Difficulty swallowing.
• Odynophagia: Painful swallowing.
• Chest pain (especially behind the breastbone) while eating.
• Food Impaction: Swallowed food getting stuck in the esophagus.
• Heartburn or Acid Reflux.
• Nausea and vomiting.

In Young Children

Children may not be able to explain the pain. Watch for:

• Feeding difficulties (refusing to eat).
• Failure to thrive (poor growth).

⚠️ EMERGENCY WARNING
Seek immediate emergency care if you:

• Suspect you have food lodged in your esophagus.
• Experience chest pain that lasts more than a few minutes.
• Have a history of heart disease and experience chest pain.

Causes & Types

Esophagitis is categorized by the conditions that cause it:

1. Reflux Esophagitis (GERD)

The most common cause. A valve (sphincter) usually prevents stomach acid from backing up. If this valve is weak, acid flows back into the esophagus, burning the tissue.

2. Eosinophilic Esophagitis (Allergy)

Caused by a high concentration of white blood cells (eosinophils) in the esophagus, usually in response to an allergy. Common triggers include:

• Foods: Milk, eggs, wheat, soy, peanuts.
• Environmental: Pollen or dust mites.

3. Drug-Induced Esophagitis

Caused by pills remaining in contact with the lining of the esophagus for too long (e.g., swallowing a pill without enough water). Common culprits:

• Pain relievers (Aspirin, Ibuprofen).
• Antibiotics (Tetracycline).
• Potassium chloride.
• Osteoporosis medications (Bisphosphonates).

4. Infectious Esophagitis

Caused by bacteria, viruses, or fungi (like Candida/Yeast). This is rare and typically occurs in people with weak immune systems (e.g., HIV/AIDS or cancer patients).

Complications

If untreated, chronic inflammation can lead to:

• Esophageal Stricture: Scar tissue narrows the esophagus, making it hard to swallow solid food.
• Barrett's Esophagus: Changes in the cells lining the esophagus, which increases the risk of esophageal cancer.

Diagnosis

Doctors use specific tests to determine the cause:

• Endoscopy: A long, thin tube with a camera is guided down the throat to view the tissue and take samples (biopsy).
• Barium X-ray: You drink a chalky solution that coats the esophagus, making it visible on X-rays to check for narrowing.
• Allergy Tests: Skin prick tests or elimination diets to check for food triggers.

Treatment

Treatment depends entirely on the underlying cause:

For Reflux (GERD)

• Proton Pump Inhibitors (PPIs): Drugs like Omeprazole (Prilosec) block acid production to allow healing.
• Surgery (Fundoplication): Wrapping part of the stomach around the valve to strengthen it.

For Eosinophilic (Allergy)

• Dietary Changes: Eliminating trigger foods (wheat, dairy, soy).
• Steroids: Swallowed (not inhaled) steroid preparations to coat the esophagus and reduce inflammation.

For Drug-Induced

• Drink a full glass of water with every pill.
• Sit upright for at least 30 minutes after taking medication.
• Switch to liquid versions of the drug if possible.

For Infection

Prescription antifungal, antiviral, or antibiotic medications are used depending on the specific germ responsible.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.