Esophagitis

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Esophagitis

Topic Overview

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 esophagitis?

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, including:
  • Vitamin and mineral supplements, 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.
  • 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 esophagitis diagnosed?

Your doctor will ask about your symptoms and past health. He or she 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 it treated?

The treatment you need depends on what is causing the esophagitis. If you have esophagitis caused by acid reflux or GERD, your doctor will likely recommend that you change your diet, lose weight if needed, and make other lifestyle changes. Here are some things to try:

  • Change your eating habits.
    • It’s best to eat several small meals instead of two or three large meals.
    • After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea.
    • Chocolate, mint, and alcohol can make GERD worse. They relax the valve between the esophagus and the stomach.
    • Spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make GERD symptoms worse in some people. If your symptoms are worse after you eat a certain food, you may want to stop eating that food to see if your symptoms get better.
  • Do not smoke or use smokeless tobacco.
  • If you have GERD symptoms at night, raise the head of your bed 15 cm (6 in.) to 20 cm (8 in.) by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
  • Do not wear tight clothing around your middle.
  • Lose weight if you need to. Losing just 2 to 5 kilograms (5 to 10 pounds) can help.

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

  • Antacids, such as Tums, Maalox, or Mylanta.
  • Stronger acid reducers, such as famotidine (for example, Pepcid) or ranitidine (for example, Zantac).

If esophagitis is caused by an infection, you may need to take antibiotics or other medicines to treat the infection.

If you or your child has esophagitis 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 your esophagus, such as a tumour.

Other Places To Get Help

Organizations

American College of Gastroenterology
P.O. Box 342260
Bethesda, MD  20827-2260
Phone: (301) 263-9000
Web Address: www.acg.gi.org
 

The American College of Gastroenterology is an organization of digestive disease specialists. The website contains information about common gastrointestinal problems.


American Society for Gastrointestinal Endoscopy
1520 Kensington Road
Suite 202
Oak Brook, IL 60523
Phone: 1-866-353-ASGE (1-866-353-2743) toll-free
Phone: (630) 573-0600
Fax: (630) 573-0691
Email: info@asge.org
Web Address: www.asge.org
 

The American Society for Gastrointestinal Endoscopy is a group of doctors who have special training in using endoscopy to look at the digestive tract. On the website you can find a doctor in your area who does these procedures. The website also has patient education videos and patient information about endoscopic procedures.


Canadian Digestive Health Foundation
Web Address: www.cdhf.ca
 

The Canadian Digestive Health Foundation provides educational information about digestive diseases and supports research into their causes and treatment.


National Digestive Diseases Information Clearinghouse (NDDIC)
2 Information Way
Bethesda, MD  20892-3570
Phone: 1-800-891-5389
Fax: (703) 738-4929
Email: nddic@info.niddk.nih.gov
Web Address: www.digestive.niddk.nih.gov
 

This clearinghouse is a service of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the U.S. National Institutes of Health. The clearinghouse answers questions; develops, reviews, and sends out publications; and coordinates information resources about digestive diseases. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability.


References

Other Works Consulted

  • Orlando RC (2008). Diseases of the esophagus. In L Goldman, D Ausiello eds., Cecil Medicine, 23rd ed., pp. 998–1009. Philadelphia: Saunders Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Peter J. Kahrilas, MD - Gastroenterology
Last Revised July 25, 2011

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.