Esophagitis: Symptoms, Causes, Treatment

What are the symptoms of esophagitis?

Esophagitis is the inflammation of the esophagus, the tube that carries food from your mouth to your stomach. The symptoms can vary depending on the cause and severity of the inflammation, but common symptoms include:

Difficulty swallowing (dysphagia): This can range from a feeling of food sticking in the throat to actual blockages in the esophagus.
Painful swallowing (odynophagia): Swallowing may be painful, particularly when you eat or drink.
Heartburn: A burning sensation in the chest, often after eating, which can worsen when lying down or bending over.
Acid regurgitation: Sour or bitter-tasting fluid backing up into your throat or mouth.
Chest pain: This can feel like a burning pain that moves up toward your neck.
Nausea: A feeling of queasiness or discomfort in the stomach.
Vomiting: Some people with esophagitis may vomit food or vomit blood.
Difficulty or pain with swallowing pills: This can be a specific symptom related to the size and texture of pills.
Sore throat: The inflammation can cause irritation and discomfort in the throat.
Cough: Sometimes, esophagitis can cause a persistent cough, especially at night.

It’s important to see a healthcare provider if you experience persistent or severe symptoms of esophagitis, as this condition can lead to complications if left untreated. Treatment typically involves addressing the underlying cause, such as reducing stomach acid with medications, managing reflux, and making dietary and lifestyle changes.

What are the causes of esophagitis?

Esophagitis can be caused by various factors, including:

Gastroesophageal reflux disease (GERD): This is one of the most common causes. GERD occurs when stomach acid flows back into the esophagus, irritating its lining and causing inflammation.
Infections: Certain infections, such as those caused by bacteria, viruses, or fungi, can lead to esophagitis. Candida (yeast) infection, particularly in individuals with weakened immune systems, is a common cause.
Eosinophilic esophagitis: This is an allergic reaction in the esophagus, characterized by a buildup of white blood cells called eosinophils. It can be triggered by allergies to certain foods, airborne allergens, or environmental factors.
Medications: Some medications, especially those that can irritate the esophagus, may cause esophagitis. These can include certain antibiotics (like doxycycline or tetracycline), nonsteroidal anti-inflammatory drugs (NSAIDs), and bisphosphonates (used to treat osteoporosis).
Chemical irritants: Ingesting or inhaling substances that can irritate the esophagus, such as certain household cleaning products or industrial chemicals, can lead to esophagitis.
Ingestion of corrosive substances: Accidental ingestion of corrosive substances, such as household cleaners or lye, can cause severe damage to the esophagus and lead to esophagitis.
Radiation therapy: Radiation treatment for cancer in the chest or upper abdomen can cause inflammation and damage to the esophagus.
Systemic diseases: Certain systemic conditions, such as autoimmune disorders like Crohn’s disease or systemic sclerosis, can affect the esophagus and lead to inflammation.
Physical injury: Trauma or injury to the esophagus, such as from swallowing sharp objects or experiencing physical trauma, can cause esophagitis.

The specific cause of esophagitis can often be determined based on a combination of symptoms, medical history, and diagnostic tests conducted by a healthcare provider. Treatment typically involves addressing the underlying cause and relieving symptoms.

How is the diagnosis of esophagitis made?

The diagnosis of esophagitis is typically made based on a combination of symptoms, medical history, and diagnostic tests. Here are some common methods used to diagnose esophagitis:

Medical history and physical examination: Your healthcare provider will ask about your symptoms and medical history. They may also perform a physical examination to check for signs of esophagitis or other related conditions.
Endoscopy: This is a procedure in which a thin, flexible tube with a light and camera on the end (endoscope) is used to examine the inside of the esophagus. During the procedure, the healthcare provider can see any inflammation, irritation, or other abnormalities in the esophageal lining. Biopsies (tissue samples) may also be taken during endoscopy to help confirm the diagnosis and determine the underlying cause.
Barium swallow: In this test, you drink a chalky liquid containing barium, which coats the inside of the esophagus and shows up on X-rays. This can help identify abnormalities in the esophagus, such as narrowing, ulcers, or inflammation.
Esophageal pH monitoring: This test measures the amount of acid in your esophagus over a 24-hour period. It can help diagnose GERD and determine if acid reflux is causing your esophagitis.
Esophageal manometry: This test measures the strength and coordination of the muscles in your esophagus. It can help diagnose motility disorders that may contribute to esophagitis.
Blood tests: Blood tests may be done to check for signs of infection or other conditions that may be causing esophagitis.

The specific tests used to diagnose esophagitis may vary depending on the suspected cause and the severity of your symptoms. It’s important to see a healthcare provider for a proper diagnosis and to determine the best course of treatment.

What is the treatment for esophagitis?

The treatment for esophagitis depends on the underlying cause and severity of the condition. Here are some common treatments for esophagitis:

Antacids and acid reducers: Over-the-counter antacids, such as Tums or Rolaids, can help neutralize stomach acid and provide quick relief from heartburn and indigestion. Acid reducers like ranitidine (Zantac) and famotidine (Pepcid) can also help reduce acid production.
Histamine-2 (H2) blockers: H2 blockers, such as ranitidine (Zantac) and famotidine (Pepcid), work by reducing the production of acid in the stomach.
Proton pump inhibitors (PPIs): PPIs, such as omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium), are more potent than H2 blockers and can also reduce acid production.
Gastroprokinetics: Motilin agonists, such as metoclopramide (Reglan), can help stimulate the muscles in the esophagus to move food into the stomach more quickly.
Antifungal medication: If the esophagitis is caused by a fungal infection, antifungal medication such as fluconazole (Diflucan) may be prescribed.
Antibiotics: If the esophagitis is caused by a bacterial infection, antibiotics such as amoxicillin or clarithromycin may be prescribed.
Lifestyle changes: Making lifestyle changes can help manage esophagitis, such as:
- Avoiding trigger foods that exacerbate symptoms
- Elevating the head of the bed by 6-8 inches to reduce acid reflux
- Losing weight if obesity is a contributing factor
- Quitting smoking
- Avoiding tight clothing that can put pressure on the stomach
Surgery: In severe cases of esophagitis, surgery may be necessary to repair any damage to the esophagus or to relieve pressure on the esophagus.

In addition to these treatments, your healthcare provider may recommend other therapies, such as:

Endoscopy: A flexible tube with a camera is inserted through the mouth to visualize the esophagus and diagnose any damage or abnormalities.
Manometry: A test that measures the muscle contractions in the esophagus to determine if there are any abnormalities.
pH monitoring: A test that measures the acidity of the stomach contents to determine if acid reflux is occurring.

It’s important to work with your healthcare provider to determine the best course of treatment for your specific case of esophagitis.

What foods trigger esophagitis?

Esophagitis is often triggered by foods and substances that can irritate the esophagus, particularly those that can stimulate acid production or cause inflammation. Here are some common food triggers that can exacerbate esophagitis:

Citrus fruits and juices: Oranges, lemons, limes, grapefruits, and their juices can stimulate acid production in the stomach and trigger symptoms.
Tomatoes and tomato-based products: Tomatoes, tomato sauce, and ketchup can also stimulate acid production.
Spicy or fatty foods: Spicy dishes, fatty meats, and fried foods can irritate the esophagus and trigger symptoms.
Chocolate: Chocolate can relax the lower esophageal sphincter, allowing stomach acid to flow back up into the esophagus.
Coffee and tea: Caffeinated beverages like coffee, tea, and energy drinks can relax the lower esophageal sphincter and trigger symptoms.
Carbonated drinks: Carbonated beverages like soda, beer, and sparkling water can irritate the esophagus and trigger symptoms.
Fried foods: Fried foods like french fries, fried chicken, and doughnuts can trigger symptoms by causing inflammation in the esophagus.
Gluten-containing foods: For people with gluten intolerance or celiac disease, consuming gluten-containing foods like bread, pasta, or baked goods can trigger inflammation in the esophagus.
Dairy products: Some people may experience an increase in acid production after consuming dairy products like milk, cheese, or ice cream.
Sour or acidic foods: Foods with high acidity levels, such as pickles, sauerkraut, or vinegar-based sauces, can trigger symptoms.
Raw onions: Raw onions can cause irritation and inflammation in the esophagus.
Raw garlic: Like raw onions, raw garlic can also cause irritation and inflammation.

It’s essential to identify which specific foods trigger your esophagitis symptoms by keeping a food diary to track your diet and symptoms. Avoiding these trigger foods can help alleviate symptoms and reduce inflammation in the esophagus.

In addition to these food triggers, other factors that can exacerbate esophagitis include:

Eating too quickly or not chewing food properly
Lying down after eating
Wearing tight clothing that puts pressure on the stomach
Smoking or exposure to secondhand smoke
Obesity
GERD (gastroesophageal reflux disease)

It’s crucial to work with your healthcare provider to develop a personalized treatment plan that addresses your specific triggers and helps manage your esophagitis symptoms.