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Esophagitis

Inflammation - esophagus; Erosive esophagitis; Ulcerative esophagitis

 

Esophagitis is present when the lining of the esophagus becomes swollen, inflamed, or irritated. The esophagus is the tube that leads from the back of the mouth to the stomach. It is also called the food pipe.

Causes

 

Esophagitis is often caused by stomach fluid that flows back into the food pipe. The fluid contains acid, which irritates the tissue. This problem is called gastroesophageal reflux  (GERD). An autoimmune disorder called eosinophilic esophagitis also causes this condition.

The following increase your risk of this condition:

  • Alcohol use
  • Cigarette smoking
  • Surgery or radiation to the chest (for example, treatment for lung cancer)
  • Taking certain medicines without drinking plenty of water. These medicines include alendronate, doxycycline, ibandronate, risedronate, tetracycline, potassium tablets, and vitamin C
  • Vomiting

People who have a weakened immune system may develop infections. Infections may lead to swelling of the food pipe. Infection may be due to:

  • Fungi or yeast (most often Candida)
  • Viruses, such as herpes or cytomegalovirus

 

Symptoms

 

The infection or irritation may cause the food pipe to become inflamed. Sores called ulcers may form.

Symptoms may include:

  • Cough
  • Difficulty swallowing
  • Painful swallowing
  • Heartburn (acid reflux)
  • Hoarseness
  • Sore throat

 

Exams and Tests

 

The doctor may perform the following tests:

  • Esophageal manometry
  • Esophagogastroduodenoscopy (EGD), removing a piece of tissue from the food pipe for examination ( biopsy )
  • Upper GI series (barium swallow x-ray)

 

Treatment

 

Treatment depends on the cause. Common treatment options are:

  • Medicines that reduce stomach acid in case of reflux disease
  • Antibiotics to treat infections
  • Medicines and diet changes to treat eosinophilic esophagitis
  • Medicines to coat the lining of the food pipe to treat damage related to pills

 

Outlook (Prognosis)

 

Most of the time, the disorders that cause swelling of the food pipe, respond to treatment.

 

Possible Complications

 

If not treated, this condition may cause severe discomfort. Scarring (stricture) of the food pipe may develop. This can cause swallowing problems.

A condition called Barrett esophagus (BE) can develop after years of GERD. Rarely, BE may lead to cancer of the food pipe.

 

When to Contact a Medical Professional

 

Call your health care provider if you have symptoms of esophagitis.

 

 

References

Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 138.

Richter JE, Friedenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44.

Zurad EG. Esophagogastroduodenoscopy. In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 101.

 
  • Esophagus and stomach anatomy - illustration

    Food is swallowed and passes through the esophagus to the stomach, where the majority of digestion takes place.

    Esophagus and stomach anatomy

    illustration

  • Esophagus - illustration

    The esophagus connects the nose and mouth with the stomach. The epiglottis folds over the trachea when a swallow occurs, to prevent the swallowed substance from being inhaled into the lungs. When a person is unable to swallow because of illness or coma, a tube may be inserted either through the mouth or nose, past the epiglottis, into the esophagus and into the stomach. Nutrients will be passed through the tube directly into the stomach.

    Esophagus

    illustration

    • Esophagus and stomach anatomy - illustration

      Food is swallowed and passes through the esophagus to the stomach, where the majority of digestion takes place.

      Esophagus and stomach anatomy

      illustration

    • Esophagus - illustration

      The esophagus connects the nose and mouth with the stomach. The epiglottis folds over the trachea when a swallow occurs, to prevent the swallowed substance from being inhaled into the lungs. When a person is unable to swallow because of illness or coma, a tube may be inserted either through the mouth or nose, past the epiglottis, into the esophagus and into the stomach. Nutrients will be passed through the tube directly into the stomach.

      Esophagus

      illustration

    A Closer Look

     

      Tests for Esophagitis

       

         

        Review Date: 7/22/2016

        Reviewed By: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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