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:

• 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.
• Medicines that irritate the esophagus, including:
  • Medicines for osteoporosis, such as alendronate (Fosamax), ibandronate (Boniva), or risedronate (Actonel).
  • Antibiotics, such as tetracycline or clindamycin.
  • Other medicines, such as mycophenolate or quinidine.
• Vitamin and mineral supplements, such as vitamin C, iron, and potassium pills.
• Radiation therapy.
• Certain diseases that make it hard to swallow, such as scleroderma.

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).

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. Esophagitis caused by acid reflux or GERD is usually treated with 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 (Pepcid), ranitidine (Zantac), or omeprazole (Prilosec OTC).

You can make changes to your lifestyle to help relieve your symptoms of GERD. 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 chew tobacco.
• If you have GERD symptoms at night, raise the head of your bed 6 in. (15 cm) to 8 in. (20 cm) 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 5 to 10 pounds can help.

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

If swallowing pills is causing the problem, talk to your doctor about your options. He or she may advise you to drink plenty of water and sit up straight when you swallow pills.

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

Related Information

• Gastroesophageal Reflux Disease (GERD)

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