Erosive Esophagitis Causes and Treatments

Erosive esophagitis is a type of esophagitis in which there is damage to the tissue lining. Esophagitis is inflammation, irritation, or swelling of the lining of the esophagus, which is the tube that runs from the throat to the stomach.

Erosive esophagitis may cause heartburn and trouble swallowing. It is usually treated with medication and lifestyle changes. 

This article discusses the symptoms, causes, diagnosis, treatment, and prognosis of erosive esophagitis, as well as complications to look out for.

A woman getting her tonsils checked by a doctor
George Doyle / Stockbyte / Getty Images 


Studies indicate that the most common symptoms of esophagitis are heartburn, chest pain, and dysphagia (discomfort swallowing).

Other symptoms of esophagitis may include: 

  • Difficulty when swallowing
  • Feeling like something is stuck in your throat
  • Burning sensation in the esophagus
  • Bleeding, seen either as blood in vomit or in stools (turning stools black or tarry)

Causes and Risk Factors

The esophageal lining is sensitive, so it's vulnerable to irritation and swelling.

Several factors can contribute to an increased risk of developing esophagitis:

  • Refluxed stomach acid: Recurrent backing of stomach acid into the esophagus is the most common cause of esophagitis. Reflux is mainly seen with gastroesophageal reflux disease (GERD), which occurs when a muscle at the end of your esophagus doesn't close properly. Other triggers of reflux include pregnancy, obesity, smoking, alcohol, caffeinated beverages, and fatty or spicy foods.
  • Excessive vomiting: The acid contained in vomit can irritate the esophagus, and excessive vomiting can lead to inflammation.
  • Pills getting stuck: If a pill gets stuck in the esophagus, it can cause burning of the lining. This usually happens when not enough water or other fluid is used to wash down the pill. However, it may also occur when the esophagus is narrowed by scarring or strictures, or if a motility disorder prevents the muscles of the esophagus from contracting properly to propel contents into the gastrointestinal tract.
  • Infections: These include infections caused by viruses (such as herpes and cytomegalovirus), fungi (such as Candida infections), and bacteria. Infections develop more often in people whose immune systems are weakened by conditions like HIV/AIDS.
  • Radiation injury: Radiation treatment in the chest or neck area as part of cancer treatment can cause esophagitis.
  • Injury from chemicals: If strong chemicals like drain cleaners are ingested, injury to the esophagus can be very severe and even life-threatening.


Your healthcare provider will perform a thorough physical exam, along with going over your medical history, before proceeding to a diagnostic test.

Tests that may be used in the diagnosis of esophagitis include:

  • Endoscopy: This procedure uses an endoscope, a flexible tube with a light and camera at the end, to provide a direct view of the esophagus.
  • Barium X-rays: These X-rays are taken in conjunction with a barium solution that's swallowed. This special dye coats the lining of the esophagus and shows up white on an X-ray, to help give a clear picture of the esophagus. 
  • Biopsy: This involves an invasive procedure, usually during endoscopy, so that the inflamed tissue can be examined with a microscope.
  • A culture: A sample of a potentially infected area is taken to identify which specific microorganisms could be causing an infection.


Treatment of esophagitis depends on the cause and may include:

  • Acid-reducing medications, such as proton pump inhibitors (PPIs) or H2 blockers, if GERD is the cause 
  • Antibiotics, antiviral, or antifungal therapies if a bacterial, viral, or fungal infection is a cause
  • Steroid medication to reduce inflammation
  • Pain medication

While you're undergoing treatment, your healthcare provider will also talk to you about lifestyle steps you can take to ease the discomfort of esophagitis.

What to Do
  • Eat five or six smaller meals during the day instead of three larger ones.

  • Eat soft foods, such as puddings, applesauce, soups, and custards.

  • Take small bites of food and chew thoroughly before trying to swallow.

  • Drink beverages through a straw.

  • Elevate the head of your bed 8 to 10 inches or sleep on a wedge pillow to help keep stomach contents out of the esophagus during sleep.

What to Avoid
  • Spicy foods

  • Acidic foods and beverages, such as citrus juices and other juices, and tomato-based products

  • Hard foods that can cause pain in the esophagus when swallowed, such as nuts and raw vegetables

  • Tobacco

  • Alcohol

  • Fatty foods

  • Caffeine

  • Chocolate


Esophagitis that's caused by reflux disease or infection usually responds well to medical treatment. If the cause is acid reflux, the treatment may be needed long-term.


You should call your healthcare provider if any of the following occurs:

  • Your symptoms don't go away with initial medical treatment. Scarring can lead to a stricture (narrowing or tightening) of the esophagus. This narrowing can cause continuing swallowing difficulties that may require additional treatment.
  • You're unable to eat or drink due to pain. Life-threatening dehydration can occur if you can't drink fluids.
  • Sudden worsening chest pain, shortness of breath, or fever. This could mean that a deep erosion or a hole has developed in the esophagus, and you should call your healthcare provider immediately. A hole can bleed and allow bacteria from your digestive tract to enter your chest cavity and cause a serious infection, which can be a life-threatening situation.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • Esophagitis. Mayo Clinic.
  • Acid Reflux (GER and GERD) in Adults. National Institute of Diabetes and Digestive and Kidney Diseases.

By Sharon Gillson
 Sharon Gillson is a writer living with and covering GERD and other digestive issues.