What Is Esophagitis?

Esophagitis is an irritation or swelling of the esophagus, the tube that carries food from your mouth to your stomach. There are several types of esophagitis, all of which usually come with symptoms like pain while swallowing and heartburn. Treatment varies based on the specific cause, but options typically include medication, dietary changes, and sometimes surgery.

This article provides an overview on esophagitis and outlines symptoms, causes, and treatment options.

Types of Esophagitis

There are many types of esophagitis, which all have different underlying causes.

• Reflux esophagitis is the most common type, which occurs when you have the digestive disorder gastroesophageal reflux disease (GERD).
• Infectious esophagitis is caused by a fungal, yeast, viral, or bacterial infection that irritates the esophagus.
• Caustic ingestion esophagitis happens when a chemical is ingested and ends up burning the esophagus.
• Medication-induced esophagitis stems from prolonged contact with pills like antibiotics or aspirin, which can disrupt the protective barrier of the esophagus.
• Eosinophilic esophagitis is prompted by an allergic or immune response to foods or environmental irritants.
• Radiation-induced esophagitis occurs as a result of irritation following radiation therapy for treating cancer.
• Systemic illness esophagitis happens when a systemic (body-wide) illness makes the esophagus more prone to inflammation.
  

Esophagitis Symptoms

With esophagitis, it's common to experience heartburn, difficulty swallowing, or pain while swallowing.

Other symptoms may include:

• Sore throat
• Feeling like something is stuck in your throat
• Burning sensation in the esophagus
• Cough
• Hoarseness
• Nausea or vomiting
• Fever

Causes

The lining of the esophagus is sensitive, so sometimes it’s vulnerable to irritation and swelling. Several factors can contribute to an increased risk of developing esophagitis, including:

• Refluxed stomach acid: For people with gastroesophageal reflux disease (GERD), stomach acid can leak back up into your food pipe. This usually happens when a muscle at the end of your esophagus doesn’t close properly. It can also be triggered by pregnancy, obesity, smoking, alcohol use, drinking carbonated beverages, or eating fatty or spicy foods.
• Excessive vomiting: The acid contained in vomit can irritate the esophagus, and excessive vomiting can lead to further inflammation.
• Medication use: Certain medications like aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS, like ibuprofen and naproxen), antibiotics, vitamin C supplements, and potassium chloride can cause damage when they're in contact with the protective lining of the esophagus for an extended period of time. This can happen when not enough water is used to wash down and swallow a pill.
• Infections: Infections caused by viruses like the herpes simplex virus, yeast (Candida), or bacteria can prompt irritation of the esophagus. This is most often seen in people with weakened immune systems due to HIV/AIDS or a recent organ transplant, but it can also happen in people with normal immune systems.
• Chemical irritation: Accidentally or intentionally ingesting a strong chemical, like household bleach, drain cleaner, or detergent, can cause injury to the esophagus. The more exposure to the chemical, the more severe (and potentially life-threatening) the irritation will be. Ingestion of a strong base, like a pipe or drain cleaner, is one of the most dangerous types of ingestions, because the base liquifies tissue.
• Radiation injury: Getting radiation treatment for cancer, particularly in the chest or neck area, can sometimes cause esophagitis. The esophagus lining is sensitive to inflammation and can start thinning or wearing away after radiation.
• Systemic illnesses: Certain illnesses that affect your entire body can contribute to the development of esophagitis. This includes conditions like scleroderma, inflammatory bowel disease (IBD), Behçet's disease, or Sjögren's syndrome.
• Allergic/immune response: Esophageal reactions to foods or irritants contribute to the development of eosinophilic esophagitis, a serious and chronic autoimmune disease.
  

Diagnosis

Your healthcare provider will first want to perform a physical exam, view your medical history, and discuss your symptoms.

From there, you may get at least one of the following diagnostic tests:

• Endoscopy: This procedure uses an endoscope (a flexible tube with a light and camera) to provide a direct view of the esophagus. It allows the healthcare provider to check for signs of inflammation in the food pipe. 
• Biopsy: If your provider spots any inflammation or ulcers in the esophagus, they may take a small sample of these tissues or cells to be examined in a lab. 
• Barium X-rays: A provider will take X-rays of your esophagus while you ingest a special solution (barium) that coats the esophageal lining and provides a clear picture of the food pipe. 
• Esophageal manometry: By inserting a tube through your nose, down your esophagus, and into your stomach, this test measures how well your esophagus is working. 
• Allergy testing: If your provider suspects that your esophagitis may be caused by an allergic or immune reaction, they may order skin prick tests, blood tests, or food patch testing to narrow down the food or environmental allergen.
  

Treatment

Treatment options for esophagitis will depend on the cause. These options can include medications, dietary and lifestyle changes, or potentially surgery.

Common treatment approaches include:

• Medication: Different medications may be prescribed depending on the suspected esophagitis cause. Proton pump inhibitors (PPIs) are usually recommended to reduce acid if GERD is the cause of the esophagitis. Corticosteroids can help reduce inflammation from systemic illness-related esophagitis. Antibiotics, antifungals, or antivirals can be prescribed for infectious esophagitis.
• Medication cessation: On the other hand, if your esophagitis is medication-induced, your healthcare provider may recommend stopping the medication or ordering a liquid version, if available. Remember never to stop taking a medication without your prescribing provider’s approval first.
• Lifestyle changes: Cases of esophagitis due to acid reflux or an allergen can be addressed with changes to your diet or surroundings. Once you identify the culprit, your provider can help you avoid or replace foods or irritants that trigger the esophagitis. They may also recommend lifestyle changes like eating slowly, losing weight, or quitting smoking.
• Surgery: Nissen fundoplication is a surgical treatment for GERD-related esophagitis. The surgeon will strengthen the sphincter (tightening muscle) at the bottom of the esophagus to cut down on acid reflux.
• Esophageal dilation: If your esophagus has narrowed due to scarring from stomach acid reflux, this procedure can help. It involves using a special tube or surgical balloon to physically open the esophagus.
  

Prognosis

Many types of esophagitis respond well to treatment. But esophagitis can have serious consequences if left untreated.

GERD-related esophagitis has the potential to develop into a condition known as Barrett’s esophagus, in which the lining of the esophagus is damaged by stomach acid. This may increase your risk for esophageal cancer.

Early diagnosis and treatment are key for the best prognosis, so it’s important to contact a healthcare provider as soon as possible if you suspect you may be experiencing some form of esophagitis.

Lifestyle tweaks such as quitting smoking, reducing alcohol intake, maintaining a healthy weight, and forming better digestive habits can help control symptoms and address the root causes of esophagitis.

Summary

Esophagitis is irritation or inflammation of the esophagus, which is the tube that runs from your throat to your stomach. There are many different causes of esophagitis, from acid reflux to chemical irritation to food allergies. Depending on the specific cause, treatment may include prescription medications, dietary changes, or surgery.

A Word From Verywell

Living with a digestive condition like esophagitis is not only physically uncomfortable, but it can be emotionally overwhelming. People diagnosed with certain types of esophagitis are at an increased risk of experiencing anxiety and depression. But help is available. If you think you might need an outside support system, ask a healthcare provider for a referral to a mental health professional to talk through any concerns and learn new tools to cope effectively.