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.
Symptoms
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 swallowingFeeling like something is stuck in your throatBurning sensation in the esophagusBleeding, 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.
Diagnosis
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.
Treatments
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 causeSteroid medication to reduce inflammationPain 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.
Prognosis
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.
Complications
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.
