Esophagitis is an inflammatory condition of the esophagus wall. In mild cases, we cannot identify it except during swallowing. But with severe inflammatory conditions, you may experience persistent pain and dysphagia (difficulty swallowing). The long-term inflammatory condition of the esophagus (oesophagitis) can cause several serious illnesses.
The esophagus is a long, muscular, hollow tube that connects the stomach to the mouth. It helps transport food and drinks from the mouth to the stomach. The outer pink tissue (mucous membrane) lining the entire esophagus comes into direct contact with food and drink. The glands of this mucous membrane produce mucus to moisten the esophagus and protect it from stomach acid.
Causes of esophagitis
Several factors and conditions cause inflammation and swelling of the esophagus, such as:
- Gastroesophageal Reflux Disease (GERD): The lower esophageal sphincter prevents stomach acids from entering the esophagus. But in GERD, this sphincter becomes defective and this backflow of acidic contents is common and irritates the esophagus. The continued irritation can lead to swelling and inflammation of the esophagus (reflux esophagitis). GERD is the most common cause of esophagitis.
- Medicines: Some drugs may be a causative factor in drug-induced esophagitis. It occurs when:
- Certain drugs remain in contact with the esophageal mucosa for a long time
- A large pill irritates the mucous membrane during swallowing.
- We don’t use enough water to swallow the pill
- Some drug residue remains in contact with the esophageal wall.
Drug-induced esophagitis occurs with certain medications, such as antibiotics, pain relievers, drugs to treat osteoporosis, and pills for potassium deficiency conditions.
- allergies: Various allergies or infections stimulate the production of eosinophils in our body. The rise in eosinophils in the esophagus causes inflammation and leads to eosinophilic esophagitis.
- infections: Various bacterial, viral, or fungal infections can cause esophagitis. The main reason for infectious esophagitis is a poor immune system, such as in HIV infection or cancer. The most common pathogens of esophagitis are Candida albicans (fungus) and Herpes simplex virus.
- Various causes: Other causes of esophagitis include excessive alcohol consumption, trauma to the nasogastric tube, radiation therapy, and injury from chemical ingestion.
Symptoms of esophagitis
The following are some signs and symptoms a patient may experience:
- Difficulty swallowing
- Pain during deglutination
- Chest pain while eating
- Food impact in the esophagus
- Stomach ache
- Gastric acid
- frequent acid regurgitation
- Nausea and vomiting
- sores in the mouth
- Esophagitis in children and babies causes feeding problems and failure to gain enough weight. Most children cannot describe the symptoms and usually refuse to eat food.
Risk factors of esophagitis
Numerous factors increase the risk of esophagitis, including:
- Binge eating
- Eating fatty and spicy foods
- Certain foods such as tomato, citrus, garlic and onion based foods
- Eat just before going to bed
- to smoke
- Hiatal hernia of the lower esophageal sphincter
- Intake of excess alcohol, caffeinated drinks, mint-flavored foods, and chocolate products.
- A family history of eosinophilic esophagitis
- Taking big drugs
- Swallowing pills with little or no water
- After certain allergic conditions, including asthma attack, atopic dermatitis, drug allergies or allergic rhinitis
- Taking medicines while lying down or just before going to sleep
Complications of esophagitis
If esophagitis is not treated in time or the symptoms are neglected, it can cause serious complications, such as:
- Tear in the esophageal lining
- Scarring of the esophagus
- Constriction or narrowing of the esophagus
- Barrett’s esophagus
Diagnosis of esophagitis
The health care provider diagnoses the condition based on the patient’s symptomatic history, medical history, and the results of the following diagnostic tests:
- Endoscopy: The doctor may look for unusual findings or tissues in the esophagus using an endoscope. The doctor may also collect small tissue samples for biopsy.
- Barium X-rays: The ingested barium from the barium-containing solution lines the esophagus and stomach and makes the organ visible during X-rays. It helps identify esophageal abnormalities, such as narrowing of the esophagus, hiatal hernia, ulcers, and tumors.
- allergy test: The doctors may prescribe a skin prick test or blood test to diagnose the causative allergen for esophagitis.
- Biopsy: The doctor removes a small sample of tissue to determine if the esophagitis is due to allergens, bacterial, viral pathogens, cancer, or precancerous conditions.
Treatment of esophagitis
The treatment approach is to relieve the symptoms and treat the underlying cause of the disease. The doctor may recommend one or a combination of the following treatment modalities:
- Diet Modification: The doctors suggest avoiding food items that cause esophagitis, including citrus fruits, spicy foods, alcohol, and caffeinated drinks. You should avoid lying down or bending over right after eating your food.
- Self-care medicines: The health care providers may prescribe antacids, H-2 receptor blockers, and proton pump inhibitors to reduce or block acid production and heal the esophagus.
- Prokinetics: These drugs enhance the effect of over-the-counter drugs and help empty the stomach quickly.
- Steroids: These medications help treat eosinophilic esophagitis.
- Precautions While Taking Medications: To avoid drug-induced esophagitis, the doctors recommend drinking plenty of water while taking a pill, splitting the drug in half if it is too large to take, or preferring a liquid if possible version of the drug.
- Surgery: The surgeon may recommend surgery when other treatments have failed or in the case of removal of precancerous or cancerous growths.
Esophagitis is a preventable and completely curable condition. If you experience discomfort or pain in your chest area, do not ignore it and contact your healthcare provider immediately.
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