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Esophagitis

Inflammation - esophagus; Erosive esophagitis; Ulcerative esophagitis; Eosinophilic esophagitis

Esophagitis is a condition in which the lining of the esophagus becomes swollen, inflamed, or irritated. The esophagus is the tube that leads from your mouth to the stomach. It is also called the food pipe.

Causes

Esophagitis is often caused by stomach fluid that flows back into the food pipe. The fluid contains acid, which irritates the tissue. This problem is called gastroesophageal reflux (GERD). An autoimmune disorder called eosinophilic esophagitis also causes this condition.

The following increase your risk for this condition:

  • Alcohol use
  • Cigarette smoking
  • Surgery or radiation to the chest (for example, treatment for lung cancer)
  • Taking certain medicines such as alendronate, doxycycline, ibandronate, risedronate, tetracycline, potassium tablets, and vitamin C, without drinking plenty of water
  • Vomiting
  • Lying down after eating a large meal

People who have a weakened immune system may develop infections. Infections may lead to swelling of the food pipe. Infection may be due to:

  • Fungi or yeast (most often Candida)
  • Viruses, such as herpes or cytomegalovirus

Symptoms

The infection or irritation may cause the food pipe to become inflamed. Sores called ulcers may form.

Symptoms may include:

  • Cough
  • Difficulty swallowing
  • Painful swallowing
  • Heartburn (acid reflux)
  • Hoarseness
  • Sore throat

Exams and Tests

The doctor may perform the following tests:

Treatment

Treatment depends on the cause. Common treatment options are:

  • Medicines that reduce stomach acid in case of reflux disease
  • Antibiotics to treat infections
  • Medicines and diet changes to treat eosinophilic esophagitis
  • Medicines to coat the lining of the food pipe to treat damage related to pills

You should stop taking medicines that damage the lining of the esophagus. Take your pills with plenty of water. Avoid lying down immediately after taking the pill.

Outlook (Prognosis)

Most of the time, the disorders that cause swelling and inflammation of the food pipe, respond to treatment.

Possible Complications

If not treated, this condition may cause severe discomfort. Scarring (stricture) of the food pipe may develop. This can cause swallowing problems.

A condition called Barrett esophagus (BE) can develop after years of GERD. Rarely, BE may lead to cancer of the food pipe.

When to Contact a Medical Professional

Call your health care provider if you have:

  • Frequent symptoms of esophagitis
  • Difficulty swallowing

References

Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 138.

Graman PS. Esophagitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 99.

Richter JE, Friedenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44.

  • Esophagus and stomach anatomy

    Esophagus and stomach anatomy - illustration

    Food is swallowed and passes through the esophagus to the stomach, where the majority of digestion takes place.

    Esophagus and stomach anatomy

    illustration

  • Esophagus

    Esophagus - illustration

    The esophagus connects the nose and mouth with the stomach. The epiglottis folds over the trachea when a swallow occurs, to prevent the swallowed substance from being inhaled into the lungs. When a person is unable to swallow because of illness or coma, a tube may be inserted either through the mouth or nose, past the epiglottis, into the esophagus and into the stomach. Nutrients will be passed through the tube directly into the stomach.

    Esophagus

    illustration

    • Esophagus and stomach anatomy

      Esophagus and stomach anatomy - illustration

      Food is swallowed and passes through the esophagus to the stomach, where the majority of digestion takes place.

      Esophagus and stomach anatomy

      illustration

    • Esophagus

      Esophagus - illustration

      The esophagus connects the nose and mouth with the stomach. The epiglottis folds over the trachea when a swallow occurs, to prevent the swallowed substance from being inhaled into the lungs. When a person is unable to swallow because of illness or coma, a tube may be inserted either through the mouth or nose, past the epiglottis, into the esophagus and into the stomach. Nutrients will be passed through the tube directly into the stomach.

      Esophagus

      illustration


     

    Review Date: 6/21/2018

    Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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