Esophagitis is an inflammatory condition of the oesophageal lining. In mild cases, we can’t identify it except while swallowing. But, in severe inflammatory conditions, you may suffer continuous pain and dysphagia (difficulty in swallowing). The long-term inflammatory condition of the esophagus (esophagitis) can cause various severe diseases.
The esophagus is a long, muscular, hollow tube that connects the stomach to the mouth. It helps transit foods and drinks from the mouth to the stomach. The outer pink tissue (mucosa) lining the whole esophagus comes directly in contact with food and beverages. The glands of this mucosa produce mucous to moisten the esophagus and protect it from gastric acid.
Causes of esophagitis
Various factors and conditions cause inflammation and swelling of the esophagus, such as:
- Gastroesophageal reflux disease (GERD): The lower esophageal sphincter stops the stomach acids from entering the esophagus. But in GERD, this sphincter becomes faulty, and this backflow of acidic contents is frequent and irritates the esophagus. The continuous irritation may lead to swelling and inflammation of the esophagus (reflux esophagitis). GERD is the most common cause of esophagitis.
- Drugs: Some medicines can be a causative factor in drug-induced esophagitis. It occurs when:
- Certain drugs remain in contact with the esophageal mucosa for an extended period
- A large pill irritates mucosa while swallowing
- We don’t use enough water to swallow the pill
- Some residues of drugs remain in contact with the esophageal lining.
Drug-induced esophagitis occurs with certain medicines, such as antibiotics, pain-relievers, medicaments for osteoporosis treatment, and pills for potassium-deficiency conditions.
- Allergies: Various allergies or infections stimulate eosinophils production in our body. The eosinophil rise 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 poor immune systems, such as in HIV infection or cancer. The most common pathogens of esophagitis are Candida albicans (fungus) and Herpes simplex virus.
- Miscellaneous causes: Other causes of esophageal inflammation are excessive alcohol consumption, trauma from the nasogastric tube, radiation therapy, and injury from chemical ingestion.
Symptoms of esophagitis
The following are some signs and symptoms a patient can experience:
- Difficulty in swallowing
- Pain while deglutination
- Chest pain while eating
- Food impaction in the esophagus
- Abdominal pain
- Heartburn
- Frequent acid regurgitation
- Nausea and vomiting
- Ulcers in mouth
- Esophagitis in children and infants causes feeding difficulty and failure to gain adequate weight. Most children can’t describe the symptoms and usually refuse to eat food.
Risk factors of esophagitis
Numerous factors increase the risk of esophagitis, including:
- Binge eating
- Overweight
- Eating fatty and spicy meals
- Certain food items such as tomato-based foods, citrus fruits, garlic, and onion
- Eating right before going to bed
- Smoking
- Hiatal hernia of the lower esophageal sphincter
- Intake of excess alcohol, caffeinated beverages, mint-flavored foods, and chocolate products.
- A family history of eosinophilic esophagitis
- Swallowing large medicines
- Taking pills with little or no water
- After certain allergic conditions, including asthma attack, atopic dermatitis, drug allergies, or allergic rhinitis
- Taking medicines while reclining or just before bed
Complications of esophagitis
If not treated on time or neglecting the symptoms, esophagitis can cause serious complications, such as:
- Tear in the esophagus lining
- Scarring of the esophagus
- Stricture or narrowing of the food pipe
- Barrett’s esophagus
Diagnosis of esophagitis
The healthcare provider diagnoses the condition according to the patients’ symptomatic history, their medical history, and the results of the following diagnostic tests:
- Endoscopy: the doctor can search for any unusual findings or tissues in the esophagus with the help of an endoscope. The doctor can also retrieve 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 food pipe, hiatal hernia, ulcers, and tumors.
- Allergy test: the doctors can prescribe a skin-prick test or blood test to diagnose the causative allergen for esophagitis.
- Biopsy: The doctor removes a small tissue sample to diagnose whether the esophagitis is due to allergens, bacterial, viral pathogens, cancer, or precancerous conditions.
Treatment of esophagitis
The treatment approach is to relieve symptoms and treat the underlying cause of the disease. The doctor can recommend one or a combination of the following treatment modalities:
- Diet modification: The doctors suggest avoiding food products that trigger esophagitis, including citrus food, spicy food, alcohol, and caffeinated drinks. You should avoid lying down or bending immediately after eating your food.
- Over-the-counter drugs: The healthcare providers can prescribe antacids, H-2 receptor blockers, and proton pump inhibitors to reduce or block the acid production and heal the esophagus.
- Prokinetics: These drugs strengthen the effect of over-the-counter medicines and help the stomach empty fast.
- Steroids: These drugs help treat eosinophilic esophagitis.
- Precautions while taking medications: To avoid drug-induced esophagitis, the doctors suggest drinking plenty of water while taking any pill, splitting the drug into half if it is too big to ingest, or preferring a liquid version of the medication if possible.
- Surgery: The surgeon may recommend surgery when other treatments don’t work or in case of precancerous or cancerous growth removal.
Esophagitis is a condition that can be preventable and completely curable. If you encounter discomfort or pain in your chest area, don’t neglect and immediately contact your healthcare provider.