Esophagitis – Symptoms and Causes
Overview
Esophagitis refers to inflammation and irritation of the esophageal lining. The esophagus is a muscular tube that transports food and drinks from the mouth to the stomach. This condition causes several uncomfortable symptoms, particularly painful swallowing and chest pain.
Several factors can trigger esophagitis.
Common causes include:
- Acid Reflux: Stomach acids flowing back into the esophagus.
- Infections: Bacterial, viral, or fungal in nature.
- Medications: Certain oral medications may irritate the esophagus.
- Allergic Reactions: Food or environmental allergens.
Without proper treatment, esophagitis can lead to serious complications.
These include:
- Esophageal scarring
- Narrowing of the esophageal passage
- Difficulty swallowing foods and liquids
- Unhealthy weight loss
- Dehydration
Treatment approaches vary based on the underlying cause and severity of tissue damage.
Signs and Symptoms
Common signs of esophagitis include difficulty swallowing and pain when you swallow food or drinks.
Some people experience food getting stuck in their throat (food impaction).
You might feel a burning pain in your chest, often called heartburn, especially when eating. This pain typically occurs behind the breastbone. Another frequent symptom is acid reflux, where stomach acid flows back up into the esophagus.
For babies and young children who cannot express how they feel, esophagitis may cause:
- Feeding difficulties (getting upset, arching the back, refusing to eat)
- Poor growth or weight gain
- Pain in the chest or stomach area for older children
When to Contact Your Doctor
Many digestive conditions can cause similar symptoms. You should call your doctor if you notice:
- Symptoms that last longer than a few days
- Problems that don’t improve after taking over-the-counter antacids
- Symptoms severe enough to affect your eating or cause weight loss
- Digestive issues that occur along with flu-like symptoms (headache, fever, muscle aches)
Seek emergency medical care if you experience:
- Chest pain lasting more than a few minutes
- Food that feels stuck in your throat
- Chest pain if you have a history of heart problems
- Pain in your mouth or throat while eating
- Shortness of breath or chest pain shortly after meals
- Heavy or forceful vomiting, or breathing problems after vomiting
- Vomit that appears yellow, green, like coffee grounds, or contains blood
Why Esophagitis Happens
When Stomach Acid Flows Back
Reflux esophagitis happens when stomach acid moves up into the food pipe. Normally, a muscle valve keeps acid in the stomach. Sometimes this valve doesn’t work right.
It might not close properly or open when it shouldn’t.
Some people have a hiatal hernia, where part of the stomach pushes through the muscle separating the chest and abdomen. This can also let acid flow back into the food pipe.
When acid backflow happens often, it’s called gastroesophageal reflux disease (GERD). Over time, GERD can damage the lining of the food pipe and cause swelling.
Allergic Reaction in the Food Pipe
Eosinophilic esophagitis occurs when special white blood cells called eosinophils build up in the food pipe. This usually happens as an allergic reaction to certain foods or substances.
Common food triggers include:
- Milk
- Eggs
- Wheat
- Soy
- Peanuts
- Seafood
Standard allergy tests often miss these triggers. Some people react to airborne allergens like pollen instead of food.
Common symptoms include food getting stuck in the throat after swallowing or trouble swallowing.
White Blood Cell Buildup
Lymphocytic esophagitis is less common. It happens when lymphocytes (another type of white blood cell) gather in the food pipe lining. This condition may be related to acid reflux or eosinophilic esophagitis.
Damage from Medications
Some pills can hurt the food pipe if they stay in contact with its lining too long. This often happens when someone takes medicine with little or no water.
Medications that can cause esophagitis include:
| Type of Medication | Examples |
|---|---|
| Pain relievers | Aspirin, ibuprofen, naproxen |
| Antibiotics | Tetracycline, doxycycline |
| Potassium supplements | Potassium chloride |
| Bone treatments | Alendronate and other bisphosphonates |
| Heart medications | Quinidine |
Germs in the Food Pipe
Infectious esophagitis happens when bacteria, viruses, or fungi infect the esophagus. This type is rare and mainly affects people with weakened immune systems, such as those with HIV/AIDS or cancer.
A common cause is the fungus Candida albicans, which normally lives in the mouth. People at higher risk for this infection include those with:
- Weakened immune systems
- Diabetes
- Cancer
- Those taking steroids or antibiotics
The infection can spread to the food pipe and cause painful swelling and irritation.
Risk Factors
Several factors increase the chance of getting inflammation from stomach acid flowing back into the food pipe.
These include:
- Eating before bedtime
- Consuming large, fatty meals
- Tobacco use
- Weight gain, including from pregnancy
Some foods that can make symptoms worse are:
| Problem Foods | Why They Matter |
|---|---|
| Coffee and tea | Contain caffeine that can relax the valve between stomach and food pipe |
| Alcoholic drinks | Irritate the lining of the food pipe |
| High-fat foods | Slows digestion and increases acid production |
| Chocolate | Contains substances that relax the valve between the stomach and esophagus |
| Peppermint | Can relax muscles that prevent acid backflow |
Allergy-Related Inflammation
Risk factors for this type of food pipe inflammation include:
- Having other allergic conditions like asthma, skin rashes, or hay fever
- Family members who have the same condition
Medication-Caused Inflammation
Factors that increase risk for medication damage to the food pipe include:
- Taking pills with too little water
- Lying down while taking medicine
- Taking medicine right before sleep
- Age-related changes in older adults
- Taking large or oddly shaped pills
These risks often relate to anything that keeps pills in contact with the food pipe lining for too long.
Infection-Related Inflammation
People more likely to get infections in their food pipe include those:
- Taking steroid medications
- Using antibiotics regularly
- Living with diabetes (especially at risk for yeast infections)
Poor immune system function raises risk significantly. This can happen due to:
- Immune disorders like HIV/AIDS
- Certain types of cancer
- Cancer treatments
- Medicines that suppress the immune system after organ transplants
Complications
Esophagitis that goes untreated can cause serious changes to the esophagus structure. These complications include:
- Stricture – scarring that narrows the esophagus.
- Esophageal Tears – rips in the esophagus lining that may happen during severe retching. They can also occur when doctors insert tools during an endoscopy procedure.
- Barrett’s Esophagus – a condition where acid reflux damages the esophageal lining cells, significantly increasing the risk of developing esophageal cancer.
These complications highlight why proper diagnosis and treatment are essential. Early intervention can prevent these serious issues from developing. It can also protect the long-term health of your digestive system.
