Esophagitis is a condition that causes swelling and irritation of the esophagus, the tube that connects the mouth to the stomach.

Esophagitis can cause symptoms such as chest pain, difficulty swallowing, heartburn, and acid regurgitation. Esophagitis can have various causes, such as acid reflux, infections, allergies, medications, radiation, or autoimmune diseases.

Esophagitis can be diagnosed by a doctor using tests such as endoscopy, biopsy, barium X-ray, or pH monitoring. Esophagitis can be treated depending on the cause and severity of the inflammation. Treatment options may include medications, dietary changes, lifestyle modifications, surgery, or other procedures. Esophagitis can lead to complications such as scarring, narrowing, or bleeding of the esophagus, or increased risk of esophageal cancer.

TYPES OF ESOPHAGITIS

Esophagitis has different types based on the cause of the inflammation. Some of the common types are:

1). Reflux esophagitis

This type is caused by stomach acid or bile flowing back into the esophagus, irritating and eroding the lining. This can happen due to gastroesophageal reflux disease (GERD), hiatal hernia, or other factors that affect the lower esophageal sphincter (LES), the valve that prevents reflux. Reflux esophagitis can be treated with medications that reduce acid production, such as proton pump inhibitors (PPIs) or H2 blockers, or surgery that repairs the LES or the hiatal hernia.

2). Infectious esophagitis

This type is caused by bacterial, viral, fungal, or parasitic infections that affect the esophagus, especially in people who have weakened immune systems. Some common infections that can cause esophagitis are candida (yeast), herpes simplex virus (HSV), cytomegalovirus (CMV), or human immunodeficiency virus (HIV). Infectious esophagitis can be treated with antibiotics, antivirals, antifungals, or antiparasitics, depending on the type of infection.

3). Eosinophilic esophagitis

This type is caused by an allergic reaction that involves eosinophils, a type of white blood cell that accumulates in the esophagus and causes inflammation. This can happen due to food allergies, environmental allergies, asthma, or other factors that trigger the immune system. Eosinophilic esophagitis can be treated with medications that suppress the immune system, such as steroids or biologics, or dietary changes that eliminate the allergens.

4). Drug-induced esophagitis

This type is caused by certain medications that damage the lining of the esophagus, either by direct contact or by increasing acid production. Some common medications that can cause esophagitis are nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, bisphosphonates, potassium chloride, or chemotherapy drugs. Drug-induced esophagitis can be prevented or treated by taking the medications with plenty of water, avoiding lying down after taking them, or switching to a different medication.

5). Radiation esophagitis

This type is caused by exposure to radiation therapy that is used to treat cancer in the chest or neck area. Radiation can damage the cells and tissues of the esophagus, causing inflammation, ulcers, or scarring. Radiation esophagitis can be treated with medications that protect the lining of the esophagus, such as sucralfate or mucosal protectants, or medications that reduce pain and inflammation, such as lidocaine or NSAIDs.

6). Autoimmune esophagitis

This type is caused by an autoimmune disease that attacks the esophagus, such as Crohn's disease, ulcerative colitis, or scleroderma. Autoimmune diseases can cause inflammation, ulcers, or strictures in the esophagus, affecting the swallowing and digestion of food. Autoimmune esophagitis can be treated with medications that suppress the immune system, such as steroids, immunosuppressants, or biologics, or surgery that removes or widens the affected part of the esophagus.

SYMPTOMS OF ESOPHAGITIS

Esophagitis can cause various symptoms, depending on the type and severity of the inflammation. Some of the common symptoms are:

i). Chest pain, especially behind the breastbone, that occurs with eating or swallowing.

ii). Dysphagia: Difficulty swallowing, or feeling that food gets stuck in the throat or chest.

iii). Heartburn, or a burning sensation in the chest or throat, that is worse after eating or lying down.

iv). Acid regurgitation, or a sour or bitter taste in the mouth, that is caused by reflux of stomach contents into the esophagus.

v). Nausea, vomiting, or loss of appetite, that is caused by irritation or obstruction of the esophagus.

vi). Weight loss, dehydration, or malnutrition, that is caused by reduced food intake or absorption due to esophagitis.

vii). Bleeding, infection, or perforation, that is caused by severe erosion or ulceration of the esophagus.

viii). Painful swallowing (odynophagia).

For example:

• Eosinophilic esophagitis may also cause food impaction, weight loss, and failure to thrive in children.

• Infectious esophagitis may also cause fever, chills, and mouth ulcers.

• Radiation esophagitis may also cause dry mouth, cough, and fatigue.

If you have any of these symptoms, you should see your doctor for a proper diagnosis and treatment. Esophagitis can lead to complications such as scarring, narrowing, or bleeding of the esophagus, as well as increased risk of esophageal cancer.

DIAGNOSIS OF ESOPHAGITIS

There are a number of diagnostic criteria that a doctor may employ to determine your chances of infection with esophagitis. These tests include:

1). Endoscopy which is a procedure that uses a thin, flexible tube with a light and a camera (endoscope) to examine the inside of the esophagus and take tissue samples (biopsy) for analysis.

2). Barium X-ray which is a test that uses a contrast agent (barium) that is swallowed and coats the esophagus, making it visible on an X-ray image.

3). pH monitoring which is a test that measures the acidity level in the esophagus using a small device that is attached to the esophagus or swallowed and passed through the digestive tract.

4). Manometry which is a test that measures the pressure and movement of the muscles in the esophagus using a thin tube that is inserted through the nose and into the esophagus.

TREATMENT OF ESOPHAGITIS

Esophagitis can be treated depending on the cause and severity of the inflammation. Its treatment options may include:

• Medications, such as antacids, acid reducers, antibiotics, antivirals, antifungals, anti-parasitics, steroids, immunosuppressants, biologics, mucosal protectants, or pain relievers, that can help reduce inflammation, infection, pain, or acid production in the esophagus.

• Dietary changes, such as avoiding foods that trigger or worsen reflux or allergies, eating smaller and more frequent meals, avoiding lying down after eating, or following a special diet that eliminates the allergens or irritants, that can help prevent or reduce inflammation in the esophagus.

• Lifestyle modifications, such as quitting smoking, losing weight, elevating the head of the bed, wearing loose-fitting clothes, or managing stress, that can help prevent or reduce reflux or inflammation in the esophagus.

• Surgery, such as fundoplication, esophagectomy, or esophageal dilation, that can help repair the lower esophageal sphincter, remove or replace the damaged part of the esophagus, or widen the narrowed part of the esophagus.

• Other procedures, such as; radiofrequency ablation, cryotherapy, or stent placement, that can help destroy or remove the abnormal cells or tissues in the esophagus, or keep the esophagus open and prevent obstruction.

COMPLICATIONS OF ESOPHAGITIS

Esophagitis can lead to complications such as scarring, narrowing, or bleeding of the esophagus, or increased risk of esophageal cancer. Some possible complications resulting from esophagitis may include:

1). Stricture, which is a narrowing of the esophagus due to scar tissue formation, that can cause difficulty swallowing, food impaction, or perforation of the esophagus.

2). Barrett's esophagus, which is a condition where the normal lining of the esophagus is replaced by a different type of tissue, that can increase the risk of developing esophageal cancer.

3). Esophageal ulcer, which is an open sore in the lining of the esophagus, that can cause bleeding, infection, or perforation of the esophagus.

4). Esophageal varices, which are enlarged veins in the lower part of the esophagus, that can rupture and bleed profusely, causing life-threatening hemorrhage.

5). Esophageal cancer, which is a malignant tumor that grows in the esophagus, that can cause difficulty swallowing, weight loss, chest pain, bleeding, or metastasis to other organs.

TIPS FOR PREVENTING ESOPHAGITIS

Bearing in mind that esophagitis is the inflammation or irritation of the oesophageal lining due to acid reflux, infections, allergies, or medications; some recommended tips for preventing esophagitis are:

• Lose weight if necessary, as excess weight can put pressure on the stomach and cause acid reflux.

• Eat smaller meals and avoid eating late at night or close to bedtime, as this can reduce the amount of acid in the stomach and prevent it from coming up the esophagus when lying down.

• Discover and avoid foods that trigger symptoms, such as spicy, fatty, acidic, or carbonated foods and drinks. Some common culprits are fried food, pizza, chocolate, peppermint, tomato-based sauces, citrus fruits, and carbonated beverages.

• Take acid-blocking medications, such as H2-blockers or proton-pump inhibitors, as prescribed by your doctor. These drugs can reduce the amount and strength of stomach acid and protect the esophagus from damage.

• Avoid smoking, alcohol, and caffeine, as these can worsen acid reflux and irritate the esophagus.

Dietary recommendations for persons suffering from esophagitis:

The type of diet you take greatly determines your health and this is no less case for esophagitis patients. The diet choice will determine the inflammation subsiding or worsening and causing other complications. These dietary tips include:

• Choose foods that are soft, moist, and easy to swallow, such as cooked cereals, mashed potatoes, scrambled eggs, yogurt, cottage cheese, soup, smoothies, and pudding. Avoid foods that are hard, dry, crunchy, or have seeds, nuts, or sharp edges, such as toast, crackers, chips, raw vegetables, or granola.

• Choose foods that are high in fiber, as they can help prevent constipation and promote regular bowel movements. Fiber can also make you feel full and prevent overeating. Some good sources of fiber are whole grains, root vegetables, green vegetables, bananas, melons, and nuts.

• Choose foods that are alkaline or have a high pH, as they can help neutralize stomach acid and prevent it from irritating the esophagus. Some examples are cauliflower, fennel, broccoli, asparagus, cucumber, celery, lettuce, and watermelon.

• Drink plenty of water and other fluids, such as broth, herbal tea, or juice, to keep hydrated and help soften food. Avoid drinking fluids that are very hot or very cold, as they can aggravate the esophagus. Also, avoid drinking fluids during meals, as they can dilute stomach acid and make digestion less efficient. Instead, drink fluids between meals or at least 30 minutes before or after eating.

💡 FAQS:

Can I take spicy foods while having esophagitis?

Spicy foods are one of the possible triggers that may worsen your symptoms, as they can irritate the inflamed tissue. Therefore, it is advisable to avoid spicy foods while having esophagitis, and follow a soft food diet that consists of easily digestible foods that do not cause acid reflux or irritation. Some examples of foods that you can eat are soups, broths, yogurt, cheese, cooked cereals, and fruits without seeds. You may also benefit from some lifestyle changes, such as raising the head of your bed, eating smaller and more frequent meals, and avoiding alcohol, tobacco, and caffeine.

Can I drink alcohol while having esophagitis?

It is not recommended to drink alcohol while having esophagitis, as alcohol can worsen your condition in several ways.

Alcohol can:

• Damage the lining of the esophagus and make it more susceptible to inflammation.

• Relax the lower esophageal sphincter, which is a muscle that prevents stomach acid from flowing back into the esophagus.

• Increase the amount of acid produced in your stomach, which can cause more irritation and heartburn.

Therefore, you should avoid alcohol and other triggers that may aggravate your esophagitis, such as spicy foods, tobacco, and caffeine. You should also follow the treatment plan prescribed by your doctor, which may include medications, dietary changes, and lifestyle modifications. By doing so, you can help your esophagus heal faster and prevent complications.