February 1, 2017

Esophagitis is an inflammation of the lining of the esophagus. In this condition, the lining of the esophagus becomes inflamed because of an infection or an irritation of the lining. Esophagitis is called acute when it occurs suddenly. It is called chronic when it lasts for a long time.

The esophagus is a muscular tube that connects the throat to the stomach and may be thought of as a food pipe. Esophagitis is an inflammation (swelling) of the esophagus that causes pain and discomfort with swallowing, or gives you the sensation of a lump in the throat. Esophagitis is a common side effect of cancer treatment that can be caused by radiation therapy or chemotherapy.

If diagnosed rapidly and treated properly, the prognosis for esophagitis is usually good. Prognosis also depends on the underlying disease process.


Esophagitis has several common causes –

Acid reflux — By far the most common cause of esophagitis is acid reflux (also called gastroesophageal reflux disease or GERD). It is a backflow of digestive acid from the stomach, resulting in a chemical burn of the esophagus.

Eating disorders — Similar to acid reflux, frequent vomiting can cause acid burn in the esophagus. Esophagitis sometimes is seen in people with eating disorders such as bulimia.

Medications — Some common medications also can cause a chemical burn in the esophagus. Pills that are most likely to cause esophagitis include –

  • aspirin
  • doxycycline
  • iron supplements
  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn)
  • osteoporosis medications such as alendronate (Fosamax) or risedronate (Actonel)

Chemotherapy and radiation therapy for cancer — Some of these treatments can injure the esophagus lining, resulting in esophagitis.

Infections — Infections in the esophagus also can cause esophagitis. They usually occur in people with a weak immune system. Esophagitis from infections is common in people who have HIV infection, use steroid medicines long-term, have had organ transplants, or have been treated with chemotherapy for cancer.

Only a few types of infection are common in the esophagus, such as –

  • yeast
  • herpes virus (HSV)
  • cytomegalovirus (CMV)

Even in someone who already has a herpes infection in the mouth, it rarely spreads down to the esophagus if the immune system is normal.

Risk Factors

People are at risk if they –

  • Are pregnant
  • Smoke
  • Are obese
  • Are an elderly adult
  • Consume a lot of alcohol, coffee, chocolate, fatty foods, or spicy foods
  • Use certain medicines, including NSAID pain relievers, nitrates, and beta blockers
  • Have a spinal cord injury
  • Have had radiation therapy for chest tumors
  • Swallow medicine with too little water or get a pill stuck in your throat
  • Have scleroderma, an autoimmune disease


A symptom is something the patient feels and describes, such as dizziness, pain, or anxiety. A sign is something other people, apart from the patient, can also detect, such as a rash, pallor, or weight loss.

These are both the signs and symptoms most commonly linked to esophagitis –

  • Abdominal pain
  • Adynophagia – pain when swallowing
  • Dysphagia – difficulty swallowing
  • Food gets stuck in the esophagus
  • Lack of appetite
  • Nausea, and possibly vomiting
  • Cough
  • Pain when eating, heartburn
  • Mouth sores

Feeding difficulties, and subsequently possible failure to thrive in young children and babies. At this age, most patients are too young to describe their symptoms


Left untreated, esophagitis can lead to changes in the structure of the esophagus. Possible complications include –

  • Narrowing of the esophagus (esophageal stricture)
  • Barrett’s esophagus, characterized by changes to the cells lining the esophagus, increasing your risk of esophageal cancer


Treatment depends on the cause of esophagitis.

Acid reflux — Lifestyle changes help reduce reflux –

  • Lose weight if necessary
  • Eat smaller meals
  • Don’t lie down right after eating
  • Discover and avoid foods that cause symptoms

Acid blocking medications, including H2-blockers and proton-pump inhibitors, are usually prescribed. For persistent esophagitis, your doctor may recommend surgery to tighten the lower esophageal sphincter.

Pill esophagitis — Drinking a full glass of water after taking a pill can help. Usually, if esophagitis has occurred, it is necessary for you to stop the medicine at least temporarily while you heal. Since acid can worsen esophagitis caused by medications, your doctor also may prescribe an acid-blocking medication to speed healing.

Infections — The choice of treatment depends upon the infectious agent causing the esophagitis. Some esophagus infections are difficult to treat with swallowed pills or liquids, so medicines may be given intravenously (into a vein).

Surgery – Fundoplication may be used to improve the condition of the esophagus if other interventions don’t work. A portion of the stomach is wrapped around the valve separating the esophagus and stomach (lower esophageal sphincter). This strengthens the sphincter and prevents acid from backing up into the esophagus.

Alternative & Complementary Treatment

Antioxidants have been shown to be protective in numerous diseases, such as Esophagitis, GERD, gastric ulcers, and GI cancers. Oxidative stress of the esophageal mucosa is a contributing factor in the pathology of GERD. Antioxidant dietary supplement containing melatonin, Ltryptophan, vitamin B6, folic acid, vitamin B12, methionine, and betaine, proves effective for this condition.

D-limonene is a monoterpene in citrus oil. Numerous studies have shown that D-limonene exerts anti-cancer, antimicrobial, and anti-inflammatory effects. In particular, studies have shown that this constituent of citrus oil is protective against GI cancers, including cancers of the stomach and colon, decreasing both growth and metastasis

Licorice Root – Historically, licorice root has been used for stomach ulcer. It contains a compound called glycyrrhizin and has soothing and healing properties.

Minerals – Calcium carbonate, magnesium, aluminum, and phosphate salts are frequently used in overthe-counter antacids. Studies have indicated that antacids are effective for treating esophagitis.

Digestive enzymes – Supplemental digestive enzymes may reduce esophagitis symptoms.

Zinc carnosine has been shown to speed healing in many types of esophagitis.

L-Glutamine is an amino acid utilized as an energy source by intestinal epithelium. Research has shown that supplementation with glutamine prevented the development in induced esophagitis.

IV treatment – To allow the esophagus to heal during treatment and to ensure proper nutrition and reduce the risk for malnutrition and dehydration, some patients require parenteral feeding (e.g., nutrition administered through a vein [IV]).


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