Esophagitis

What Is It?

The esophagus is the muscular tube that carries food through the chest, from the mouth to the stomach. Normally you don't feel it except when you are swallowing. However, if the inside lining of your esophagus becomes inflamed, you may experience pain or problems with swallowing. This inflammation of the esophagus is called esophagitis.

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.

Symptoms

The main symptoms of esophagitis are:

  • Pain in the chest (behind the breastbone) or throat. The pain can be burning, heavy or sharp. If acid reflux is the cause of esophagitis, the pain may be worse after meals or when you lie flat. Pain from esophagitis may be constant or may come and go.

  • Swallowing problems including worsening of the chest pain when you swallow or a feeling of food sticking in your chest after you swallow

  • Bleeding, seen as blood in vomit or as darkening of the stools

Diagnosis

The diagnosis often is made based on your symptoms.

The most accurate way to check for esophagitis is for a doctor to look directly at the inside of the esophagus with a video camera called an endoscope. The endoscope has a camera at the end of a flexible, plastic-coated cord. This tube is long enough to reach through the stomach to the first portion of the intestine (duodenum). The procedure is sometimes called esophagogastroduodenoscopy or EGD.

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