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Oesophagitis

Oesophagitis is an inflammation of the lining of the oesophagus, the tube that carries food from the throat to the stomach. If left untreated, this condition can become very uncomfortable, causing problems with swallowing, ulcers, and scarring of the oesophagus. In rare instances, a condition known as " Barrett's oesophagus" may develop, which is a risk factor for oesophageal cancer.

What causes oesophagitis?

Oesophagitis is caused by inflammation of the lining of the oesophagus, due to an infection or irritation. The most common cause is GORD, or gastrooesophageal reflux disease. Other causes of irritation leading to oesophagitis include the following:

  • Vomiting
  • Surgery
  • Medications such as aspirin and other anti-inflammatory drugs
  • Taking a large pill with too little water or just before bedtime where fragments get stuck in the throat
  • Swallowing a toxic substance
  • Hernias
  • Radiotherapy injury

Infections that can cause oesophagitis may be due to bacteria, viruses or fungi. These usually occur because of diseases or other conditions that weaken the immune system, such as AIDS or steroid medications. Infections that cause oesophagitis include:

  • Candida. This is a yeast infection of the oesophagus caused by the same fungus that causes vaginal thrush. The infection develops in the oesophagus when the body's immune system is weak (such as in people with diabetes or HIV). It is usually very treatable with antifungal drugs.
  • Herpes. Like Candida, this viral infection can develop in the oesophagus when the body's immune system is weak. It is treatable with antiviral drugs.

What are the symptoms of oesophagitis?

Symptoms of oesophagitis include:

  • Difficult and/or painful swallowing
  • Heartburn
  • Mouth sores
  • A feeling of something of being stuck in the throat
  • Nausea
  • Vomiting

If you have any of these symptoms, you should seek medical advice as soon as possible.

How is oesophagitis diagnosed?

Once your doctor has performed a thorough physical examination and reviewed your medical history, there are several tests that can be used to diagnose oesophagitis. These include:

  • Upper endoscopy . A test in which a long, thin, flexible lighted tube, called an endoscope, is used to look at the oesophagus.
  • Biopsy. During this test, a small sample of the oesophageal tissue is removed and then sent to a laboratory to be examined under a microscope.
  • Barium swallow. During this procedure, x-rays are taken of the oesophagus after drinking a barium solution. Barium coats the lining of the oesophagus and shows up white on an x-ray. This characteristic enables doctors to view certain abnormalities of the oesophagus.

What is the treatment for oesophagitis?

Treatment for oesophagitis depends on its cause. Possible treatments include:

  • Medications that block acid production eg proton pump inhibitors (PPIs)
  • Proton pump inhibitors
  • Antibiotics, antifungals, or antivirals to treat an infection.
  • Pain medications that can be gargled or swallowed.
  • Intravenous (by vein) nutrition to enable the oesophagus to heal and to reduce the likelihood of malnourishment or dehydration.
  • Endoscopy to remove any lodged pill fragments.

If other treatments have not produced relief, your doctor may recommend surgery to strengthen the lower oesophageal sphincter to eliminate reflux

While being treated for oesophagitis, there are certain steps you can take to help limit discomfort. In mild cases these changes may be enough to relieve symptoms.

  • Avoid spicy foods such as those with pepper, chilli powder, curry, and nutmeg.
  • Avoid hard foods such as nuts, and raw vegetables.
  • Avoid acidic foods and drinks such as tomatoes, oranges, grapefruits, and their juices. Instead, try imitation fruit drinks with vitamin C.
  • Add more soft foods such as cooked cereals, mashed potatoes, custards, puddings, and high protein shakes to your diet.
  • Take small bites and chew food thoroughly.
  • If swallowing becomes increasingly difficult, try tilting your head upward so the food flows to the back of the throat before swallowing.
  • Drink liquids through a straw to make swallowing easier.
  • Avoid alcohol and tobacco.

 

WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on February 28, 2014

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