What is Esophagitis? 6 Facts You Need to Know

If you've ever suffered from any kind of inflammation of your esophagus, the "pipe" through which food travels from your mouth down to your stomach, then you've experienced the condition known as esophagitis.

Various factors can cause the esophagus to become irritated and painful. Not only is esophagitis unpleasant, but left untreated, it can cause complications. Here's what you need to know about esophagitis:

  1. Acid reflux is the most common cause of esophagitis. Acid reflux occurs when the lower esophageal sphincter, the valve that normally keeps food contained within the stomach, leaks or becomes floppy. This causes stomach acid to back up into the esophagus and may result in a burning sensation in the chest known as heartburn. Acid reflux may occur in anyone from time to time, but if it happens regularly, a person may be diagnosed with gastroesophageal reflux disease, or GERD. Untreated GERD can cause chronic esophageal inflammation and subsequent tissue damage.

    Another cause of esophagitis is eosinophilic esophagitis (EE). This is a chronic immune system disease that causes white blood cells to build up in the lining of the esophagus. People with EE typically have multiple allergies that cause this build-up, which can lead to difficulty swallowing and damage to the esophagus. Other causes of esophagitis include pills that lodge in the throat for prolonged periods, and infections such as candida (yeast), which can affect people with diabetes.
  2. Anyone can get esophagitis, but certain people are more at risk. Obese patients, for example, are more likely to experience esophageal inflammation. "Obesity contributes to reflux mainly from excess weight increasing intra-abdominal pressure, thus promoting reflux of stomach contents upward," says Richard Desi, MD, a gastroenterologist at Mercy Medical Center in Baltimore. Smokers, too, are at risk, as tobacco relaxes the lower esophageal sphincter, making it easier for acid to escape upwards.
  3. The best way to diagnose esophagitis is via endoscopy. This procedure involves placing a long, slender tube down the patient's throat to examine the esophagus; it’s the only way to actually see any damage to the esophagus. During an endoscopy, small pieces of tissue may be removed and examined for abnormalities.
  4. Dietary changes can make a difference. Certain foods are known to aggravate acid reflux because they reduce the pressure necessary to keep the lower esophageal sphincter closed. If your esophagitis is caused by acid reflux, consider cutting down on or eliminating the following from your diet: chocolate, tomato-based products such as pasta sauce, citrus fruit, caffeine, alcohol, garlic, onions, mint-flavored products, and anything spicy.
  5. If losing weight or quitting smoking doesn't help, consider medication. "For reflux, the mainstay of treatment is acid suppression with proton pump inhibitors (PPIs)," Desi says. (Proton pump inhibitors are oral medications that reduce or block the production of stomach acid.) "For eosinophilic esophagitis, PPIs tend to help, as does seeing an allergist. I usually also use topical steroids for six weeks as well. For candida, treatment is with anti-fungal agents."
  6. Esophagitis can lead to other problems. Experts say that untreated esophageal inflammation can lead to structural changes in the esophagus, such as a narrowing of the passageway or the formation of rings of tissue in its lining. One especially serious complication is known as Barrett’s esophagus, which is a concern only for people with acid reflux. In Barrett’s esophagus, cells lining the esophagus mutate into cells that resemble those lining the intestines. Barrett's esophagus is a known risk factor for esophageal cancer, which carries a five-year survival rate of about 20 percent. That’s just one of the many reasons it’s important to consult your healthcare provider if you have symptoms of esophagitis.

Richard Desi, MD, Mercy Medical Center, Baltimore, reviewed this article.


Richard Desi, MD, Mercy Medical Center, Baltimore. Email conversation with source, August 22-26, 2014.

"What Are the Key Statistics About Cancer of the Esophagus?" American Cancer Society. Accessed on August 26, 2014. 

"Eosinophilic Esophagitis." Mayo Clinic. Accessed on August 25, 2014.