The term oesophagitis is used when the oesophageal mucus is inflamed, with an additional layer covering it. The mucus quite often becomes irritated or inflamed. The oesophagus is part of the digestive system and it connects the mouth to the stomach. The mouth and the oesophagus are separated by cardia, which is a type of valve that aims to prevent gastric juices go up to the mouth once they have passed through the stomach.
Common signs and symptoms of esophagitis include –
• Difficult swallowing
• Painful swallowing
• Chest pain, particularly behind the breastbone, that occurs with eating
• Swallowed food becoming stuck in the esophagus (food impaction)
• Acid regurgitation
In infants and young children, particularly those too young to explain their discomfort or pain, signs of esophagitis may include –
• Feeding difficulties
• Failure to thrive
There are many causes for oesophagitis –
• Reflux oesophagitis
This happens when there is an issue in the lower oesophageal sphincter, which is what ensures that the acid in the stomach is far away from the oesophagus. If this doesn’t work properly and it opens when it shouldn’t or doesn´t close, the stomach content returns to the oesophagus. This is known as gastroesophageal reflux. This is a common and continuous disease.
• Eosinophilic oesophagitis
Eosinophils are white blood cells that play a crucial role in allergic reactions. Eosinophilic oesophagitis happens when there is a concentration of white blood cells in the oesophagus in response to an allergen. Some foods that can cause it include; milk, eggs, wheat, beef, and rye.
• Lymphocytic oesophagitis.
Uncommon oesophagus disorder in which there is a high number of lymphocytes in the oesophageal lining.
• Drug-induced esophagitis.
Some medications can cause tissue damage, an example of this is taking a pill without water. The medications may be anti-inflammatory painkillers, antibiotics, potassium chloride, bisphosphonates, or quinidine.
• Infectious oesophagitis.
A bacterial or viral infection in the oesophagus can cause this, although it is very rare.
Risk Factors –
There are risk factors that increase the chances of having gastroesophageal reflux. They include –
• Eating just before going to sleep
• Excessive consumption of alcohol, chocolate, caffeine, or mint flavours
• Eating big portions of greasy food
• Spicy food
• Obesity or being overweight
• Hiatus hernia
Left untreated, esophagitis can lead to changes in the structure of the esophagus. Possible complications include –
• Scarring or narrowing (stricture) of the esophagus
• Tearing of the esophagus lining tissue from retching (if food gets stuck) or during endoscopy (due to inflammation)
• Barrett’s esophagus, characterized by changes to the cells lining the esophagus, increasing your risk of esophageal cancer
Once your doctor has performed a thorough physical examination and reviewed your medical history, there are several tests that can be used to diagnose esophagitis. These include –
A long, flexible lighted tube called an endoscope is used to look at the esophagus.
A small sample of the esophageal tissue is removed and sent to a laboratory to be examined under a microscope.
• Barium X-ray
X-rays are taken of the esophagus after the patient drinks a barium solution. Barium coats the lining of the esophagus and is visible on X-ray. This enables doctors to view abnormalities of the esophagus.
Antacids are alkaline liquids or tablets that reduce the amount of acid. A dose usually gives quick relief. There are many brands which you can buy. You can also obtain some on prescription. You can use antacids ‘as required’ for mild or infrequent bouts of heartburn.
• Acid-suppressing medicines
If you have symptoms frequently then see a doctor. An acid-suppressing medicine will usually be advised. Two groups of acid-suppressing medicines are available – proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers). They work in different ways but both reduce (suppress) the amount of acid that the stomach makes. PPIs include omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. H2 blockers include cimetidine, famotidine, nizatidine and ranitidine.
An operation can ‘tighten’ the lower oesophagus to prevent acid leaking up from the stomach. It can be done by ‘keyhole’ surgery. In general, the success of surgery is no better than acid-suppressing medication. However, surgery may be an option for some people whose quality of life remains significantly affected by their condition and where treatment with medicines is not working well or not wanted long-term.
Lifestyle changes & Home remedies –
Depending on the type of esophagitis you have, you may lessen symptoms or avoid recurring problems by following these steps –
• Avoid foods that may increase reflux.
Avoid eating excessive amounts of foods that you know worsen your symptoms of gastroesophageal reflux. These may include alcohol, caffeine, chocolate and mint-flavored foods.
• Use good pill-taking habits.
Always take a pill with plenty of water. Don’t lie down for at least 30 minutes after taking a pill.
• Lose weight.
Talk to your doctor about an appropriate diet and exercise routine to help you lose weight and maintain a healthy weight.
• If you smoke, quit.
Talk to your doctor if you need help ending a smoking habit.
• Avoid certain medications.
Avoid some pain relievers and antibiotics, as well as some other medications, if you have an enlarged left upper heart chamber (atrium) or after heart surgery.
• Avoid stooping or bending, especially soon after eating.
• Avoid lying down after eating.
Wait at least three hours after eating to lie down or go to bed.
• Raise the head of your bed.
Place wooden blocks under your bed to elevate your head. Aim for an elevation of 6 to 8 inches (15 to 20 centimeters). Raising your head by using only pillows isn’t effective.
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