Esophagitis

Overview

Esophagitis is inflammation of the esophagus, the muscular tube that carries food from the mouth to the stomach.

Painful, burning sensations, chest pain, and difficulty swallowing can all be symptoms of esophagitis. Esophagitis can be brought on by a number of factors. Backflow of stomach acids into the esophagus, infections, oral medications, and allergies are a few prominent causes.

The following are the different types of esophagitis.

• Reflux esophagitis: When the acidic contents of your stomach and digestive flow back and reflux into the esophagus, the mucous lining (mucosa), which lines the esophagus, becomes irritated and erodes. This is the most frequent type of esophagitis. If the patient frequently experiences acid reflux or frequently throws up, this could occur.

Causes of reflux esophagitis including gastroesophageal reflux disease (GERD), bile reflux, and bulimia nervosa.

• Eosinophilic esophagitis: Eosinophilic esophagitis is a type of immune hypersensitivity reaction characterized by an exaggerated response of the immune system. In this condition, the immune system mobilizes an excessive number of eosinophils to combat a perceived threat, such as an infection or an allergy. However, even after the initial threat has been resolved, these eosinophils continue to accumulate in the esophagus, leading to persistent inflammation. This condition is more commonly observed in individuals with diverse allergies, who are more susceptible to its occurrence.
• Drug-induced esophagitis: Pill esophagitis can occur when oral medications come into prolonged contact with the lining of the esophagus, leading to tissue damage. This can happen when a patient swallows a pill with inadequate water or fails to swallow it completely, causing the tablet or pill residue to remain in the esophagus. In such cases, the prolonged presence of medication in the esophagus can cause irritation and injury to the esophageal tissues, resulting in pill esophagitis.

Examples of such medications include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, antibiotics, potassium chloride, bisphosphonates, and chemotherapy drugs.

• Infectious esophagitis: Esophageal infections are uncommon unless an individual has a compromised immune system, which makes them more susceptible to frequent and severe infections overall. Typically, infections in the esophagus originate from other parts of the body and subsequently spread to the esophagus. Among these infections, viral and fungal infections are the most commonly encountered types.
• Lymphotic esophagitis (LE): Lymphocytes, a type of white blood cell, increase in the lining of the esophagus in lymphocytic esophagitis. LE could be connected to GERD or eosinophilic esophagitis.
• Autoimmune esophagitis: In addition to eosinophilic esophagitis, some other autoimmune diseases can also result in esophagitis as a complication. These conditions include Behçet’s disease, inflammatory bowel disease (IBD), and graft vs host disease.
• Radiation esophagitis: Radiation mucositis, an inflammation of the mucosa in the esophagus, may result from radiation therapy that targets the esophagus, chest, or throat. Although it happens seldom, some persons who have received radiation can develop chronic esophagitis.

The treatment approach for esophagitis depends on its underlying cause and the extent of damage to the esophageal tissue lining. If left untreated, esophagitis can negatively impact the ability of the esophagus to efficiently transport food and liquids from the mouth to the stomach. Additionally, esophagitis may lead to complications such as esophageal scarring or narrowing, unintended weight loss, and dehydration. Therefore, it is important to address esophagitis promptly to prevent these potential complications.

Symptoms

The following are typical signs and symptoms of esophagitis:

• Difficulty or painful swallowing
• Heartburn
• Food impaction, which is the condition in which swallowed food becomes lodged in the esophagus.
• Chest pain
• Acid regurgitation or reflux
• Nausea and vomiting
• Blood in the vomit
• Mouth sore
• Feeding difficulties in children
• Chest or abdominal pain in children

The majority of esophagitis symptoms can be brought on by a few distinct digestive disorders. It is crucial to seek immediate medical attention if you experience symptoms that persist for more than a few days, do not improve with over-the-counter antacids, make eating difficult, or are accompanied by flu-like symptoms such as headache, fever, and muscle aches. Similarly, if you are experiencing unexplained weight loss, it is important to consult a healthcare provider promptly.

Additionally, if you have chest pain lasting more than a few minutes or difficulty breathing after eating, immediate medical attention is necessary. Recognizing the severity of these symptoms and seeking timely medical care is vital for proper diagnosis and appropriate treatment.

Causes

Inflammation of the esophageal tissues can occur when your immune system is mobilized to combat an infection, during an allergic reaction, or as a result of corrosive damage inflicted on the tissues.

• Acid reflux such as GERD
• Allergies to food, pollens, or air
• Infections, either bacterial, viral, or fungal.
• Medications such as pain-relieving medications, antibiotics, potassium chloride, and quinidine (heart problem medication)
• Radiation therapy
• Autoimmune diseases.

Risk factors

The different types of the condition can affect the risk factors for esophagitis.

• Reflux esophagitis: The following are risk factors for gastroesophageal reflux disease (GERD), which are also risk factors for reflux esophagitis:
  • Eating just before going to bed
  • Eating large and fatty meals.
  • Smoking.
  • Having extra weight and that also include pregnancy.

Food such as fatty food, chocolate, caffeine, alcohol, and peppermint can worsen symptoms of reflux esophagitis.

• Eosinophilic esophagitis: The following risk factors for eosinophilic esophagitis, or allergy-related esophagitis may includes:
  • Family history of eosinophilic esophagitis.
  • History of allergic reactions, that includes asthma, atopic dermatitis and allergic rhinitis.
• Drug-induced esophagitis: Drug-induced esophagitis risk factors are typically linked to conditions that impede a quick and complete passage of a tablet into the stomach. These factors consist of:
  • Ingesting a tablet without any or little water.
  • Aging, maybe as a result of changes to the esophageal muscles brought on by aging or a decrease in salivation.
  • Pills with unusual shapes or sizes
  • Taking drugs while lying down.
  • Using medicines just before bed, which is probably related to the fact that people tend to swallow less and produce less saliva while they sleep.
• Infectious esophagitis: Medications like steroids or antibiotics are frequently linked to risk factors for infectious esophagitis. Diabetes also increases the risk of certain infections, particularly candida esophagitis.

Immune system dysfunction may be a factor in further infectious esophagitis causes. An immunological illness, AIDS or HIV, or specific malignancies could be responsible for this. Additionally, several cancer therapies and medications known as immunosuppressants, which prevent immune responses to transplanted organs, may raise the chance of contracting infected esophagitis.