Esophagitis

Esophagitis is esophageal inflammation. The muscular tube that carries food from your mouth to your stomach is the esophagus.

Chest discomfort and unpleasant, challenging swallowing are two symptoms of esophagitis. Esophagitis can be brought on by a variety of factors. Backflow of stomach acids into the esophagus, infections, oral medications, and allergies are a few prominent reasons.

The underlying cause of esophagitis and the degree of damage to the tissue lining the esophagus determine the course of treatment. Esophagitis can harm this lining and prevent it from doing its job of transporting food and liquids from your mouth to your stomach if left untreated. Esophagitis may also result in side effects such as esophageal scarring or constriction, unexpected weight loss, and dehydration.

Esophagitis: Causes

The disease that causes esophagitis is typically used to name the condition. It could have several causes in various circumstances. The most typical varieties include −

Esophagitis with Reflux

The lower esophageal sphincter, a valve, typically prevents the stomach's acidic contents from entering the esophagus. Yet occasionally, this valve fails to shut off or opens when it shouldn't. A hiatal hernia is when the top portion of the stomach slides into the chest above the diaphragm. If this occurs, the stomach's contents may reflux into the esophagus (gastroesophageal reflux).

The illness known as gastroesophageal reflux disease (GERD) is characterized by persistent or regular acid reflux.

Esophagitis with Eosinophilia

White blood cells called eosinophils are important in allergic responses. If there is a significant accumulation of these white blood cells in the esophagus, eosinophilic esophagitis may develop. This is most often a reaction to an allergen, acid reflux, or a combination of the two.

Many times, foods including milk, eggs, wheat, soy, peanuts, and shellfish can cause this sort of esophagitis. Nevertheless, standard allergy testing is unable to accurately pinpoint the offending foods. Several non-food allergies may also exist in those who have eosinophilic esophagitis. For instance, pollen and other airborne allergens may occasionally be to blame. Food impaction or difficulty swallowing, sometimes referred to as dysphagia, is the most typical symptom of eosinophilic esophagitis.

Leukocytic Esophagitis

Lymphocytes, a kind of white blood cell, are more prevalent in the lining of the esophagus in lymphocytic esophagitis (LE), a rare disorder of the esophagus. LE might be connected to GERD or eosinophilic esophagitis.

Esophagitis Brought on by Drugs

If oral medications come into prolonged touch with the lining of the esophagus, they may harm the tissues. For instance, the tablet itself or pill residue may stay in the esophagus if you swallow a pill with little or no water. The following medications have been associated with esophagitis −

• Aspirin, ibuprofen, and naproxen sodium are some examples of painkillers.

• Antibiotics like doxycycline and tetracycline.

• Potassium chloride is a medication used to treat a lack of potassium.

• Alendronate is a kind of bisphosphonate used to treat osteoporosis, a condition characterized by fragile and brittle bones.

• Quinidine is a medication for cardiac issues

Virus-induced Esophagitis

Esophagitis may be brought on by a bacterial, viral, or fungal infection in the tissues of the esophagus. The majority of cases of infectious esophagitis, which is quite uncommon, are seen in patients with compromised immune systems, such as those with cancer or HIV/AIDS.

Infectious esophagitis is frequently brought on by Candida albicans, a fungus that is typically found in the mouth. These infections frequently occur in people who have weak immune systems, diabetes, cancer, or who take steroids or antibiotics.

Esophagitis: Symptoms

The patient with esophagitis mainly presents with the following symptoms that include −

• Having trouble swallowing.

• Swallowing pains.

• Food impaction is the term for when food that has been swallowed becomes lodged in the esophagus.

• Chest discomfort that worsens as you eat, especially beneath the breastbone.

• Heartburn.

• Regurgitation of acid.

Esophagitis symptoms in babies and young children, especially those unable to communicate their discomfort or pain, may include −

• Feeding issues, including irritability, back arches, and a lack of appetite.

• Lack of success.

• Pain in the chest or abdomen in older kids.

Esophagitis: Risk Factors

Several factors play an important role in the development of esophagitis which includes −

• Eating just before retiring during the evening

• Meals that are very huge and greasy

• Smoking

• Weight gain, especially that caused by pregnancy

GERD or reflux esophagitis symptoms may be worse by several foods −

• Caffeine

• Alcohol

• Fattening foods

• Chocolate

• Peppermint

Esophagitis: Diagnosis

The diagnosis of esophagitis is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes −

Endoscopy

A long, thin tube fitted with a small camera is inserted down your neck and into your esophagus during this surgery. The name of this device is an endoscope.

Stomach Sponge

This examination can be carried out at the doctor's office. It entails ingesting a capsule that is strung up on a string.

X-ray for Barium

You consume a solution or swallow a tablet containing the substance barium for this test. The lining of the stomach and esophagus is coated with barium, which also makes the organs visible.

In-lab Examinations

During an endoscopic examination, small tissue samples are extracted and submitted to the lab for analysis. The following tests may be used, depending on the disorder's likely cause −

• Determine whether the infection is bacterial, viral, or fungal.

• Count the number of eosinophils and white blood cells associated with allergies.

• Recognize abnormal cells that could point to esophageal cancer or precancerous alterations

Esophagitis: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Conservative treatments include −

• Therapies that are not on a prescription. Antacids fall under this category, as do drugs termed H-2-receptor blockers, which lower acid production and include cimetidine, as well as proton pump inhibitors, which stop acid production and treat the esophagus. They include, among others, lansoprazole and omeprazole.

• Medications on prescription. They include proton pump inhibitors and H-2 receptor blockers with a prescription.

Surgical Treatment

If alternative treatments fail to improve the condition of the esophagus, fundoplication surgery may be employed. In this surgery, a section of the stomach is wrapped around the lower esophageal sphincter, the valve dividing the esophagus from the stomach. As a result, the sphincter is strengthened and acid cannot back up into the esophagus.

Esophagitis: Prevention

Some of the measures that can help to prevent esophagitis include −

• Eat no things that could make reflux worse.

• Practice responsible pill-taking.

• become thinner.

• Quit smoking if you do.

• Avoid bending or stooping, especially right after eating.

• Following a meal, avoid lying down.

Conclusion

There are several esophagitis causes, and healthcare professionals from a variety of specialties will encounter these individuals. An interdisciplinary approach is required to prevent diagnostic delays.

Most patients have a fair prognosis if they receive quick care, but the underlying reason ultimately determines the results. Because other more serious causes of chest discomfort must be ruled out, repeated esophagitis might result in concern and absences from work.

Erosive esophagitis, if left untreated, might result in stricture development and undernutrition. Perforation and bleeding are two additional somewhat frequent consequences.