John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Esophagitis is a term used to describe inflammation of the esophagus, which is the tube that connects the throat to the stomach. There are several types of esophagitis depending on the cause. Esophagitis can be caused by infection, irritation of the esophagus, or inflammation of the lining of the esophagus.
What causes esophagitis?
Esophagitis can be caused by infection or irritation of the esophagus.
Infections of the esophagus can be caused by bacteria, viruses, or fungi, including:
Candida, a yeast infection. This is more common in patients with weakened immune systems, such as those with diabetes, HIV/AIDS, patients undergoing chemotherapy, or people who are taking antibiotics or steroids.
Herpes, a viral infection. It may develop in the esophagus when the body's immune system is weak.
One of the main causes of esophageal irritation is reflux of stomach acid. There are several causes for reflux:
GERD (gastroesophageal reflux disease):weakness or dysfunction of the muscle that keeps the stomach closed (sphincter) can allow stomach acid to leak into the esophagus (acid reflux), causing irritation of the inner lining. Also called GERD esophagitis - in severe cases it can become erosive esophagitis.
Vomiting: when vomiting is frequent or chronic it can lead to acid damage to the esophagus. Excessive or forceful vomiting may cause small tears of the inner lining of the esophagus, leading to further damage.
Hiatal hernia: This abnormality occurs when a part of the stomach moves above the diaphragm producing a small abnormal pouch, or hiatal hernia, which can lead to excess acid refluxing into the esophagus.
Achalasia: This is a disorder where the lower end of the esophagus does not open normally, and as a result food can get stuck in the esophagus or is regurgitated. People with achalasia have a higher than normal risk of esophageal cancer.
Medical treatments for other problems can also cause esophageal irritation.
Surgery, including certain types of bariatric (weight loss) surgery, can lead to increased risk of esophagitis. Medications such as aspirin and other anti-inflammatory drugs can irritate the lining of the esophagus, and also cause increased acid production in the stomach that can lead to acid reflux. Large pills taken with too little water or just before bedtime can dissolve or get stuck in the esophagus, causing irritation. Radiation to the chest (thorax), for cancer treatment can cause burns leading to scarring and inflammation of the esophagus.
Other causes of esophageal irritation:
Swallowing of foreign material or toxic substances
Esophageal cancer: A malignant tumor of the esophagus. The risk of cancer of the esophagus is increased by long-term irritation of the esophagus, such as from smoking, heavy alcohol intake, and Barrett esophagitis. Very small tumors in the esophagus usually do not cause symptoms. As a tumor grows, the most common symptom is difficulty in swallowing. There may be a feeling of fullness, pressure, or burning as food passes down the esophagus. Cancer of the esophagus can also cause indigestion, heartburn, vomiting, and frequent choking on food. Because of these problems, weight loss is common. Esophageal cancer can be diagnosed through a barium X-ray study of the esophagus and endoscopy and biopsy of the tumor. Treatment includes chemotherapy and sometimes surgery.
Many years ago, Schatzki described a
smooth, benign, circumferential, and narrow ring of tissue in the lower end of
the esophagus (the food pipe that connects the mouth to the stomach). These rings