Diagnostics
Typical symptoms of esophagitis are an indefinable, burning pain at the level of the sternum. Swallowing difficulties also occur, which feel different depending on the location of the inflammation. In addition, one frequently encounters sourness and when swallowing, a kind of foreign body sensation occurs.
If there are already pre-existing conditions, an acute infectious disease or frequent heartburn, the suspicion of an esophagitis becomes stronger. In order to diagnose it reliably, a gastroscopy is necessary. A tube is inserted through the mouth into the stomach.
The tube contains a light and a camera. The esophagus can then be viewed from the inside on a high-resolution screen. The doctor can detect inflammation by the appearance of the mucous membrane. By means of a tissue sample the inflammation can be proven and with the help of an additional probe the acid content in the stomach can be measured.
Treatment
The treatment of esophagitis must be planned depending on the cause of the inflammation. In the most common form of esophagitis, which is caused by heartburn, changes in eating habits help in the early stages. Especially acidic foods must be reduced.
Typical triggers are acidic drinks. These include coffee, carbonated beverages and often alcohol, especially wine. Drinks that are pleasant for the esophagus are still water and tea instead of coffee.
It can also help not to eat and drink just before going to bed and to sleep in bed with your head slightly elevated. In addition to habits, medication and, in severe cases, surgery may be necessary. Many medications can reduce the acidity of the stomach to protect the esophagus.
Various surgical techniques are used to treat advanced esophageal diseases. Almost all of them aim to constrict the sphincter muscle between the esophagus and the stomach and to protect the esophagus from gastric acid in the long term. Inflammations of the esophagus that are not caused by heartburn must also be treated completely differently.
If the inflammation is caused by a bacterial pathogen, it must be treated with antibiotics. Antacids are the drugs of choice for the treatment of esophagitis. They are used for initial inflammation and mild symptoms.
By means of a simple chemical neutralization reaction, they bind the stomach acid and counteract inflammation caused by heartburn. If the symptoms persist for about two weeks despite the antacids, proton pump inhibitors are used. The most prominent representatives of this group are Pantozol®, omeprazole or esomeprazole.
They block an enzyme that is essential for the production of hydrochloric acid in the stomach. The agents must therefore be taken before a meal so that they can block the enzyme before the acid is produced. Proton pump inhibitors vary in their effective doses depending on the severity of the esophagitis.
For persistent inflammation, they can be used for 6 months. More rarely, “histamine receptor blockers” or so-called “prokinetics” are used. They also reduce the contact of the esophagus with the harmful acid, but have greater side effects.
The side effects of proton pump inhibitors, on the other hand, are extremely small, which is why they are widely used in everyday clinical practice. Since some of the prominent painkillers can trigger heartburn, the proton pump inhibitors are prescribed at the same time as stomach protection. If the inflammation of the esophagus progresses over months or years despite drug treatment, surgical methods can be used.
The duration of treatment for esophagitis depends on the severity of the inflammation and its treatment. Slight discomfort can be avoided by changing eating and drinking habits and can be relieved within a few hours or days. These changes can initially cause the incipient inflammation to subside.
If the habits are resumed afterwards, the symptoms may either disappear or start again. In the case of long-term symptoms, consideration should be given to adjusting your lifestyle before consequential damage can occur.If an actual inflammation is present, treatment is usually with gastric acid-binding medication. Antacids are agents that bind and neutralize stomach acid through simple chemical reactions.
If the symptoms do not subside after about 2 weeks despite taking the antacids, other drugs must be prescribed. Proton pump inhibitors are often used, which are taken daily for about one to two weeks. They inhibit the production of stomach acid and give the inflammation time to subside slowly.
If the esophagus is inflamed for years due to the stomach acid, long-term damage to the mucous membrane of the esophagus can occur. Before irreversible damage occurs, an operation can be performed to strengthen the lower sphincter muscle of the esophagus and reduce the acidity. The total duration of the symptoms may vary.
Frequent heartburn and initial difficulty in swallowing are too often ignored until a solid inflammation of the esophagus has developed. This can result in irreversible long-term damage over the years. The symptoms must be recognized in time. Even a slight heartburn several times a week for years can have serious consequences.
