Esophagitis, or inflammation of the esophagus, results from poor eating habits, stress, or a weak sphincter muscle at the junction with the stomach. The delicate mucous membrane becomes damaged and can cause pain and discomfort when swallowing. You can treat esophagitis with diet, medication or, in severe cases, surgery.
What is esophagitis?
Esophagitis occurs when the mucous membrane lining the esophagus becomes inflamed. Esophagitis can occur acutely or be chronic. In most cases, the lower third of the esophagus is affected, where it connects to the stomach. The esophagus is a tube of muscle and tissue that connects the mouth to the stomach. The skin of the esophagus is made up of different layers of tissue. The outermost is a layer of muscle, followed by a layer of connective tissue in which there are glands for the production of mucus. This mucilaginous substance is released onto the innermost layer so that food slides more easily when swallowed, but also as protection for the mucous membrane. If stomach acid now frequently flows from the stomach back into the esophagus, or if fungi, viruses or sharp objects swallowed accidentally enter, esophagitis can result.
Causes
There can be several causes of esophagitis. The most common trigger is a lack of closure of the junction with the stomach. Normally, the lower esophageal sphincter prevents stomach acid from flowing into the esophagus. But if the muscle is damaged or too weak, if too much stomach acid is produced due to poor diet, or if there is tumor disease on the stomach, then it is possible that the closure will no longer function properly. Obesity or pregnancy can also be triggers for increased pressure on the stomach closure. The stomach acid then flows into the esophagus and attacks the sensitive mucous membrane there. Inflammation of the esophagus is then the result. Another possible cause is the accidental swallowing of sharp objects or corrosive substances or the improper intake of medication. Fungal infection or viral invasion can also cause esophagitis.
Symptoms,, complaints and signs
Esophagitis can manifest itself through a number of symptoms. Typically, heartburn and acid regurgitation occur, along with severe pain when swallowing. Often, esophagitis is also associated with an unpleasant taste in the mouth. Accordingly, those affected have strong bad breath and an overall very dry, easily irritated mouth. The symptoms can cause sleep disturbances. This often results in other health problems, such as fatigue, moodiness and concentration problems. Those affected also describe a feeling of pressure behind the breastbone, which, like the symptoms mentioned, occurs mainly after meals. In particular, the consumption of sweet or spicy foods leads to an acute increase in symptoms, accompanied by additional pain in the esophagus. Severe pain may also occur in the stomach area, which becomes stronger when touched and after eating. The inflammation may also cause an irritating cough, hoarseness, nausea and vomiting, and fever. The discomfort increases when the patient is lying down as well as when pressing or during physical exertion. If esophagitis is treated early, the symptoms subside within a week. In the absence of treatment, the signs of the disease intensify and there is a risk that the inflammation will spread to the lungs and respiratory tract.
Diagnosis and course
The first symptoms of esophagitis are burning in the esophagus and pain when swallowing. Swallowing movements are difficult, and there is a feeling that the food pulp is scraping against the esophagus, is stuck, and cannot move swiftly down to the stomach. Sometimes there is an additional burning sensation behind the breastbone. One has a bad taste in the mouth and has to burp sourly more often. The latter is the sign of insufficient closure to the stomach, the most common cause of esophagitis. The symptoms usually occur after eating or after drinking carbonated beverages.Pain and pressure in the upper abdomen are also felt when bending over or doing strenuous activities. To check whether esophagitis is present, the doctor will first ask about the medical history. Usually, a gastroscopy is then performed, during which the condition of the mucous membrane is examined. In addition, a probe inserted through the nose is used to measure acidity in the esophagus.
Complications
Untreated esophagitis can take a chronic course. In many cases, the inflammation, which is constant or occurs at short intervals, leads to the formation of ulcers. These narrow the esophagus and become noticeable through swallowing difficulties, a feeling of pressure behind the breastbone and cramping pain. A feared complication in particular is the so-called barrett’s esophagus: This mucosal change associated with a narrowing in the lower part of the esophagus represents a precursor of esophageal cancer. Carcinoma of the esophagus tends to grow into surrounding tissue and form daughter tumors in lymph nodes and other organs. If the mucosa of the esophagus becomes severely irritated due to chronic inflammation or tissue overgrowth, it may begin to bleed. If large areas are affected, the bleeding may assume life-threatening proportions. Drinking acids or alkalis can cause acute esophagitis, which requires immediate intensive medical treatment. In the worst case, the esophageal wall ruptures and fluid enters the chest – a resulting mediastinal inflammation can be fatal. Even if a chemical burn is treated successfully, scarring is often not absent, and depending on its severity, it can significantly impair food intake. When esophagitis is treated, the risk of developing osteoporosis or kidney disease may increase as a side effect of certain medications.
When should you see a doctor?
Esophagitis is often indistinguishable from normal heartburn to the layperson. Therefore, going to the doctor is recommended for several reasons when a burning sensation or pain is felt in the esophagus. On the one hand, when a burning sensation cannot be associated with a specific event such as the consumption of spicy foods or alcohol, as well as stressful experiences. On the other hand, also when pain or burning persists over a longer period of time and cannot be completely eliminated with home remedies or over-the-counter medications. A change in the character of the pain or a sudden significant change in the symptoms is also a reason for a visit to the doctor. Anyone who has already had esophagitis is also in good hands with a doctor in order to rule out a possible recurrence or to detect it at an early stage. The contact person for esophagitis is the family doctor, and subsequently also the internist and gastroenterologist. A naturopath can also be consulted if the inflammation recurs chronically and is to be treated supportively with naturopathic remedies. However, the basis of any therapy is a solid diagnosis. Therefore, the visit to the doctor is important at an early stage at the onset of symptoms to determine an esophagitis or even just heartburn. In both cases, early action is optimal for successful treatment of the symptoms.
Treatment and therapy
There are several ways to treat esophagitis. First, one should pay attention to proper nutrition and, if necessary, make a change in diet. Particular attention should be paid to which foods cause the discomfort and then replace them with more tolerable ones. Carbonated drinks, acidic fruit juices, black coffee and alcoholic beverages should be consumed as little as possible. The last meal should not be eaten directly before going to bed. Also, several small meals are more tolerable than a few large ones. Furthermore, esophagitis can be treated with medication. Active substances are used which bind the stomach acid and thus take away its corrosive properties. There are also acid formation inhibitors that reduce the production of gastric acid. If the esophagitis is very severe, surgical interventions are available for treatment. This involves narrowing the lower sphincter muscle in an endoscopic procedure.For this purpose, instruments are inserted through small incisions in the upper abdomen up to the stomach portal, which are then used to place a kind of cuff around the portal of the stomach and the sphincter muscle. This tightens the sphincter muscle and allows it to completely close the stomach again. There are other surgical techniques, but the previously mentioned is the most successful procedure for esophagitis.
Prevention
To prevent esophagitis, it is recommended to pay attention to healthy diet. Both compatible food and the right amount of food should be on the menu. Excessive alcohol consumption and too much seasoning should be avoided. A balanced low-stress life, a balanced diet and enough time to eat are the best measures to prevent esophagitis.
Follow-up
In the case of esophagitis, there are few measures of aftercare available to the patient. In the first place, an early diagnosis and also a subsequent treatment should be carried out so that complications and the development of other complaints do not occur in the further course. The earlier a doctor is contacted in the case of esophagitis, the better the further course of this disease usually is. Therefore, a doctor should be contacted at the first symptoms and signs. In general, the trigger of esophagitis should be completely avoided, although in some cases the underlying disease must first be identified and treated. Only then can this inflammation itself be completely cured. Most of those affected are dependent on taking various medications for this. Here, the prescribed dosage and regular intake should always be observed in order to properly counteract the symptoms. Likewise, a doctor should always be consulted first if there is any uncertainty or if there are any questions. Those affected should have regular examinations and checks carried out by a doctor during treatment in order to possibly detect further damage at an early stage. The further course of esophagitis generally cannot be predicted, although in some cases the disease may reduce the life expectancy of the affected person.
Here’s what you can do yourself
In many cases, esophagitis is caused or facilitated by the patient’s behavior. Therefore, it is well amenable to self-help, although severe cases always require treatment by a physician (family doctor or internist). The rising of gastric acid into the esophagus, the so-called reflux, is often the cause of the inflammatory disease. Reflux can be positively influenced by the patient by not eating too large portions at meals and avoiding sweet and spicy foods during the acute phase of the inflammation. The consumption of alcohol and nicotion also has an unfavorable effect and is not advisable in the case of esophagitis or disposition to this disease. The risk of reflux is particularly high in the supine position. Therefore, it is best to choose the position when sleeping so that the upper body is slightly higher. Eating directly before going to bed is not advisable. Home remedies can also be used as part of self-help. A handful of oatmeal, which is swallowed dry and can bind the acid, often helps against heartburn. Caution is also advised when it comes to drinks. In addition to alcohol, sugary drinks, coffee and carbonated water are also unfavorable. Those affected are best advised to use still mineral water or unsweetened herbal teas. Orange juice is also not advisable because of the fruit acid.
