Brief overview
- Typical symptoms of esophagitis are difficulty swallowing and a burning sensation behind the breastbone. Affected people have little appetite and may lose weight. Sometimes, on the other hand, there are no clearly identifiable symptoms.
- Causes: Refluxing stomach acid, infections, medications or the immune system itself irritate and inflame the mucosa.
- Treatment: Therapy depends on the cause. Sometimes lifestyle adjustments are sufficient, in other cases with medication or surgery is necessary.
- Examination: Clarification by a physician is advisable in any case. He looks into the esophagus with the help of an endoscope (esophagoscopy). If necessary, tissue samples and swabs are taken.
- Home remedies: Lifestyle adjustments are helpful. These include abstaining from irritating substances and a change in diet.
What is esophagitis?
Esophagitis refers to the inflammation of the mucous membrane lining the inside of the esophagus (food pipe). Medical professionals refer to it as esophagitis. The inflammation itself is caused by cells of the immune system.
Most often, the esophagus is inflamed by refluxing stomach acid, called reflux esophagitis. However, infections, the diet or disorders of the immune system can also be responsible.
What are the symptoms of esophagitis?
An inflamed esophagus can cause various symptoms, but sometimes it can also be symptom-free. Typical symptoms of esophagitis are:
- Difficulty swallowing (dysphagia): Affected persons find it difficult to swallow, sometimes they also have pain (odynophagia). Whether painful or not depends on the cause.
- Lump in the throat: Pieces of food get stuck more easily due to the impaired function of the esophagus and can be felt in the throat. Often the inflammation itself causes the lump feeling.
- Loss of appetite: Sometimes due to the difficulty in swallowing or pain, the desire to eat dwindles.
- Pain: A burning sensation or pain behind the breastbone can also occur. Depending on the cause, they occur when lying down after eating or when swallowing.
Pain behind the breastbone and nausea can also indicate a heart attack. Other warning signs are sweating, shortness of breath or circulatory problems. Let them clarify the complaints immediately by a physician (emergency doctor).
Due to the loss of appetite, those affected lose weight (weight loss), especially in chronic cases. If there is an underlying infection, the pathogens may enter the blood and cause sepsis (“blood poisoning”).
What home remedies help?
Chamomile tea, bread or baking soda? Most of the known home remedies of esophagitis are useful especially in case of reflux. They aim to neutralize the stomach acid or flush it out of the esophagus. You can read more about this in our articles “Reflux disease” and “Heartburn”.
If another cause irritates and inflames the esophagus, these home remedies may be ineffective or even counterproductive.
In addition, the following tips for everyday life can protect the esophagus:
Water and chamomile tea against esophageal inflammation.
Chamomile tea also has mild antibacterial properties. It is important not to consume tea and other drinks too hot, as this irritates the mucous membrane. Chewing increases saliva production. Therefore, it is advisable to consciously chew extensively when eating (“Well chewed is half digested!”). Chewing gum after a meal also helps: it stimulates saliva production for a long time.
Avoid coffee, alcohol and cigarettes
It is also important to reduce external stimuli to the esophageal mucosa. Coffee and alcohol irritate the mucosa. Therefore, drink as little coffee as possible and avoid alcohol if you have esophagitis. Acidic fruit juices also additionally attack the mucous membrane and are better not drunk at all.
Which general measures still help and can prevent the discomfort of esophagitis in certain cases, you can read in our article “Heartburn”.
Home remedies have their limits. If your symptoms persist for a long period of time, do not improve or even get worse, you should always consult a doctor.
How is esophagitis treated?
- Reflux disease: Lifestyle adjustments are usually all that is needed. In addition, doctors often prescribe proton pump inhibitors (PPI), which inhibit acid production in the stomach. You can read everything else in our article “Reflux disease”.
- Infection caused by Candida yeast fungi (thrush esophagitis): antifungal drugs (antifungals) such as fluconazole help to combat the fungal infection. Doctors also look for the cause of the disease, since Candida infections in this form rarely occur in healthy people. You can read more about this in the article “Soorösophagitis”.
- Viral infection caused by herpes or cytomegaloviruses: The doctor prescribes antivirals to treat viral esophagitis. They slow down the multiplication of the virus in the body. For example, he uses ganciclovir to treat CMV esophagitis and aciclovir for herpes esophagitis.
- Crohn’s disease: In chronic inflammatory bowel diseases such as Crohn’s disease, drugs are used that downregulate the immune system. In acute cases, corticosteroids (“cortisone”), for example, are used. You can read more about this here.
- Burns: In severe burns, necrotic (dead) segments of the esophagus must be removed in surgery. Doctors often replace the missing segment with a piece of intestine. Alternatively, they pull up the stomach.
Causes and risk factors of esophagitis.
Esophagitis has many possible causes. Roughly, these can be divided into two groups: On the one hand, stomach acid or medications, for example, can directly damage and inflame the mucosa. On the other hand, pathogens can infect the mucosa. They usually play a role when the immune system is severely weakened.
The following list contains the most important causes of esophagitis.
Reflux disease: stomach acid is the most common cause of esophagitis. The acid and the enzyme pepsin directly damage the esophageal lining. As a result, inflammatory reactions set in, which can be acute or chronic. Everything about reflux disease can be found here.
Medications: Some medications interfere with esophageal movement, promoting reflux of stomach acid, and some directly damage the mucosa. These include tetracyclines, bisphosphonates, clomethiazole and non-steroidal anti-inflammatory drugs (NSAIDs, known as painkillers). One tip: Always take tablets with plenty of water!
Eosinophilic esophagitis: In this disease, patients react to certain substances similar to an allergy. As a result, the esophageal mucosa becomes inflamed. Patients frequently affected are known allergy sufferers (hay fever, etc.) and asthmatics. Read more about eosinophilic esophagitis here.
Infectious: Yeast fungi (Candida) and viruses (esp. herpes simplex and cytomegalovirus) are the most common pathogens affecting the esophagus. However, bacteria (e.g. viridans streptococci, staphylococci) or parasites (e.g. cryptosporidia) can also trigger esophagitis. It mainly affects immunocompromised people, for example due to immunosuppressive drugs (immunosuppressants, chemotherapies), cancer or AIDS. Esophagitis may occur in the context of syphilis or tuberculosis.
Chemical burns: Acids and alkalis cause great damage to the esophagus if swallowed. Alkalis in bleach or surface disinfectants, for example, are particularly dangerous. They liquefy the surrounding tissue and can cause the esophageal wall to break through. Swallowed batteries also cause chemical burns.
Esophageal burns are an emergency and must be treated immediately at the hospital. Alert emergency medical services immediately if you suspect a burn.
How long does esophagitis last?
Several factors play a role in the prognosis of esophagitis. The cause, duration and severity of the inflammation are decisive. The sooner the cause is addressed, the sooner the esophagus can begin to regenerate. Depending on how severe the damage taken so far is, this repair process takes more or less time.
How is esophagitis diagnosed?
The first point of contact for complaints of esophagitis is the family doctor. He or she questions and examines the patient. If necessary, he or she will then refer the patient to a specialist for diseases of the digestive tract, the gastroenterologist.
The most important diagnostic tool is esophagoscopy. During this procedure, the examiner inserts a movable tube with a camera into the esophagus. This allows him to see the mucous membrane and possible changes that often already indicate a certain form of esophagitis.
Reddish streaks and mucosal damage indicate inflammation. Sometimes the mucosa also bleeds easily. If the examiner sees white coatings on the mucosa, there is probably infection with the white yeast fungus Candida.
