Esophagitis

An oesophagitis describes in a narrower sense the inflammation of the mucous membrane that lines the esophagus. Mostly the lower third is affected. Classically, those affected complain of heartburn and belching, sometimes also of difficulty swallowing and breathing.

There are various causes of esophagitis, the most common being the passage of gastric acid from the stomach. This is normally prevented by a sphincter muscle, but various factors (e.g. coffee, nicotine) can impair its function. Overweight or pregnancy increases the pressure in the abdomen, so that there is often backflow of gastric acid.

This leads to the mucous membrane of the oesophagus coming into contact with acid. Since this contact does not occur regularly, the mucous membrane is not able to protect itself from the acid, which can lead to oesophagitis. Accidental swallowing of corrosive substances or sharp objects can also cause esophagitis.

In addition, infectious causes such as fungi and viruses in particular can cause esophagitis. This occurs most often when the immune system is weakened, for example by AIDS or certain drugs. An esophagitis is diagnosed by means of a mirror image, and the therapy is cause-dependent.

Esophagus constricted

A narrowing of the esophagus usually affects the lower part of the esophagus and results in the food no longer being able to be transported sufficiently into the stomach. Patients complain of difficulty in swallowing (dysphagia) and pain when swallowing (odynophagia). Increased belching and bad breath can also result.

Very often a narrowing of the esophagus is caused by reflux disease (heartburn). The reflux of acid gastric juice into the esophagus irritates its mucous membrane and triggers an inflammatory and remodelling reaction, in the course of which the lower section of the esophagus thickens and narrows. In rare cases, a tumor of the esophageal mucosa can lead to a narrowing, so that malignancy can usually be ruled out in such cases.

Certain anatomical conditions such as an enlarged thyroid gland or scars from previous surgery can constrict the esophagus. Very rarely, children develop symptoms due to a congenital narrowing of the esophagus. A more common cause is the so-called achalasia, whereby the lower sphincter muscle that separates the esophagus from the stomach is permanently tense.This makes it more difficult to transport the food into the stomach. This is caused by the death of nerve cells that are responsible for the contraction of the muscles in the esophagus. As a reaction to the lack of flaccidity, hypertrophy (thickening of the muscles) of the section located above the sphincter muscle occurs.