Pain in the esophagus

Various diseases in the area of the esophagus can lead to pain. Depending on the location of the disease at the esophagus, the pain is projected further up or down the esophagus in the area behind the sternum. Often, pain in the esophagus is caused by reflux esophagitis (heartburn).

In this case, gastric acid passes over (reflux) into the lower part of the esophagus, where it irritates the mucous membrane. A burning and acidic belching are the result. In so-called achalasia, the lower sphincter muscle of the esophagus is diseased and can no longer open properly.

In addition, the mobility of the esophagus is severely restricted. Severe pain, especially during food intake, is the consequence, so that weight loss is often the result. So-called esophageal diverticula can also cause pain in the area of the esophagus.

This is a pathological bulging of the esophagus, usually in the upper third. Initially, the bulges cause a foreign body sensation and difficulty swallowing, and later pain behind the sternum. If food remains accumulate in the bulge of the diverticulum, this can lead to unpleasant bad breath. In rare cases, tumors (benign or malignant changes in the mucous membrane of the esophagus) can be the cause of esophageal pain. For this reason, prolonged pain in the area of the esophagus should always be clarified by a doctor.

Esophagus is inflamed

An inflamed esophagus can have various causes. A typical cause is the frequent occurrence of reflux (which is not necessarily noticed by the patient). The esophagus is lined by a special mucous membrane that is not designed for constant contact with the acidic gastric juice.

If this happens, an inflammation develops, sometimes with visible damage (erosions). Other causes of an inflamed esophagus can be the swallowing of acids or foreign bodies. Some medications, radiation therapy and a stomach tube can also cause inflammation of the esophagus.

In addition, alcohol abuse and infections are considered to be triggers for an inflamed esophagus. Possible pathogens are mainly fungi and viruses, whereby the development of such an inflammation is usually based on a weakness of the immune system. A persistent inflammation of the esophagus can lead to ulcers, tears (esophageal tears), bleeding and even scars.

These can constrict the esophagus and thus disturb the passage of food. Typical symptoms of esophagitis are difficulty swallowing and pain, which is classically located behind the sternum (“retrosternal”) and in the upper abdomen. However, vomiting and diarrhoea, blood in the stool or a tightness in the throat can also indicate an inflamed esophagus.

Especially if the inflammation of the esophagus is due to reflux disease, heartburn is often complained of. If the symptoms indicate an inflamed esophagus, a so-called esophagoscopy (reflection of the esophagus) is performed. This involves examining the esophagus with a small camera for changes in the mucous membrane and signs of inflammation.

Tissue samples can also be taken. If the endoscopy confirms the suspicion of an inflamed esophagus, a therapy is carried out depending on the cause. A reflux disease, for example, is mainly treated with medication, the first choice being proton pump inhibitors, which reduce acid production in the stomach. If infectious pathogens such as viruses or fungi are the cause of the inflamed esophagus, treatment is carried out with drugs that are specifically effective against them. If the esophagus has already become narrow, it may be necessary to widen it again (“bougienage”).