Symptoms | Burning in the esophagus

Symptoms

Most diseases of the esophagus are characterized by similar symptoms. As a rule, the affected patients feel frequent heartburn (esophagus burns) right from the beginning. Within a short period of time it comes more and more frequently to tormenting burning which is localized directly behind the breastbone.

An esophagus that burns usually occurs shortly after eating. The symptoms can last from minutes to hours and can be very stressful for the patients concerned. In addition, diseases of the esophagus often lead to the affected patients having to burp acid.

In particularly pronounced cases, this can cause the stomach acid to rise up into the oral cavity. From there, it can penetrate the windpipe and destroy its tissue. For this reason, advanced diseases of the esophagus are often accompanied by severe coughing and hoarseness. These symptoms are most noticeable during the night and immediately after eating.

Causes

A burning sensation in the esophagus can have various causes. If heartburn occurs only occasionally, it is usually not a cause for concern. However, patients who suffer from frequent heartburn should definitely consult a specialist.

The most common conditions that lead to esophagus burning are

  • Inflammation of the oesophagus (esophagitis)
  • Reflux disease (reflux esophagitis)
  • Esophageal cancer
  • Diaphragmatic hernia (hiatus hernia)
  • Achalasia (cramped esophageal sphincter)

Inflammation of the esophagus occurs when inflammatory processes spread within the mucosa lining the esophagus. In general, two forms of esophagitis are distinguished: acute and chronic. In most of the patients affected, the lower third of the esophagus is affected directly at the transition to the stomach.

Normally, the mucous membrane of the esophagus is covered by a viscous substance.This ensures that the chyme can be passed on more easily. In addition, the secretion of the esophagus offers a certain protection against acid rising from the stomach. The main cause of esophagitis is incorrect eating habits.

In addition, esophagitis, which causes the esophagus to burn, is often caused by stress and acids rising from the stomach. In patients who suffer from a too weak lower esophageal sphincter, the sensitive mucous membrane of the esophagus can be enormously damaged. In addition, pronounced overweight (obesity) and hormonal changes during pregnancy can promote inflammatory processes in the mucous membrane of the esophagus.

The inflammation of the esophagus is usually manifested by difficulty swallowing and frequent belching. In addition, affected patients usually have the feeling that their esophagus is burning. In very pronounced cases, esophagitis can also lead to breathing difficulties.

These typical symptoms already provide an initial indication of the presence of esophagitis. Further diagnostics are carried out by a so-called “gastroscopy” following a comprehensive doctor-patient consultation (anamnesis). In this procedure, a movable tube is inserted into the esophagus via the oral cavity.

With the help of a camera, which is located at the end of this tube, the condition of the esophagus can be examined. In addition, tissue samples can be taken from a patient who feels that the esophagus is burning. During gastroscopy, a probe is usually inserted through the nose.

This probe can be used to measure the acidity in the lower section of the esophagus. In a patient who feels that the esophagus is burning, a significantly lowered pH value (pH < 7) can usually be detected. The treatment of esophagitis is always based on the underlying problem.

Most patients are already helped by a targeted change in their eating habits. In particular, the consumption of acidic foods and beverages, black coffee and alcohol should be drastically reduced if esophagitis is present. In addition, food intake must be urgently stopped immediately before going to bed.

Drug treatment of esophagitis is usually done by taking proton pump inhibitors. These reduce the stomach acid produced by the stomach lining and thus prevent the acid from rising into the esophagus. Affected patients usually feel after only a few days that the esophagus burns less.

The term “reflux disease” refers to an inflammatory change in the mucous membrane of the esophagus, which is manifested by acid burping, irritable cough and hoarseness. In addition, affected patients often have the feeling that the esophagus is burning immediately behind the breastbone (heartburn). Reflux esophagitis is a widespread disease that requires urgent medical treatment.

This is the only way to avoid serious secondary damage. Within the industrialized countries it is assumed that at least 20 percent of the population suffers from recurrent heartburn. The direct cause for the development of reflux disease is a weakness of the lower esophageal sphincter.

Since the sphincter muscle can only seal the access to the stomach inadequately, acid gastric juice rises into the esophagus. The mucous membrane of the lower sections of the esophagus cannot withstand this acidic secretion in the long term and is damaged. As a result, inflammatory processes spread and the affected patient gets the impression that the esophagus is burning.

The extensive inflammation can cause a rupture of the esophagus, so that there is a passage to the chest and the chest can be contaminated. Chronic reflux disease can affect the esophageal tissue to such an extent that the risk of developing esophageal cancer increases significantly. The risk of developing esophageal reflux disease with esophageal burning is increased by several factors.

The most important factors in this context include Nicotine, alcohol, overweight, frequent use of medication, stress. In addition, reflux disease often occurs during pregnancy. The reason for this is the fact that the growing baby presses on the stomach starting from the abdomen.The diagnosis of reflux disease is usually based on the typical symptoms (esophagus burns (heartburn), acid reflux, coughing, belching).

Further diagnostics can usually be done by gastroscopy. The treatment of reflux disease corresponds as far as possible to the therapy of a common esophagitis. Chronic forms of the disease can also be treated surgically (restoration of the closure mechanism of the lower esophageal sphincter).