What is Esophagitis?
The esophagus is the part of the digestive system that connects the mouth to the stomach. It is separated from it by a valve that is the lower esophageal sphincter and has the function to prevent food and gastric juices to go up from stomach.
Esophagitis is the inflammation of the mucosa of the inner layer of the esophagus and that can be due to different causes.
What Causes Esophagitis?
The most common cause of esophagitis is gastroesophageal reflux. Reflux is a disorder in which the lower esophageal sphincter is abnormally relaxed and allows the contents of the stomach (gastric acids) to reflux and ascend into the esophagus.
There are other causes of esophagitis which are less frequent by different mechanisms, inflammation and irritation of the esophageal mucosa. These are at the following:
- Consumption of medications such as non-steroidal anti-inflammatories, antibiotics and corticosteroids
- Repeated vomiting
- Treatment with radiotherapy in the chest (as in the case of lung cancer)
- Infections with viruses such as herpes and cytomegalovirus; Some fungi like candida
- Previous surgery of the area
- Ingestion of caustics (such as bleach)
- Systemic diseases
The most frequent symptom of esophagitis (because the most frequent cause is reflux disease) is heartburn. The patient describes it as a burning sensation that goes up from the stomach to the throat. Regurgitation may also occur and a feeling of return of the gastric contents be felt.
Other symptoms of esophagitis include:
- Back, chest pain or discomfort (especially in the pit of the stomach).
- Difficulty swallowing (dysphagia). In long-term esophagitis, scar tissue can form that causes strictures in the esophagus that may hinder swallowing.
- Repeated nausea, vomiting and belching.
- Loss of weight and appetite, especially in cases of chronic and advanced disease
- Reflux can cause ulcers to appear in the esophagus which can bleed and lead to iron loss leading to chronic anemia due to blood loss
Diagnosis of Esophagitis
The diagnosis of esophagitis is based on patient-reported symptoms and findings in a series of specific diagnostic tests.
You can perform:
- Gastroscopy: it is the diagnostic test of choice. Allows you to view directly esophagus and mucosal lesions as well as rule out other problems such as hiatal hernia or gastric ulcer.
- Ph-metry: this test measures the acidity in the lower esophagus during a 24-hour period. It quantifies the frequency and duration of episodes of reflux responsible of esophagitis.
- Esophageal manometry: measures pressures within the esophagus. It is not a test that is performed on a regular basis. In cases of reflux, the closing pressure of the lower esophageal sphincter is decreased.
The treatment will be aimed at improving the symptoms that predominate in each patient and in those cases where it is possible, treatment of the underlying disease will be performed.
Analgesics in those esophagitis that are accompanied by important pain such as secondary to radiation or after ingestion of caustics.
In cases which there is gastroesophageal reflux, a specific treatment will be performed. This is based on a series of hygienic-dietary measures, pharmacological treatment (with antisecretors and antacids) and surgical treatment. In cases where there are serious complications or treatment is to be performed in a chronic manner.