Esophagitis

“Esophagitis” simply means inflammation of the esophagus. It can contribute to swallowing disorders (dysphagia) and pain with swallowing (odynophagia).

Reflux disease is the most common cause of esophagitis and a frequent cause of swallowing problems. Often treatment of the reflux disease can improve the swallowing symptoms. Infrequently, surgery can be performed to tighten the lower esophageal sphincter and reduce reflux.

Infectious esophagitis is most commonly caused by yeast (candida). While people with a suppressed immune system are at higher risk, we frequently see candida esophagitis in healthy people. It is usually easily treated with medication. Other less common types of infectious esophagitis are viral (herpes, CMV, HIV).

Pill-induced esophagitis is a frequent cause of dysphagia. Many drugs systemically cause problems with swallowing and/or promote reflux (oral contraceptives, ethanol, tobacco, theophylline, alpha-antagonists, anticholinergic agents, dopamine, nitrates, meperidine, morphine, calcium channel blockers, and diazepam). Other pills cause local inflammation in the esophagus, especially if they become lodged. Common offending agents are slow-release potassium, tetracylines, nonsteroidal anti-inflammatory agents (NSAIDS), and alendronate (Fosamax). Changing the medication regimen to liquid formulations can alleviate the problem.

Eosinophilic esophagitis is more common in children but may also be seen in adults. It is probably associated with allergies. Diagnosis must be made by biopsy. This disorder is associated with recurrent food impactions. It can sometimes be treated with steroid medications.

 

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Last Updated: 03-05-2014
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