1. What is esophagitis?
4. Medical tests
6. Can it be prevented?
8. Which specialist treats it?
What is esophagitis?
The esophagus is a part of the digestive system whose function is to communicate the mouth with the stomach. Mouth and esophagus are separated by the cardia, a kind of valve whose purpose is to prevent gastric juices from returning to the mouth once they have passed through the stomach.
Thus, esophagitis occurs when there is an inflammation of the mucosa of the esophagus, a kind of internal layer that lines it. With esophagitis, the mucosa becomes inflamed, irritated or swollen.
Prognosis of esophagitis
Esophagitis is caused by a variety of factors, although in most cases these causative problems respond well to treatment. In the case of untreated esophagitis, some changes may occur in the structure of the esophagus and interfere with its normal functions. Some complications may include the following:
- Tearing of the tissue lining the esophagus.
- Difficulty swallowing
- Scarring of the esophagus
- stricture (narrowing) of the esophagus
- Barrett’s esophagus — after several years of untreated gastroesophageal reflux, Barrett’s syndrome may develop, sometimes leading to esophageal cancer.
Symptoms of esophagitis
The symptoms of esophagitis are as follows:
- Difficulty swallowing
- Pain when trying to swallow
- Stabbing pain in the chest when eating.
- Food that is successfully swallowed becomes trapped in the esophagus.
- Heartburn, acid reflux
- Sore throat
- Acid regurgitation
A large part of the symptomatology of esophagitis may be caused by a wide variety of conditions affecting the digestive tract. However, the patient should see a specialist in the following cases:
- Symptoms extend over several days.
- Symptoms do not improve even if antacids are administered.
- Symptoms make it difficult to eat
- Symptoms are accompanied by headache, muscle aches or fever.
- There is chest pain for several minutes
- The patient has a history of heart problems and feels discomfort or pain in the chest
- Patient feels pain and/or discomfort in the throat when trying to eat
- Shortness of breath
- Severe vomiting, which may be yellow or greenish and contain blood
Medical tests for esophagitis
At the time the patient visits a specialist, the Doctor will ask a series of basic questions and perform a physical examination. However, some tests can be performed to detect esophagitis:
- Barium X-ray: the patient will swallow a barium solution or a tablet containing barium. The barium will coat the mucosa covering the esophagus and stomach, making the organs visible. Thus, possible changes or conditions can be observed.
- Endoscopy: a long, very thin tube with a microscopic camera at the end is inserted. Any unusual presence in the esophagus can be detected.
- Laboratory analysis: A biopsy is performed during endoscopy, and samples are sent to the laboratory for analysis. A bacterial, viral or fungal infection, white blood cells or the identification of possible abnormal cells that may indicate that the problem is leading to esophageal cancer can be diagnosed.
What are the causes of esophagitis?
There are risk factors that increase the risk of gastroesophageal reflux. Some are:
- Eating just before bedtime
- Excessive consumption of alcohol, chocolate, caffeine or mint flavors
- Large, fatty food
- Spicy foods
- Obesity and/or overweight
- Hiatal hernia
There are several origins for esophagitis:
- Reflux esophagitis: occurs when there is a problem in the lower esophageal sphincter, which is responsible for keeping the acidic contents of the stomach away from the esophagus. If it fails, opens when it should not or does not close properly, the contents of the stomach can back up into the esophagus, this phenomenon is known as gastroesophageal reflux. This disease is a frequent and continuous disorder. Its main problem is that it can become chronic, damaging the esophageal tissues.
- Eosinophilic esophagitis. Eosinophils are white blood cells that play a key role in allergic reactions. Eosinophilic esophagitis occurs when there is a concentration of white blood cells in the esophagus in response to an allergen. Some causative foods can be milk, eggs, wheat, beef, rye.
- Lymphocytic esophagitis. A rare disorder of the esophagus in which there is an elevated number of lymphocytes in the lining of the esophagus.
- Drug esophagitis. Some medications can cause tissue damage, such as a pill without water. Some would be pain relieving medications such as anti-inflammatory drugs, antibiotics, potassium chloride, biophosphates or quinidine.
- Infectious esophagitis. A bacterial or viral infection in the esophagus causes the disease, although it is very rare.
Can esophagitis be prevented?
When it comes to esophagitis prevention, the simplest thing to do is to eliminate or reduce the consumption of certain foods or substances in our diet and add others that can be beneficial.
- Avoid abundant meals with high fat content, especially two or three hours after going to bed, since fat implies a slow digestion and generates a lot of reflux.
- Reduce consumption or eliminate coffee and alcoholic beverages from the diet.
- Keep a schedule of meals and avoid long periods of time between each meal.
- Avoid lying down right after eating.
- Eat foods high in fiber.
- Losing weight
Treatments for esophagitis are aimed at reducing
symptomatology, such as stricture.
Treatment for esophagitis
Treatment for esophagitis mainly seeks to reduce symptoms and keep complications under control.
- Reflux esophagitis
o Treatments with over-the-counter products, such as antacids, medications that reduce or block acid production.
o Prescription medications
o Surgery: fundoplication may be used to improve the condition of the esophagus. A portion of the stomach is wrapped around the valve separating the esophagus and stomach, strengthening the sphincter and preventing acid from backing up into the esophagus.
- Eosinophilic esophagitis
o Proton pump inhibitors
o Elimination of an allergen (food) and elemental diets.
- Drug-induced esophagitis: based on avoidance of the drug causing the problem.
o Taking an alternative medication is recommended
o Taking the medication in liquid form
o Sitting up for at least half an hour after taking the pill.
The stomach can also be expanded in cases where the narrowing is very severe. For this, the specialist uses an endoscopic device. There are versions in which this endoscope has a cone-shaped tip that widens little by little and another one in which at the end there is a balloon that expands once inserted.
What specialist treats it?
The person in charge of studying and treating esophagitis problems and digestive diseases are the specialists in Digestive Tract.