Esophagitis is a non-specific term which means inflammation of the esophagus (swallowing tube), and it usually presents as pain behind the breastbone or sometimes trouble with swallowing. It is most often caused by stomach acid that refluxes (flows backwards) up into the esophagus (see GERD/ HIATUS HERNIA/ ACID REFLUX). Less often, other non-acid stomach contents, such as bile, can also reflux and be irritating to the esophagus. Infections such as Candida (a fungus) or Herpes (a virus) can also result as esophagitis, but these conditions usually occur in patients whose immune systems are compromised in some fashion (Diabetes, HIV, chemotherapy, etc.). Ingested toxic chemicals are a rarer cause of esophagitis. A special case of esophagitis, called eosinophilic esopagitis (see EOSINOPHILIC ESOPHAGITIS, or EE), results from an excess of a particular type of WBC (eosinophil) that invades the lining of the esophagus, and it is addressed elsewhere on our website.
A diagnosis of esophagitis is established during an endoscopic exam, both visually and by biopsies (cell samples) that can obtained during the exam. The approach to treating esophagitis is to eliminate the cause of the inflammation. Usually, this means acid suppressive therapy with medications called proton pump inhibitors, or if infections are present, they are treated with appropriate anti- infection medications.
Rare complications of esopagitis are stricture (narrowing) of the esophagus, caused by scar tissue that develops in response to prolonged esophageal irritation, or occasionally bleeding from the esophagus itself.