10138 Esophagitis

Overview

Esophagitis is inflammation (swelling and irritation) of the esophagus, the long tube that carries food and drinks from your mouth to your stomach. It can cause pain, difficulty swallowing, and uncomfortable reflux symptoms.

Yes, esophagitis is fairly common, especially in adults. Many cases are linked to acid reflux, which affects millions of people worldwide.

It can affect people of all ages, including children and older adults. You may be more likely to get esophagitis if you have acid reflux, take certain medications, or have food allergies.

Symptoms

Common symptoms

• Heartburn or a burning feeling in your chest
• Pain or discomfort when swallowing
• Difficulty swallowing or feeling like food gets stuck
• A sore throat or hoarse voice
• Regurgitation (acid or food coming back up into your mouth)
• Coughing or frequent clearing of your throat

Symptoms in children

• Fussiness or crying during feeding
• Slow weight gain or weight loss
• Refusing to eat or spitting up frequently
• Nausea or stomach pain

Symptoms in older adults

• Chest pain that may be mistaken for heart problems
• Difficulty swallowing that gets worse over time
• Less typical symptoms like hoarseness, cough, or unintended weight loss

Causes

Main causes

• Acid reflux (stomach acid backing up into the esophagus)
• Infections, such as fungal or viral infections in the esophagus
• Allergies (eosinophilic esophagitis), a condition where certain foods trigger inflammation
• Certain medications that can irritate the food tube if they get stuck (for example, some antibiotics or pain relievers)

Risk factors

• Gastroesophageal reflux disease (GERD)
• Being overweight or having obesity
• Pregnancy (due to increased pressure on the stomach)
• Hiatus hernia
• Taking medications without enough water or just before lying down
• Weakened immune system (from disease or certain treatments)
• Food allergies or frequent vomiting

When to see a doctor

See a doctor urgently if:

• If you have severe symptoms like vomiting blood, black stools, or intense chest pain — call your local emergency number right away.
• If you are unable to swallow liquids or food, seek urgent medical care today.

Book a routine appointment if:

• If you have frequent heartburn or pain when swallowing that lasts more than a few weeks
• If over-the-counter antacids do not help or symptoms are interfering with your daily life
• If you have unintentional weight loss or poor appetite

Diagnosis

A doctor will ask about your symptoms and medical history, and may do a physical exam. If they suspect esophagitis, they may refer you for tests to look inside your esophagus or measure acid exposure.

Tests that may be done

• Endoscopy – a thin, flexible tube with a camera is passed down your throat to look at the esophagus and take small tissue samples if needed
• Barium swallow – you drink a chalky liquid and X-rays are taken to show the shape of your esophagus
• pH monitoring – a sensor measures how much acid enters your esophagus over 24 hours
• Allergy testing – for suspected eosinophilic esophagitis

What to expect at your appointment

Diagnosis often starts with a clinic visit where you discuss your symptoms. If an endoscopy is needed, it is usually done at a hospital or day clinic and takes about 15–20 minutes. You will likely receive sedation to help you relax.

Treatment

Treatment for esophagitis depends on the cause. The main goals are to reduce irritation, heal the lining of the esophagus, and prevent symptoms from coming back. Your doctor will work with you to create a plan that fits your situation.

Self-care at home

• Eat smaller, more frequent meals instead of large ones
• Avoid lying down for at least 2–3 hours after eating
• Raise the head of your bed by about 15–20 cm (6–8 inches)
• Avoid trigger foods like spicy dishes, fatty foods, citrus, chocolate, and caffeine
• If a medication seems to be causing symptoms, talk to your doctor before stopping it

Medical treatments

Depending on the cause, treatment may include acid-suppressing medicines (these reduce stomach acid), medicines to protect the esophagus, antifungal or antiviral medicines for infections, or medicines that help control allergic inflammation. Always discuss any treatment with your healthcare provider — do not start or change medications on your own.

When is surgery considered?

Surgery is rarely needed, but it may be considered if medicines do not work or if there is a structural problem like a hiatus hernia. For a narrowed esophagus from scarring, a procedure called dilation may be done to gently widen the tube.

Living with this condition

Day-to-day with esophagitis means being mindful of what you eat, how you eat, and when you lie down. Keeping a diary of symptoms and foods can help you spot your personal triggers. It's also important to take medicines as prescribed and attend follow-up appointments.

Lifestyle tips

• Maintain a healthy weight to reduce pressure on your stomach
• Stop smoking, if you smoke, and avoid secondhand smoke
• Limit alcohol, especially before bedtime
• Wear loose-fitting clothes around your waist
• Elevate the head of your bed if night-time acid reflux bothers you

Diet and exercise

Gentle, relaxed meals are best. Chew slowly and take your time. Some people find that eating soft, moist foods makes swallowing easier. Regular, moderate exercise like walking can help with weight management and digestion, but avoid intense exercise right after eating.

Mental health and emotional wellbeing

Living with pain or trouble swallowing can be stressful and worrying. It's normal to feel anxious about eating or to feel frustrated when symptoms persist. Talking to family, friends, or a counselor can help, and your healthcare team can offer support too.

Prevention

You can reduce your risk of esophagitis by managing acid reflux, eating a balanced diet, avoiding late-night heavy meals, maintaining a healthy weight, and not smoking. If you have food allergies, avoiding those foods can help prevent allergic esophagitis.

Complications

If left untreated

• Narrowing (stricture) of the esophagus, which makes swallowing harder
• Bleeding or sores (ulcers) in the lining of the esophagus
• Change in the cells of the esophagus lining (Barrett's esophagus), which needs monitoring
• Severe pain or difficulty eating, leading to weight loss and poor nutrition

Long-term outlook

The outlook for most people with esophagitis is very good. With the right treatment — whether lifestyle changes, medicines, or other procedures — symptoms usually improve and the esophagus can heal. It may take time, but most people return to normal eating and comfortable daily life.

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