Esophagitis

Esophagitis is inflammation of the esophagus—the muscular tube that connects the throat to the stomach. It can be painful and may lead to swallowing difficulties, chest discomfort, or even bleeding if untreated. Several different causes exist, each with unique features and treatments.

🔬 Types & Causes of Esophagitis

1. Reflux Esophagitis

• Most common type, caused by acid reflux (GERD).
• Chronic exposure of esophageal lining to stomach acid damages tissue.

2. Infectious Esophagitis

• More common in immunocompromised patients (e.g., HIV, cancer, transplant).
• Common pathogens:
  • Candida albicans (fungal)
  • Herpes simplex virus (HSV)
  • Cytomegalovirus (CMV)

3. Eosinophilic Esophagitis (EoE)

• Chronic, allergic/immune condition.
• Involves eosinophil infiltration (a type of white blood cell) in the esophageal lining.
• Triggered by food allergens (milk, wheat, soy, etc.)

4. Drug-Induced Esophagitis

• Caused by pills lodging in the esophagus and irritating the lining.
• Offending drugs include:
  • Tetracyclines
  • NSAIDs
  • Bisphosphonates
  • Iron supplements

5. Radiation Esophagitis

• Occurs in patients receiving radiation therapy for chest or neck cancers.

⚠️ Symptoms

🧪 Diagnosis

🧴 Clinical History:

• Symptoms + risk factors (GERD, immunosuppression, medications, allergies)

🔬 Endoscopy (EGD):

• Direct visualization of esophagus
• May show:
  • Redness, erosions, white plaques (Candida)
  • Ulcers (HSV, CMV)
  • Furrows, rings, strictures (EoE)
• Biopsy confirms type (especially EoE or infection)

🧪 Other tests:

• Esophageal pH testing (for GERD-related cases)
• Allergy testing (for suspected EoE)
• Viral PCR or fungal cultures (if infection suspected)

💊 Treatment

🛡️ Prevention Tips

• Treat and control GERD
• Take pills with plenty of water and avoid lying down right after
• Monitor for esophageal symptoms if you’re immunosuppressed
• Identify and avoid food allergens (for EoE)

🧠 Complications (if untreated)

• Esophageal ulcers
• Strictures (narrowing → swallowing problems)
• Barrett’s esophagus (precancerous condition from reflux)
• Bleeding or perforation (rare)