Oesophagitis

Oesophagitis is a common digestive problem that can lead to discomfort and difficulty swallowing. Many people experience oesophagitis symptoms, which may include heartburn, chest pain, and trouble eating. Let's explore the different types of oesophagitis, its causes, and risk factors. We'll also discuss the symptoms to watch out for, potential complications, and how doctors diagnose this condition. Additionally, we'll cover oesophagitis treatments, including medication and home remedies, and guide you on when to see a doctor. 

What is Oesophagitis? 

Oesophagitis is a condition characterised by inflammation of the oesophagus. It is a muscular tube that connects your throat to your stomach. This inflammation can cause the oesophagus lining to become sore, swollen, and raw, leading to a burning sensation. The condition can make swallowing painful and difficult and also cause chest pain. 

Types of Oesophagitis 

Oesophagitis can be classified into several types based on its underlying oesophagitis causes. These are: 

• Reflux Oesophagitis: It is one of the most common forms, occurring when stomach acids back up into the oesophagus. This often happens due to gastroesophageal reflux disease (GERD), which can lead to ongoing inflammation and tissue damage. 
• Infectious Oesophagitis: It is caused by bacterial, viral, or fungal infections. Candida oesophagitis, a fungal infection, is the most prevalent form of infectious oesophagitis. It's more common in people with weak immunity, such as those with HIV/AIDS or cancer. 
• Eosinophilic Oesophagitis: It's characterised by a high concentration of white blood cells called eosinophils in the oesophagus, often in response to allergens. 
• Drug-induced Oesophagitis: Also known as pill oesophagitis, drug-induced oesophagitis occurs when certain medications damage the oesophageal lining. 
• Radiation and Chemoradiation Oesophagitis: It can develop in patients undergoing cancer treatments. 

Causes and Risk Factors of Oesophagitis 

Oesophagitis has several causes and risk factors. These are: 

• Gastroesophageal Reflux Disease (GERD): In GERD, stomach acid flows back into the oesophagus, irritating its lining. 
• Medications: These include aspirin, ibuprofen, and some antibiotics. 
• Infections: It is prevalent in people with weakened immune systems and can cause oesophagitis. 
• Food Allergies and Sensitivities: This type occurs when the immune system overreacts to certain foods, causing inflammation. 
• Radiation Therapy: It can weaken the oesophagus lining 

Other risk factors include: 

• Smoking 
• Excessive alcohol consumption 
• Obesity 

Symptoms of Oesophagitis 

Oesophagitis can cause a range of uncomfortable symptoms that affect the throat and chest area, such as: 

• Difficulty Swallowing: It can be painful and may lead to a feeling of food being lodged in the throat. 
• Heartburn: It feels like a burning sensation in the chest that often worsens after eating. 
• Chest Pain: It is mainly seen behind the breastbone and is another frequent symptom. 
• Acid Reflux: Here, stomach contents flow back into the oesophagus, giving rise to a sour taste in the mouth. 
• Feeding Difficulties: Infants and young children might have feeding difficulties, such as irritability during mealtimes or arching their back when eating. They may also fail to gain weight properly. 
• Other symptoms include regurgitation, indigestion, nausea, and mouth sores. 

Complications 

Oesophagitis, if left untreated, can lead to serious complications that affect the structure and function of the oesophagus. 

• Formation of Ulcers: It is one of the most common issues. These ulcers can cause pain and bleeding. 
• Gastrointestinal Perforation: In rare cases, ulcers may wear through the oesophagus, creating a hole. This condition increases the risk of infections spreading to the chest cavity or bloodstream. 
• Oesophageal Stricture: Long-term inflammation can cause scarring, narrowing the oesophagus and making swallowing difficult. This can result in dehydration, weight loss, and malnutrition if left unaddressed. 
• Barrett's oesophagus: In this condition, the cells lining the oesophagus change to resemble those of the intestines. This cellular change, also called intestinal metaplasia, is a precursor to oesophageal cancer. 

Diagnosis 

Diagnosing oesophagitis involves a combination of medical history, physical examination, and diagnostic tests. 

• Personal History: Doctors ask about symptoms and conduct a thorough physical exam. 
• Upper Endoscopy: During this diagnostic procedure, a thin, flexible tube. It has a light source and a camera. This tube is guided down the throat and into the oesophagus to allow the doctor to visually inspect the oesophageal lining for signs of inflammation, ulcers, or other abnormalities. 
• Biopsy: The doctor may also take small tissue samples (biopsies) for laboratory analysis during the endoscopy. These samples can help identify infections, allergic reactions, or precancerous changes in the oesophageal cells. 
• Blood Tests: These are done to check for elevated eosinophil counts or immunoglobulin E levels, which might suggest an allergic cause. 
• Barium X-ray: It can identify structural changes or narrowing of the oesophagus. 
• Oesophageal Sponge: This involves swallowing a capsule attached to a string, which dissolves in the stomach and releases a sponge. When pulled out, the sponge collects oesophageal tissue samples for analysis. 

Treatment for Oesophagitis 

Treating oesophagitis involves addressing the underlying cause and managing symptoms. The following are some common oesophagitis treatment options: 

• Eosinophilic Oesophagitis: Treatment focuses on avoiding allergens and reducing allergic reactions. Medications such as proton pump inhibitors and swallowed steroids may be prescribed. 
• Drug-induced Oesophagitis: The primary approach is to stop using the problematic medication when possible. Your doctor may suggest alternative medicines or recommend taking pills with a full glass of water while remaining upright for at least 30 minutes afterward. 
• Infectious Oesophagitis: It requires targeted treatment with antifungal, antiviral, or antibacterial drugs, depending on the specific cause. 

When to See a Doctor 

Oesophagitis can significantly impact your quality of life, and it's crucial to seek medical attention when symptoms persist or worsen. 

• Consult a doctor if you experience: 
• Heartburn most days 
• Difficulty swallowing 
• Frequent vomiting 
• Unexplained weight loss 

Prevention 

Preventing oesophagitis involves making lifestyle changes and being mindful of your diet. 

• Avoid Foods that Trigger Reflux: These often include alcohol, caffeine, chocolate, and mint-flavoured foods. 
• Good Pill-taking Habits: Always take medication with plenty of water and remain upright for at least 30 minutes afterwards. 
• Maintaining a Healthy Weight: Excess weight, especially around the midsection, can pressure the stomach and worsen reflux symptoms. 
• Quit Smoking: Smoking tobacco can increase stomach acid production and weaken the lower oesophageal sphincter, making reflux more likely. 
• Adjusting Your Sleeping Position: Raise the head of your bed by 6 to 8 inches. You can use wooden blocks or a wedge between your mattress and box spring. This elevation can help keep stomach contents from flowing back into the oesophagus while you sleep. 

Conclusion 

Managing oesophagitis often involves a mix of lifestyle changes, medicines, and, in some cases, medical procedures. Working closely with doctors is crucial to find the best approach for individual cases. With proper care and attention, most people with oesophagitis can find relief from their symptoms and prevent long-term damage to their oesophagus. 

FAQs 

1. What is oesophagitis caused by? 

Oesophagitis has several causes. The most common reason is acid reflux, where stomach acid goes back into the oesophagus, irritating its lining. This often occurs due to a weakened lower oesophageal sphincter. Other causes include certain medications, infections, allergies, and radiation therapy. Some people may develop eosinophilic oesophagitis, an allergic reaction in the oesophagus. Chronic vomiting and certain autoimmune diseases can also lead to oesophagitis. 

2. What is the fastest way to cure oesophagitis? 

The quickest way to treat oesophagitis depends on its cause. For acid reflux-related oesophagitis, taking antacids or acid-blocking medications like proton pump inhibitors can provide relief. Lifestyle changes can also help, like avoiding trigger foods and eating smaller meals. For eosinophilic oesophagitis, eliminating allergens from the diet and using topical steroids may be effective. In cases of infectious oesophagitis, targeted antifungal or antiviral medications are used. 

3. How long can oesophagitis last? 

The duration of oesophagitis varies based on its cause and treatment. With proper management, symptoms may improve within a few days to weeks. However, healing the oesophageal lining can take up to 8 weeks with successful lifestyle changes and oesophagitis medication. Chronic conditions like GERD may require ongoing management to prevent recurrence. It's important to follow your doctor's advice and complete the entire course of any prescribed medications. 

4. Can oesophagitis be permanent? 

For many people, oesophagitis is a temporary condition that can be effectively managed with proper treatment. When caused by acid reflux or certain medications, symptoms often improve within a few weeks of starting treatment. However, if left untreated or if the underlying cause persists, oesophagitis can become chronic. 

CARE Medical Team