Oesophagitis

What is Oesophagitis?

Oesophagitis is a condition affecting the oesophagus, a tube running connecting your mouth to your stomach. Where irritation caused by stomach acid occurs, this can inflame the lining of the oesophagus and cause oesophagitis. In some individuals, it can be brought on by a condition known as eosinophilic oesophagitis; this is where white blood cells accumulate in the tube and cause inflammation, often as a result of food allergies. The symptoms which present themselves are similar to that of heartburn and acid reflux, and repeated acid reflux can lead to ongoing oesophagitis. If left untreated, the condition can worsen and lead to Barrett’s oesophagus, a complication of gastroeosophageal reflux disease (GERD); in extreme cases, this may also develop into oesophagal cancer. Oesophagitis treatment is available following a diagnosis, usually by prescription medications and making dietary and lifestyle changes. 

What are the typical symptoms of Oesophagitis?

Oesophagitis symptoms are very similar to those experienced with acid reflux. Common symptoms that oesophagitis present with include:

• Heartburn. This is the main symptom, and is best described as a burning pain or discomfort felt anywhere between the lower part chest right up to the back of your throat.
• Bitter taste in the mouth. A hot, sour, and unpleasant taste may be presented. This is caused by acid rising from the stomach up the oesophagus and can lead to bad breath.
• Pain or difficulty swallowing. Also known as dysphagia, this is a result of the irritation that stomach acid can take on your oesophagus. Pain and discomfort may also be experienced when eating and drinking, particularly hot liquids. 
• Bloating and burping. These symptoms typically accompany each other and may be a result of inflammation in the stomach lining caused by gastric acid or stomach acid. This could also lead to excess coughing and/or hiccups that don’t seem to go away easily.

Some less common symptoms, but still indicative of oesophagitis, may include:

• Hoarseness. Due to the irritation and inflammation on the oesophagus, this can cause a hoarse voice and the sensation of a dry, sore throat. 
• Persistent cough. This symptom usually resents itself more at night and it may feel difficult to fully clear the throat. 
• Shortness of breath. Asthmatic-like symptoms, like feeling short of breath, may present with more advanced cases of oesophagitis; this can be caused by the throat narrowing due to inflammation.  

What causes Oesophagitis?

There are a number of causes for oesophagitis; it tends to present itself in adults, although some children have been diagnosed with the condition. The various causes are categorised below:

• Reflux oesophagitis. This is the most common cause of oesophagitis. Gastric acid is used to break down food during digestion in the stomach. A valve, known as the lower esophageal sphincter (LES) prevents food passing into the stomach when it’s closed and relaxes to let food in when you swallow. Sometimes, the LES can fail which causes gastric acid to flow back into your throat or ‘reflux’.  Where this occurs continually, it can cause irritation on the lining of the oesophagus and inflames it, resulting in reflux oesophagitis. 
• Eosinophilic oesophagitis (EO). White blood cells, or eosinophils, accumulate This is thought to be a genetic condition combined with your body’s natural response to certain environments and foods. Hayfever and food allergies are common with cases of EO, as well as asthma. Lymphocytic oesophagitis is a related condition, but much less common. 
• Drug-induced oesophagitis. Certain medications can lead to irritation of the tissue in the oesophagus causing damage, such as antibiotics, ibuprofen, naproxen, potassium chloride, and quinidine. Swallowing pills without water can also lead to damaging the lining in the oesophagus, leading to drug-induced oesophagitis.
• Infection. A bacterial or viral infection can cause infectious oesophagitis, though this is not a common cause. 
• Hiatus hernia. One side effect of suffering with a hiatus hernia, where a part of the stomach moves up into the chest, can be an onset of oesophagitis. 

How to help prevent Oesophagitis

The most effective approach to prevent oesophagitis is to adopt different dietary habits. Changes in lifestyle could also lead to a reduced risk of suffering from oesophagitis. Some of the following are proven to reduce the likelihood of developing different types of oesophagitis:

• Change in diet. Cutting down caffeine and alcohol, and other ‘trigger’ foods for acid reflux, can significantly reduce the likelihood of reflux oesophagitis. Reducing salt intake and fatty foods can also be beneficial, as well as increasing the amount of fibre in your diet.
• Quit smoking. There are many health benefits to giving up smoking, including reduced likelihood of experiencing oesophagitis. Smoking is known to relax LES, which increases the risk of an acid reflux, leading to reflux oesophagitis. 
• Avoid eating late at night. Going to bed shortly after eating is a strong contributor to experiencing a bout of acid reflux.
• Lose weight. Maintaining a healthy weight can reduce pressure on the stomach, which will prevent the LES being forced open after eating.
• Change in medication. Some drugs have been known to lead to drug-induced oesophagitis, and changing a prescription to something that carries less risk of irritation can reduce the likelihood of oesophagitis presenting itself. 

How is Oesophagitis typically diagnosed?

If you experience the symptoms described for oesophagitis, a doctor can usually diagnose you by a combination of physical examination and diagnostic investigations. They may ask questions in relation to your diet or lifestyle to better understand the severity of your case. Should further tests be needed, a doctor may request one or more of the following examinations:

• Gastroscopy. This procedure involves a long, flexible camera being inserted down your throat and towards your stomach. A local anaesthetic spray is administered beforehand to reduce any discomfort.
• Biopsy. During a gastroscopy examination, a doctor may cut a small sample of tissue from the oesophagus to send off for laboratory analysis. This can help diagnose the type of oesophagitis causing the inflammation. 
• Barium swallow. A highly effective test that involves swallowing a solution before being x-rayed to show how it passes through your throat, highlighting any issues in the oesophagus. 

How is Oesophagitis treated?

It is usually easy for a doctor to diagnose from investigations combined with your oesophagitis symptoms, and treatment should begin sooner rather than later. Oesophagitis can be treated in different ways depending on the cause, and the main focus is to alleviate symptoms and manage the condition. Oesophagitis treatment may involve the following:

• Reflux oesophagitis. Change in diet and lifestyle, over-the-counter and prescription medications (such as proton pump inhibitors), can help reduce symptoms of reflux oesophagitis. 
• Eosinophilic oesophagitis. Medication can be prescribed to help treat eosinophilic oesophagitis, including proton pump inhibitors and steroids. Identifying any food allergies and avoiding these is also highly recommended. 
• Drug-induced oesophagitis. Alternative medications or liquid formulations of medications can be prescribed to help alleviate symptoms of drug-induced oesophagitis. 

Though it’s uncommon, complications can arise if the condition goes untreated, such as:

• Stricture. This describes scarring and narrowing of the oesophagus, and can worsen if not treated.
• Barrett’s oesophagus. A condition whereby the cells in the oesophagus mutate, increasing the risk of becoming malignant (cancerous).
• Cancer. One complication of oesophagitis if untreated in oesophagal cancer, however this is very rare.

When should I go to the doctor for Oesophagitis?

Although it is not a serious condition, some of the more severe symptoms of oesophagitis should not be ignored. You should speak to a doctor if you experience dysphagia (difficulty or pain whilst swallowing) for a consecutive number of days; if food gets stuck in the oesophagus, seek immediate medical attention. Equally, if flu-like symptoms such as headache, fever, and muscle aches present themselves, you should seek medical assistance to begin treatment. Complications as a result of oesophagitis are rare and do not affect most people experiencing the condition, but it’s best to begin treatment straight away. 

How can Doctify help with Oesophagitis?

At Doctify, we are proud to work with leading specialists in all fields of medicine. Our service could put you in touch with some of the country’s leading consultants based on real patient reviews. To find the right doctor for you, visit www.doctify.com/uk.