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oesophagitis Images (Click to view larger image)
Definition
Oesophagitis is an inflammation of the lining of the oesophagus. The oesophagus is the tube that carries food from the mouth to the stomach.
What is going on in the body?
The lining of the oesophagus becomes inflamed because of an infection or something that has irritated the lining. Oesophagitis is called acute when it occurs suddenly. It is called chronic when it lasts for a long time.
What are the signs and symptoms of the disease?
Symptoms of oesophagitis include: What are the causes and risks of the disease?
Causes of oesophagitis include: - infections by organisms such as candida, cytomegalovirus (CMV), or herpes simplex
- diseases and conditions that weaken the immune system, such as HIV, poorly controlled diabetes, immunodeficiency disorders, chemotherapy, chronic steroid use, or malnutrition
- chemicals that are swallowed
- pills that become stuck in the oesophagus
- gastrooesophageal reflux disease, or GORD, a condition in which stomach acid splashes back up into the oesophagus
- medications and supplements such as non-steroidal anti-inflammatory drugs, alendronate, doxycycline, iron, and potassium
What can be done to prevent the disease?
Maintaining a healthy weight, avoiding smoking, and limiting alcohol intake may decrease the risk of oesophagitis. Other ways to decrease the risk include: - eating a nutritious diet based on the Australian Guide To Healthy Eating
- getting adequate rest
- practicing safer sex
- getting proper treatment for GORD
Oesophagitis caused by toxic substances can be avoided by: - storing chemicals in properly labelled containers and keeping them out of the reach of children
- always taking pills with adequate amounts of liquid and at least 15 minutes before lying down
Prevention of oesophagitis is not always possible.
How is the disease diagnosed?
After a complete history and physical, any of these tests may be done: - endoscopy, which uses a scope, or long tube, to see the oesophagus and look for possible causes of symptoms. Biopsies may also be done with the endoscope.
- upper GI series, in which the person swallows liquid barium, and X-rays are taken to follow the course of the barium through the oesophagus and into the stomach.
- blood tests, including a full blood count (FBC), to check for infection
- oesophageal motility tests, to evaluate the movement of food through the oesophagus
- pH tests, to measure the acid content of the oesophagus
Other tests may be done, depending on the symptoms.
What are the long-term effects of the disease?
If the cause of the oesophagitis is an infection, and the infection is treated, the inflammation may improve. If a toxic chemical, such as lye, bleach, or petrol is ingested, the oesophagus can perforate, or rupture. This oesophageal perforation can be fatal.
Conditions such as GORD can irritate and narrow the oesophagus. Chronic GORD can result in Barrett's oesophagus. In Barrett's oesophagus, the lining of the oesophagus is so badly damaged that a new lining is formed. The changes in the cells lining the oesophagus pose an increased risk for oesophageal cancer.
What are the risks to others?
Oesophagitis itself is not contagious and poses no risk to others. If the cause is an infection, such as herpes simplex, the infection may be contagious.
What are the treatments for the disease?
Treatment of oesophagitis is directed at the cause. Treatment may include: - antibiotics, antiviral, or antifungal medications for infections
- medications to treat underlying conditions, such as GORD or diabetes
- maintaining a healthy lifestyle
- surgery to repair the oesophagus
What are the side effects of the treatments?
Medications used to treat infections may cause allergic reactions, stomach upset, and headache. Surgery carries a risk of bleeding, infection, and allergic reactions to anaesthesia.
What happens after treatment for the disease?
For mild, intermittent symptoms, treatment with antacids, diet changes, and activity recommendations may control symptoms. Recovery from surgery may be a few days to several weeks depending on the procedure used.
How is the disease monitored?
Any new or worsening symptoms should be reported to the doctor. Careful attention to symptoms that recur is important so that early treatment can begin.
Author: David J. Craner, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
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