Esophagitis

What is esophagitis?

Esophagitis is the irritation and inflammation of the lining of the esophagus, or food pipe. Esophagitis can cause difficulty swallowing and can result in the esophagus narrowing or bleeding.

What causes esophagitis?

There are a number of possible causes of irritation and inflammation of the esophagus including:

  • Stomach acid in the food pipe. Gastroesophageal reflux disease (GERD) causes stomach acid to leak backward into the esophagus. If this occurs on a regular basis, it may cause esophagitis. Learn more about GERD.
  • Chronic vomiting.
  • Medications. Some medications, such as aspirin or other anti-inflammatory drugs, can cause esophagitis.
  • Medical procedures. Radiation therapy can make the esophagus inflamed or sore.
  • Infections that weaken the immune system.
  • Food allergies. Learn more about food allergies.

Esophagitis can have serious consequences that can affect a child’s quality of life. If left untreated, esophagitis may develop into a condition called Barrett’s esophagus that increases the risk for esophageal cancer.

What are the symptoms of esophagitis?

Children and young adults with esophagitis may experience these symptoms:

  • Sore throat
  • Feeling that something is stuck in their throat
  • Mouth sores
  • Nausea or vomiting
  • Difficulty or painful swallowing
  • Heartburn
  • Chest pain.

Who’s at risk for esophagitis?

Children, adolescents and young adults may be at risk if they:

  • Are obese
  • Consume a lot of chocolate, fatty foods or spicy foods
  • Use certain medicines, including NSAID pain relievers, nitrates and beta blockers
  • Have a spinal cord injury
  • Have had radiation therapy for chest tumors
  • Swallow medicine with too little water or get a pill stuck in their throat
  • Have medical problems that predispose to esophagitis such as gastroesophageal reflux
  • Are pregnant
  • Smoke
  • Consume alcohol or coffee
  • Have a suppressed immune system making them susceptible to infection.

How is esophagitis diagnosed?

At CHOC Children’s, our pediatric gastroenterologists work with each patient and his or her family to carefully diagnose esophagitis and create a treatment plan based on the underlying cause for the condition. The process begins with a thorough medical history and physical exam. The gastroenterologist may also order:

  • An upper GI series. X-ray images of the esophagus and stomach taken while the child swallows a contrast agent.
  • An endoscopy. This is an outpatient procedure in which a small camera on a thin, flexible tube is used to look inside the esophagus for signs of esophagitis or other problems. Learn more about endoscopy.
  • An esophageal pH test for stomach acid. Sensors or thin wires are inserted to gather information about reflux. It can be performed in conjunction with an endoscopy.

How is esophagitis treated?

Treatment for esophagitis depends on the cause. At CHOC, all treatment plans are planned with the assistance of your child’s family and other members of your child’s medical team—including other physicians and dietitians involved in your child’s care. Possible treatments can include:

  • Lifestyle changes. If the esophagitis is caused by GERD, your child’s gastroenterologist might offer these recommendations:
    – Raise the head of the child’s bed so that they sleep with their head slightly above their feet.
    – Change the child’s eating habits to limit acid or irritation of the esophagus. This might mean switching to a bland diet for a while and avoiding spicy foods, citrus foods, chocolate, fatty foods and caffeine.
    – Maintain a healthy weight.
    – Become more active.
    – For adolescents and young adults, this also may include quitting smoking and alcohol.
  • Acid-blocking medicines.
  • Additional medications. In some cases, the gastroenterologist may prescribe drugs to help the stomach empty and prevent esophagitis.
  • Dietary changes. Changing your child’s diet to help with reflux or address the needs of a patient diagnosed with eosinophilic esophagitis.
  • Surgery. Surgery may be recommended if your child has bleeding or narrowing of the esophagus. It also might be recommended if needed to control the spread of precancerous cells.

What is eosinophilic esophagitis?

Eosinophilic esophagitis (EoE), is a relatively newly recognized disease that is characterized by eosinophils (allergy cells) building up in the lining of the esophagus. Research has shown a strong connection between food allergies and EoE. Environmental allergens may also play a role in this disease. EoE is a chronic disease that can be managed through diet and/or medical treatment. Although it is not life threatening, if left untreated it may cause permanent damage to the esophagus. Learn more about the Eosinophilic Esophagitis Clinic at CHOC Children’s.