In this article we will talk a little about esophagitis, what it is, its symptoms, causes and I will give you some recommendations to prevent it.
First, let me explain a little, as you know, the esophagus is a muscular tube that transports food from the mouth to the stomach, separated from it, is the internal esophageal sphincter, whose function is to prevent reflux from the stomach.
Esophagitis is the inflammation, erosion, congestion, and edema of the esophageal epithelium. This can be due to multiple causes, among which gastroesophageal reflux stands out. These lesions are generally located at the gastroesophageal junction and 10 cm above it.
Esophagitis includes the following signs (which the doctor can observe and measure) and symptoms (what the patient feels and reports):
- Dysphagia: difficulty swallowing.
- Odynophagia: painful swallowing.
- Acid regurgitation.
- Food plug: food stuck in the esophagus.
- Chest pain when eating, behind the breastbone.
- Burning from mouth to stomach.
- Painful intermittent dyspnea (difficulty breathing).
- Decreased appetite, weight loss.
- Nausea and vomiting.
- Throat pain.
- With frequent reflux, the chances of an esophageal ulcer increase, which can be hemorrhagic and lead to anemia.
Causes of Esophagitis
- Obesity: An increase in stomach pressure, eating a large amount of food, conditions the opening of the internal esophageal sphincter for reflux.
- Smoking: smoking has been related to epithelial alterations such as hyperplasia, metaplasia, dysplasia. Associated with cancer of the mouth, larynx, esophagus, stomach.
- Repeated vomiting: repeated exposure of the esophageal epithelium to stomach acid.
- Taking certain medications without plenty of water (alendronate, tetracycline, doxycycline, ibandronate, risedronate, potassium tablets or vitamin C).
- Radiation therapy to the chest as in lung cancer.
- Weakness of the immune system: patients with AIDS or cancer are usually infected by fungi (candida) or viruses (herpes or cytomegalovirus).
- Hiatal hernia: part of the stomach protrudes through the diaphragmatic opening, causing gastroesophageal reflux.
Types of Esophagitis
- Caustic: esophageal burns from the consumption of caustic products (household cleaning products such as bleach or ammonia).
- Post-radiotherapy: secondary effect of local radiotherapy in the chest.
- Eosinophilic: polynuclear eosinophils infiltrated in abnormal conditions in the esophageal epithelium as a result of an allergen (history: family and allergic reactions).
- Medicinal: certain drugs such as tetracyclines can cause ulcers. Use alternative medications.
- Infectious: usually due to candida or herpes simplex virus type 1 (HSV1). In particular, diabetics are at higher risk for candida esophagitis.
- Endoscopy: allows determining the characteristics and extent of the lesion, it can be mild, severe, or complicated (according to Savary-Miller).
- Obtaining a biopsy to analyze the tissue.
- Manometry to measure LES pressure
- X-rays – to look at structural changes (narrowing, hiatal hernia, tumors, or other abnormalities).
- Allergy test: skin test, to observe signs of allergic reactions with allergen extracts.
Treatment to treat esophagitis
The treatment to choose will depend on the cause and the type that triggered the inflammation:
- Change in habits:
-Eliminate alcohol, tobacco and soft drinks.
-Lose weight if it is the case.
-Antiacids: bicarbonate, aluminum and magnesium salts.
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-Gastric antisecretors: Antihistamines and PPI proton pump inhibitors
– Fundoplication: To strengthen the LES and prevent gastroesophageal reflux. It is achieved by wrapping a portion of the stomach around the sphincter. Also used in hiatal hernia problems.
-Linx: used to strengthen the LES; It consists of a magnetic ring.
-Dilatation of the esophagus: In the presence of food accommodation in the esophagus or severe narrowing due to fibrosis as in radiotherapies.
-Stenosis: esophageal narrowing
-Digestive hemorrhage – anemia
-Oesophageal rings: abnormal tissue
-Barrett’s esophagus: a metaplasia as the esophageal epithelium is modified. It can lead to cancer.
Recommendations for Taking Pills:
-Take alternative medications, similar in their active principle, which are less likely to cause esophagitis.
-Replace the tablets with another presentation, if possible, liquid, or capsules that can be opened.
-Lay down for at least 30 minutes after taking a pill.
-Drink plenty of water with the pill (otherwise it has liquid contraindications).
Avoid inflammatory foods in the diet for a speedy recovery. Cut out sugar, refined and unnatural products. Drink infusions of: chamomile, licorice (in moderation) and slippery elm. Add to your diet cold-extracted unsaturated oils, such as linseed, sunflower and sesame oil; they reduce inflammation, regenerate the epithelium and are anticancer.