Reflux Esophagitis Treatment
There are several types of esophagitis with different causes, but in particular, reflux esophagitis refers to esophageal mucosal damage caused by the leakage of stomach acid into the esophagus. Reflux esophagitis is also referred to as gastroesophageal reflux disease (GERD) quite often. GERD itself is chronic acid reflux. If a patient doesn’t receive reflux esophagitis treatment, it can cause damage to the esophagus. Read on to learn more about what reflux esophagitis is, what causes it, and when you should consult your gastroenterologist.
What Is Reflux Esophagitis?
Esophagitis is an irritation of the esophagus that causes inflammation. Most commonly, it is caused by GERD, whose hallmark symptoms are severe heartburn, regurgitation, and sometimes, chest pain.
To understand what reflux esophagitis is, you need to understand how the esophagus moves food into the stomach with its muscles. One of the most important muscles in the esophagus is the lower esophageal sphincter (LES), which opens like a valve to allow food and liquid to enter the stomach. In a perfectly functioning LES, once the contents move through, the valve closes. In an LES that isn’t working properly, the LES can flutter (open, then closed, then open) or it can be “stuck” open completely. This allows stomach acid to escape the stomach, leaking into the esophagus. Over time, this can cause noticeable symptoms and esophageal damage.
GERD is not the only cause of general esophagitis; it is referred to as reflux esophagitis. Other types of esophagitis can be caused by:
- Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin
- Persistent vomiting
- Weakening of the immune system from viruses, bacteria, and fungi, among other diseases
There is another type of esophagitis known as eosinophilic esophagitis. This typically develops from an allergic reaction to food or beverages. The most common culprits are foods or beverages that contain dairy, soy, egg, or wheat products.
What Are the Symptoms of Reflux Esophagitis?
Symptoms of reflux esophagitis present noticeably. Since the term reflux esophagitis is almost synonymous with GERD, it shares many of the same signs and symptoms. Like GERD, reflux esophagitis treatment is needed to prevent complications of the esophagus. Symptoms of reflux esophagitis include:
- Heartburn (burning sensation in the chest)
- Dysphagia (difficulty swallowing)
- Painful swallowing
- Regurgitation (when food and liquid travel from the esophagus to the mouth)
- Food impaction (food becoming stuck in the esophagus because of the narrowing of the esophagus)
- Chest pain, particularly during and immediately after meals
If an infant or young child presents with possible reflux esophagitis, look for symptoms such as failure to thrive and difficulty feeding/eating.
Causes of Reflux Esophagitis
The cause of reflux esophagitis is GERD, so it’s wise to examine what causes GERD to understand reflux esophagitis. GERD itself is caused by a poorly functioning lower esophageal sphincter, but some factors can contribute to GERD. These include:
- Spicy or fried foods, or foods you have a slight intolerance to, such as dairy
- Hiatal hernia. This occurs when the stomach bulges and pushes up into the diaphragm.
- Certain medications, such as antidepressants, painkillers, high blood pressure medications, allergy medications, and medications for asthma
- Pressure on the abdomen (this is most common in pregnant women)
In rare cases, esophagitis can be caused or affected by the insertion of a nasogastric tube, This is a feeding tube that allows food to enter the stomach through the nose. Although they are typically benign esophageal strictures, a nasogastric tube can cause or affect reflux esophagitis, often resulting in esophageal stricture (narrowing of the esophagus). It is important to know the risks if you have a nasogastric tube inserted.
Quite often, your gastroenterologist will have to treat the underlying condition that is causing your reflux esophagitis.
Reflux Esophagitis Treatment and Diagnosis
If you think you may have reflux esophagitis or GERD, you need a diagnosis so your provider can give you the proper reflux esophagitis treatment. Reflux esophagitis is most often diagnosed with:
- Upper GI endoscopy
- Biopsy (this is typically performed during the endoscopy)
- Barium X-ray (barium swallow)
Depending on the underlying cause, your gastroenterologist may recommend several different types of reflux esophagitis treatment, such as:
- Over-the-counter and prescription medications. Your doctor may suggest OTC medications at first, such as antacids, proton pump inhibitors (PPIs), and H-2 receptor blockers. If these aren’t effective, your provider may suggest prescription versions of these medications.
- Minor surgery. Your physician may perform a procedure called fundoplication, in which a portion of the stomach is wrapped around the LES to help it function better.
In complicated or severe cases, esophageal dilation may be necessary. This is used when there is severe narrowing of the esophagus. In the procedure, your healthcare provider uses an endoscopic procedure to dilate (enlarge) the esophagus.
What Happens If Reflux Esophagitis Goes Untreated?
In the long term, if patients receive reflux esophagitis treatment, the outlook and prognosis are very positive. However, if reflux esophagitis goes untreated, serious complications can arise. One of these is esophageal stricture, as previously mentioned, which is a narrowing of the esophagus. Some cases can be severe.
Untreated reflux esophagitis can also lead to Barrett’s esophagus, which is a precursor to esophageal cancer. There are two types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. Both are serious and require conventional cancer treatment, such as chemotherapy or radiation therapy.
Untreated reflux esophagitis can also result in tears in the lining of the esophagus. Having proper reflux esophagitis is imperative so these complications do not arise.