Esophagitis

The esophagus is the part of the digestive system that communicates the mouth with the stomach. It is separated from it by a valve that is the lower esophageal sphincter or cardio and that has the function of preventing food and gastric juices from flowing back from the stomach. Esophagitis is inflammation of the mucosa, that is, of the inner layer that lines the esophagus and that can be due to different causes.

How is it produced?

The most common cause of esophagitis is gastroesophageal reflux. Reflux is a disorder in which the lower esophageal sphincter is abnormally relaxed and allows stomach contents (gastric acids) to reflux up into the esophagus. There are other less frequent causes of esophagitis that cause, by different mechanisms, inflammation and irritation of the lining of the esophagus and include:

• Consumption of medications such as non-steroidal anti-inflammatory drugs, antibiotics and corticosteroids, among others.
• Repeated vomiting.
• Treatment with radiation therapy to the chest (as in the case of lung cancer).
• Virus infections such as herpes and cytomegalovirus; some fungi such as candida.
• Previous surgery of the area.
• Trauma
• Intake of caustics (such as bleach).
• Systemic diseases.

Symptoms

The most common symptom of esophagitis (since the most common cause is reflux disease) is burning or heartburn. The patient describes it as a burning sensation that rises from the stomach to the throat. Regurgitation may also appear, that is, a sensation of return of gastric contents to the mouth. Other symptoms of esophagitis include:

• Retrosternal or abdominal pain or discomfort (especially).
• Difficulty swallowing (dysphagia). In long-term esophagitis, scar tissue can form, causing narrowing of the esophagus that can make swallowing difficult.
• nausea, vomiting, and repeated belching.
• Loss of weight and appetite, especially in cases of chronic and advanced disease.
• Cough.
• Reflux can cause ulcers to develop in the esophagus, which can bleed, and lead to iron losses leading to chronic anemia from blood loss.

Diagnosis

The diagnosis of esophagitis is based on the symptoms reported by the patient and the findings in a series of specific diagnostic tests.

They can be performed:

• Gastroscopy: it is the diagnostic test of choice. It allows to see the esophagus directly and the lesions of the mucosa as well as to rule out other problems such as hiatal hernia or gastric ulcer.
• Ph-metry: This test measures the acidity in the lower esophagus over a 24-hour period. This quantifies the frequency and duration of the reflux episodes responsible for esophagitis.
• measures the pressures within the esophagus. It is not a routine test. In cases of reflux, the closing pressure of the lower esophageal sphincter is decreased.

Treatment

Treatment will be aimed at improving the symptoms that predominate in each patient and in those cases in which it is possible, treatment of the underlying disease will be carried out: antibiotics, antifungals or antivirals in infectious esophagitis. significant pain such as secondary to radiation or after ingestion of caustics.

Other procedures such as dilations of the esophagus if there is significant narrowing (stenosis) in some areas. In those cases in which there is gastroesophageal reflux, a specific treatment will be carried out. This is based on a series of hygienic-dietetic measures, pharmacological treatment (with antisecretors and antacids) and surgical treatment in those cases where there are serious complications or the treatment has to be carried out on a chronic basis.

Prevention

In the case of gastroesophageal reflux, preventive measures include reducing weight if there is obesity, avoiding large and high-fat meals, giving up tobacco and diet with foods that do not worsen reflux. Radiation esophagitis can be tried to be prevented by spacing the time between cycles of chemotherapy and radiation therapy and with the use of anti-inflammatories.

At the first signs of gastroesophageal reflux, it is advisable to go to a specialist doctor to diagnose the severity of the symptoms. In this regard, MAPFRE Health Insurance is a perfect option to have the best professionals and quality coverage.