Esophagitis is an inflammation or swelling of the esophagus that causes the esophagus to narrow. A corrosive version of esophagitis is a narrowing caused by damage such as occurs with gastroesophageal reflux disease or GERD. This is when a sphincter at the bottom of the esophagus doesn’t close all the way and stomach contents, which are acidic, reflux back into the esophagus and irritate it. Other causes of esophagitis include swallowing lye or other corrosive agents, bulimia, or feeding tubes that have been left in place for too long. People with compromised immune systems and who are on medications like corticosteroids are at risk for infections that may cause esophagitis.
The symptoms of esophagitis are a decrease in the ability to swallow, which may be sudden or gradual. At first, it’s difficult to swallow solid foods, then it becomes difficult to swallow liquids. There’s also pain in the mouth and chest after eating a meal, an increase in salivation and a rapid breathing rate. Another symptom is vomiting mucous or blood.
The risk of esophagitis increases with alcohol, smoking, and persistent vomiting. The patient is also at higher risk if they’ve had radiation or surgery to the chest, and if they’ve taken oral medications like tetracycline without lots of water. A physician might perform an endoscopy or a barium swallow to determine whether the condition is esophagitis.
The complications of esophagitis are malnutrition due to the inability to eat properly, and in a worse case, perforation of the esophagus, which is a medical emergency.
A person who suffers from esophagitis should seek a doctor’s care. If necessary, they might be hospitalized and receive intravenous feeding if the condition is severe, or even surgery to remove scar tissue from the esophagus. The esophagus can also be dilated from time to time. The prognosis for esophagitis is good with treatment, which may include treatment that stretches the scar tissue, or stricture. This is done with heavy dilators about once a month under a doctor’s care. The treatment should be performed regularly to keep the stricture from returning.
A doctor might also prescribe cortisone drugs to reduce inflammation and scarring, as well as antibiotics. In the meantime the patient should eat a soft or liquid diet until they can swallow normally. In a soft diet all liquids but alcohol are allowed, as are most cold breads and cereals. Salt, pepper and cinnamon are allowed, as are plain desserts like pudding, sherbets and ice cream, though any desert that has dates, nuts, raisins or coconut are omitted. Butter, cream and margarine are allowed in moderation, though lard and pork fat are omitted. Cooked, but not raw fruits are allowed as well. Broiled, roasted, baked or stewed meat are allowed, as well are cottage and other mild cheeses, and soft cooked eggs. Milk, potatoes and pasta can be taken as can broth or creamed soups. Low fiber vegetables and vegetable juices are also allowed, but gas forming vegetables like Brussels sprouts, onions, legumes and cabbage should be avoided.
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