What is reflux esophagitis?

Esophagitis is an inflammation of the lower part of the esophagus. The esophagus is the tube that connects the throat and stomach. Esophagitis produces heartburn and pain in the area below the breastbone.

Reflux esophagitis is caused by gastroesophageal reflux, which is when the acid contents of the stomach flow back, or reflux, into your esophagus, causing heartburn. When gastroesophageal reflux occurs often, acidic juices backed up into the esophagus can inflame it.

How does it occur?

It can occur with:

• obesity
• pregnancy
• hiatal hernia
• recurrent vomiting
• scleroderma
• nasogastric tubes.

What are the symptoms?

Symptoms can appear when you lie down after eating and are relieved when you sit upright. They include:

• heartburn
• cramping, severe pain, or pressure below the breastbone
• pain
• spitting up at night
• coughing
• shortness of breath
• fluid or vomit inhaled into the lungs
• anemia due to blood in the bowel movement.

Heartburn, the most common symptom, usually occurs 30 to 60 minutes after you eat and may be severe. The pain may spread to your neck, jaw, arms, and back.

How is it diagnosed?

The doctor will review your symptoms and examine you, and may order the following tests:

• x-ray
• endoscopy (using a viewing scope to look in the esophagus)
• acid perfusion test
• esophageal manometry (a test to monitor gas pressure)
• a test to monitor esophageal acidity and alkalinity.

How is it treated?

The doctor may prescribe:

• antacids to take after meals and at bedtime
• H2 receptor blockers
• proton pump inhibitors
• gastrointestinal stimulants.

Surgery is necessary for less than 25% of those with reflux esophagitis.

When your esophagus narrows from repeated inflammation and scarring, the doctor may:

• dilate your esophagus
• use surgery to restore and anchor the stomach below the diaphragm
• use bypass surgery to create a new segment of esophagus from a stomach tube.

How long will the effects last?

The duration of symptoms and response to treatment varies from person to person.

How can I take care of myself?

Follow these guidelines:

• Take medications with plenty of liquid. Swallowing medication dry or without enough liquid can cause some pain in the esophagus.
• Eat nutritious food and lose weight if you are overweight.
• Avoid alcohol, smoking, and these foods:
• Fat
• Chocolate
• Peppermint
• Caffeine
• Citrus foods
• Tomato products.
• Wear loose-fitting clothes without belts.
• Sleep with the head of your bed elevated at least 4 inches.

What can be done to help prevent reflux esophagitis?

Follow these guidelines:

• Avoid stress, especially during meals.
• Eat frequent, small meals.
• Avoid smoking.
• Avoid lying down for at least 3 hours after meals.