Reflux Esophagitis

What is reflux esophagitis?

Reflux esophagitis is inflammation of the lower part of the esophagus. The esophagus is the tube that carries food from the back of your mouth to your stomach. This problem causes heartburn and pain in the area below the breastbone.

How does it occur?

Reflux esophagitis is caused by gastroesophageal reflux, which is when the acid contents of the stomach flow back (reflux) into your esophagus, causing heartburn. Your esophagus may become inflamed if the reflux of acid happens often.

Reflux esophagitis can occur with:

• overweight
• pregnancy
• hiatal hernia (a condition in which part of the stomach protrudes through the diaphragm from the abdomen into the chest)
• recurrent vomiting
• scleroderma (a disease that causes thickening and tightness of the skin)
• nasogastric tubes (tubes passed through your nose down into your stomach).

What are the symptoms?

Symptoms include:

• heartburn
• cramping, severe pain, or pressure below the breastbone
• pain
• acid taste, especially at night
• coughing
• shortness of breath.

Symptoms may occur when you lie down after eating and may be relieved when you sit upright. 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?

Your health care provider will review your symptoms and examine you Your provider may order the following tests:

• x-ray
• endoscopy, a procedure in which a thin flexible tube with a tiny camera is placed in your mouth and down into your stomach so your provider can see your esophagus and stomach
• esophageal manometry (a test to measure pressure in the esophagus).

Often no tests are necessary.

How is it treated?

Your health care provider may recommend or prescribe:

• antacids to take after meals and at bedtime
• medicine that decreases the amount of acid your stomach makes
• medicine that helps food and acid move forward through your digestive tract
• weight loss to decrease the pressure on your stomach.

Repeated inflammation and scarring may make your esophagus become narrower. If this happens, your health care provider may:

• dilate (widen) your esophagus
• use surgery to restore and anchor the stomach below the diaphragm if you have a hiatal hernia
• use bypass surgery to create a new segment of esophagus.

How long will the effects last?

The duration of symptoms and response to treatment vary from person to person. It is important to keep your follow-up appointments with your health care provider, especially if your symptoms are not getting better. Severe reflux esophagitis can eventually cause changes in the cells that line the esophagus, resulting in a condition called Barrett's esophagus. These changes increase your risk of cancer of the esophagus.

How can I take care of myself?

Follow these guidelines:

• Take medicines with plenty of liquid. Swallowing medicine without enough liquid can irritate the esophagus.
• Avoid smoking.
• Avoid drinking alcohol.
• Avoid eating chocolate, peppermint, fatty foods, citrus foods, caffeine, or tomato products. These foods make reflux worse.
• Wear loosely fitting clothing without belts.
• Sleep with your head elevated at least 4 inches.
• Maintain your proper weight.
• Keep your follow-up appointments with your health care provider.
• Tell your health care provider if your symptoms get worse.

How can I help prevent reflux esophagitis?

Follow these guidelines:

• Eat frequent, small meals.
• Avoid smoking.
• Avoid lying down for at least 3 hours after meals.
• Eat foods that don't cause symptoms.
• Maintain a healthy weight.