Alternative names: Indigestion and Heartburn
The term ‘indigestion’ is a layman’s term and is used to cover the symptoms of a few different medical conditions.
The esophagus is a muscular tube that carries food from the mouth to the stomach, playing a vital role in the digestive process. It carries food and liquids from the mouth to the stomach, and any disruption in this process can lead to symptoms and complications.
Medical conditions that are often described as ‘indigestion’ and which have ‘indigestion’ as a symptom are:
- Heartburn (gastro-oesophageal reflux)
- Ulcers
- Non-ulcer dyspepsia (when you have symptoms of an ulcer but no sign of ulcer on investigation)
- Food intolerance, e.g., lactose intolerance
- Bloating and flatulence and
- Aerophagia (swallowing excessive amounts of air)
Symptoms of esophagitis can include chest pain, trouble swallowing, and food getting stuck (called food impaction), which may indicate inflammation or damage to the lining of your esophagus. Different types of esophagitis include reflux esophagitis, eosinophilic esophagitis, infectious esophagitis, and medication-induced esophagitis. Autoimmune esophagitis is another specific type, caused by autoimmune diseases, and is distinct from eosinophilic or infectious esophagitis. Inflammation in esophagitis often involves the accumulation of white blood cells, such as eosinophils or lymphocytes, in the esophageal tissue.
Many people with indigestion suffer in silence, sometimes for years, receiving little or no medical treatment apart from over-the-counter antacids.
While these are very effective in medicating heartburn, there are now many more medications available, which can provide perfect symptomatic relief.
Heartburn and reflux are often caused by acid backflow due to a malfunctioning lower esophageal sphincter, a valve that normally prevents stomach acid from entering the esophagus. When this sphincter does not function properly, it can lead to reflux esophagitis, a condition medically called gastroesophageal reflux disease (GERD). Structural abnormalities such as a hiatal hernia, where the upper part of the stomach protrudes through the diaphragm, can also contribute to reflux esophagitis. Other reflux esophagitis factors include certain foods, obesity, and lifestyle habits. Radiation therapy, especially when targeting the chest, throat, or esophagus, can also cause esophagitis, known as radiation esophagitis.
There is also a greater awareness that acid reflux, which causes heartburn, may damage the lining of the esophagus and increase the potential for serious health problems due to the process of chronic inflammation. Severe esophagitis can result in severe chest pain, bleeding, or narrowing of the esophagus and may require specialized treatment.
Medicine-induced esophagitis, also called drug-induced esophagitis, occurs when certain oral medications damage the esophageal lining, often due to improper swallowing techniques such as taking pills with insufficient water. Drug-induced esophagitis is a form of tissue damage resulting from medications that remain in contact with the esophagus for too long. Medicine-induced esophagitis involves avoiding the causative medication when possible and adopting proper pill-taking habits to prevent recurrence.
Eosinophilic esophagitis is an allergy-related condition, and eosinophilic esophagitis risk factors include allergies, family history, and environmental exposures.
Infectious esophagitis is more common in individuals with a weakened immune system. Poor immune system function, such as in HIV/AIDS or cancer, increases susceptibility to infectious esophagitis. Infectious esophagitis risk factors include the use of steroid or antibiotic medicines, medicines called immunosuppressants, underlying health conditions like diabetes, and poor immune system function. A common cause of infectious esophagitis is a fungal Candida infection, particularly by a fungus normally found in the mouth called Candida albicans. The use of steroid or antibiotic medicines and medicines called immunosuppressants can increase the risk of infectious esophagitis by suppressing or blocking immune system reactions.
It is becoming increasingly important to treat your symptom of heartburn less casually and discuss the prospects for treatment with your doctor. Esophagitis is diagnosed by a healthcare provider through symptom evaluation, physical examination, and diagnostic tests, often performed by specialists such as gastroenterologists.
Introduction to Esophagitis
Esophagitis is a medical condition marked by inflammation of the lining of the esophagus—the muscular tube that carries food from the mouth to the stomach. This inflammation can result from several causes, including gastroesophageal reflux disease (GERD), acid reflux, exposure to stomach acid, reflux esophagitis, eosinophilic esophagitis, and infectious esophagitis. If not properly managed, esophagitis can lead to serious health issues such as narrowing of the esophagus, digestive and kidney diseases, and even esophageal cancer.
The symptoms of esophagitis often depend on the underlying cause but commonly include trouble swallowing, chest pain, and heartburn or reflux symptoms. In some cases, an allergic reaction to certain foods or substances can trigger eosinophilic esophagitis, while a malfunctioning lower esophageal sphincter can allow stomach acid to irritate the esophagus, leading to reflux esophagitis. Infectious esophagitis may develop in individuals with weakened immune systems, and medicine-induced esophagitis can occur when certain medications irritate the esophageal lining.
Treatment for esophagitis depends on its cause and severity. For example, reflux esophagitis treatment often involves medications like proton pump inhibitors to reduce stomach acid, while eosinophilic esophagitis treatment may require an elimination diet to identify and avoid trigger foods. Medicine-induced esophagitis treatment typically involves stopping or changing the medication responsible for the irritation.
If you experience persistent symptoms of esophagitis, such as ongoing reflux symptoms, chest pain, or difficulty swallowing, it’s important to seek medical attention. A healthcare professional can diagnose esophagitis through a physical exam and may recommend further tests to determine the best course of action. Early diagnosis and treatment are crucial to prevent complications and protect the health of your digestive system.
In addition to medical therapies, lifestyle changes can play a significant role in managing esophagitis. Maintaining a healthy weight, avoiding fatty foods and certain foods that trigger symptoms, and considering complementary or alternative medicines under professional guidance can all help reduce discomfort and prevent flare-ups. By understanding the causes, recognizing the symptoms, and working with your healthcare provider, you can take proactive steps to manage esophagitis and safeguard your long-term health.
Working with a Healthcare Provider for Gastroesophageal Reflux Disease
Managing esophagitis effectively starts with partnering closely with a healthcare provider. Because esophagitis can be caused by a range of factors, including gastroesophageal reflux disease (GERD), acid reflux, stomach acid irritation, reflux esophagitis, eosinophilic esophagitis, and infectious esophagitis, it’s essential to identify the specific cause to create a successful treatment plan. Inflammation of the lining of the esophagus can lead to serious complications if left untreated, such as narrowing of the esophagus or even esophageal cancer. In cases where the esophagus becomes very narrow or food gets stuck, esophageal dilation is a medical procedure performed by a gastroenterologist to expand the esophagus and relieve obstruction.
A healthcare provider, often a gastroenterologist, will begin by reviewing your symptoms and medical history, followed by a physical exam. To confirm the diagnosis and assess the severity of the condition, additional tests like an endoscopy may be recommended. These steps help pinpoint whether your esophagitis is related to acid reflux, an allergic reaction, infection, or medication use, such as pill esophagitis.
Treatment for esophagitis depends on its underlying cause. For reflux esophagitis, your healthcare provider may suggest lifestyle changes like avoiding fatty foods, spicy foods, and certain foods that can make acid reflux worse. Medications that reduce stomach acid, such as proton pump inhibitors, are often prescribed as part of reflux esophagitis treatment. If you are diagnosed with eosinophilic esophagitis, your provider may recommend an elimination diet to identify and avoid foods that trigger an allergic reaction, along with medications to treat eosinophilic esophagitis and block immune system responses. In some cases, a healthcare professional replaces food with specialized formulas or closely oversees the elimination diet process to ensure safety and effectiveness in managing eosinophilic esophagitis.
In cases where esophagitis is caused by medication known as pill esophagitis or medicine-induced esophagitis, your provider may adjust how you take your prescription medicines or suggest alternatives. Infectious esophagitis, which can occur in people with weakened immune systems, is treated with antibiotics or antifungal medications, depending on the type of infection.
Working with your healthcare provider also means discussing lifestyle changes that can help manage symptoms and prevent complications. Maintaining a healthy weight, avoiding foods and drinks that trigger heartburn or reflux symptoms, and following your provider’s advice on medication use are all important steps. If you are considering complementary or alternative medicines, be sure to talk with your provider, as some remedies may interact with prescription medicines or affect your digestive system.
Regular follow-up appointments are key to monitoring your progress and making any necessary adjustments to your treatment plan. By staying in close contact with your healthcare provider and following their recommendations, you can reduce your symptoms, prevent the progression of esophagitis, and protect your long-term health.
