|Esophagitis refers to inflammation of the tube (esophagus) that leads from the back of the mouth or throat to the stomach.|
There are three main types of esophagitis: reflux, infectious, and corrosive. Reflux esophagitis is a complication of backflow of stomach contents into the esophagus (gastroesophageal reflux). The stomach contents contain hydrochloric acid and a protein-digesting enzyme (pepsin). These can irritate and cause inflammation of the mucus membrane (mucosa) that lines the esophagus when it is exposed to these substances on a long-term basis. Risk factors for developing reflux esophagitis include gastroesophageal reflux disease (GERD), upset stomach (dyspepsia), hiatal hernia, or chronic ingestion of highly-seasoned foods or drugs that increase stomach acidity. It can also develop because of vomiting, surgery, or swallowing a sharp object.
Infectious esophagitis develops when fungus, yeasts (especially Candida), viruses (such as herpes or cytomegalovirus), or bacteria invade the esophagus causing it to become irritated and inflamed. Taking antibiotics is a risk factor for developing infectious esophagitis because antibiotics decrease the number of normal mouth and throat bacteria, while allowing other microscopic organisms to grow unchecked. Other risk factors for infectious esophagitis include diabetes mellitus, any condition that decreases the movement (motility) capacity of the esophagus, and the decreased responsiveness of the immune system.
Corrosive esophagitis will develop when the esophagus becomes burned, irritated, and inflamed in response to the accidental or deliberate ingestion of corrosive chemicals. The severity of the burn depends upon the type and concentration of the chemical, and the length of time the esophagus has been exposed to the chemical. As with other kinds of burns, esophageal burns are classified as first-, second-, or third-degree. First-degree burns of the esophagus involve only the outer (superficial) mucosa, while second-degree burns involve the entire thickness of the mucosa, and may extend into the muscular layer of the esophageal wall. Notably, ingestion of strong acids usually produces minor esophageal injury with severe stomach (gastric) burns. Risk factors for corrosive esophagitis include ingestion of strong acids (such as drain cleaners, vinegar, or aspirin) or bases (such as lye, oven cleaner, or ammonia). Third-degree burns affect all layers of the esophagus.
Recently there is increased awareness of eosinophilic esophagitis (EE), which may be related to a food allergy or autoimmune disorder. Like other types of esophagitis, symptoms in adults are heartburn, reflux, and dysphagia. A common complaint with EE is food impaction. There is a presence of vast numbers of intra-epithelial eosinophils in the esophagus as diagnosed by endoscopic esophageal biopsy.
Risk: Infectious esophagitis from Candida infection is common in individuals with AIDS.
Ingestion of irritating materials that result in corrosive esophagitis usually happens among children. However, in all individuals, ingestion of household acids or bases results in corrosive esophagitis in about half of cases.
Seventy-five percent of individuals with eosinophilic esophagitis are male, with the diagnosis usually occurring between 30 and 50 years of age (Fox).
Incidence and Prevalence: The incidence of reflux esophagitis is estimated to be relatively low in the general population; however, this figure increases substantially in individuals who have been treated for other gastrointestinal maladies such as hiatal hernia and gastritis.
Prevalence of esophagitis in individuals with gastroesophageal reflux disease (GERD) is anywhere between 10% and 70% (Faybush).
Infectious esophagitis occurs infrequently in the general population; however, it develops in significantly higher rates in individuals who have compromised immune systems.
Incidence of eosinophilic esophagitis (EE) is 2 in 10,000 (Rothenberg).
Source: Medical Disability Advisor