Interventions for esophagitis are intended to lessen symptoms, manage complications and treat underlying causes of the disorder. Treatment strategies vary primarily based on the cause of the disorder.
Treatment for reflux esophagitis may include the following:
- Proton pump inhibitors block acid production in the stomach and allow time for damaged esophageal tissue to heal. Drugs available by prescription include omeprazole (Prilosec), esomeprazole (Nexium) and lansoprazole (Prevacid). Over-the-counter proton pump inhibitors also are available. Other treatments for gastroesophageal reflux disease (GERD) may alleviate GERD symptoms temporarily, but generally have little effect on esophagitis.
- Fundoplication, a surgical procedure, may be used to treat GERD and improve the condition of the esophagus if other interventions don't work. During this procedure, a portion of the stomach is wrapped around the valve separating the esophagus and stomach (lower esophageal sphincter). This strengthens the sphincter and prevents acid from backing up into the esophagus. Fundoplication may also correct problems related to a hiatal hernia.
Treatment for eosinophilic esophagitis is primarily avoiding the allergen and reducing the allergic reaction with medications.
- Oral steroids. Corticosteroids may lessen the inflammation associated with allergic reactions and allow for the esophagus to heal. Side effects associated with long-term use of oral steroids, however, can be severe. These effects include loss of bone density, slowed growth in children, diabetes, acne and mood disorders. Your doctor may first prescribe inhaled steroids to minimize these side effects.
- Inhaled steroids. Inhaled steroids are used to manage asthma. Some studies have shown that these medications may help treat eosinophilic esophagitis. Your doctor will instruct you on how to swallow the steroid preparation, rather than inhaling it, so that it coats your esophagus. This delivery system for steroids is much less likely to cause serious side effects.
- Proton pump inhibitors. If you've been diagnosed with eosinophilic esophagitis and your doctor suspects that acid reflux may be involved, he or she may prescribe a proton pump inhibitor. These medications, such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), block acid production.
- Restricted diet. If tests show that you have food allergies, your doctor may ask you to eliminate the problem foods from your diet. Your doctor may refer you to a dietitian, who can help you manage your diet and plan healthy meals. Your doctor may also recommend vitamins or supplements or special nutritional drinks if your allergies significantly limit your food choices.
Treatment for drug-induced esophagitis is primarily avoiding the problem drug when possible and reducing the risk with better pill-taking habits. Your doctor may recommend:
- Taking an alternative drug that is less likely to cause drug-induced esophagitis
- Taking a liquid version of a medication if possible
- Drinking an entire glass of water with a pill (unless you've been told by your doctor to restrict your fluid intake because of another condition, such as kidney disease)
- Sitting or standing for at least 30 minutes after taking a pill
Your doctor may prescribe a medication to treat a bacterial, viral, fungal or parasitic infection causing infectious esophagitis.
Treating common complications
A gastroenterologist may perform a procedure to expand (dilate), the esophagus. This treatment is generally used only when the narrowing is very severe or food has become lodged in the esophagus.
This procedure is performed with one or more endoscopic devices, small narrow tubes inserted through the esophagus. Versions of these devices may be equipped with a:
Sep. 15, 2011
- Tapered tip that starts with a rounded point that gradually widens
- Balloon that can be expanded after it's inserted in the esophagus
- Franciosi JP. Eosinophilic esophagitis. Immunology and Allergy Clinics of North America. 2009;29:19.
- Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.htm. Accessed Aug. 1, 2011.
- Castell DO. Medication-induced esophagitis. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
- Graman PS. Esophagitis. In: Mandell GL, et al. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-443-06839-3..00094-1&isbn=978-0-443-06839-3&uniqId=270386537-4#4-u1.0-B978-0-443-06839-3..00094-1. Accessed Aug. 1, 2011.
- Patti MG. Gastroesophageal reflux disease: From pathophysiology to treatment. World Journal of Gastroenterology. 2010;16:3745.
- Geagea A, et al. Scope of drug-induced, infectious and allergic esophageal injury. Current Opinion in Gastroenterology. 2008;24:496.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Aug. 11, 2011.