Table of ContentsView AllTable of ContentsRefluxInfectiousCausticMedication-InducedEosinophilicRelated to Cancer TreatmentRelated to Systemic IllnessSymptoms and VariationsDiagnosisTreatment

Table of ContentsView All

View All

Table of Contents

Reflux

Infectious

Caustic

Medication-Induced

Eosinophilic

Related to Cancer Treatment

Related to Systemic Illness

Symptoms and Variations

Diagnosis

Treatment

Esophagitisis inflammation of youresophagus, the tube from your mouth to your stomach. While a condition it its own right, diagnosis can’t stop there. Esophagitis can stem from infectious or non-infectious causes, and the seven main types of esophagitis that result range in terms of treatment approaches and possible associated health consequences—some of which can be life-threatening.

The seven main types of esophagitis include:

Finding out the type of esophagitis you have is the first step in getting you on the road to feeling better.

Westend61 / Getty Images

Doctor examining a man.

Reflux Esophagitis

Most people will experience some reflux of stomach contents. However, you will have an increased risk of developing esophagitis if you experience frequent exposure to stomach acid, pepsin (enzyme in the stomach), and bile, as they can cause inflammation and ulcerations in your esophagus.

Infectious Esophagitis

If you have a weakened immune system, you will be more susceptible to acquiring an infection that causes esophagitis. This is most often seen in people that haveacquired immunodeficiency syndrome (AIDS), an organ transplant, or in people who’ve had chemotherapy.

While you are at an increased risk for esophagitis from infectious causes if you are immunocompromised, you can still acquire infectious esophagitis with a competent immune system.

Infections that commonly cause esophagitis include:

Caustic Esophagitis

Caustic esophagitis occurs when you ingest a chemical that burns your esophagus. Alkaline substances—such as lye, household bleach, batteries, or detergents —are especially likely to cause irritation, ulcers, or perforation (holes or tears) of your esophagus.

Harm to your esophagus will be proportional to the amount of time your esophagus was exposed to the chemical, as well as its toxicity. If only a little contact occurred, you may only have some irritation. Further exposure increases your risk for the formation of ulcers or worse damage.

What Is an Esophagus Tear?

Medication-Induced Esophagitis

Medications that have a low pH (acidic) and can cause medication-induced esophagitis include:

Aspirin andnonsteroidal anti-inflammatory drugs (NSAIDs), like Ibuprofen, can disrupt the protective barrier of the esophagus and stomach. This can increase your risk of developing esophagitis.

Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is an allergic/immune response. Eosinophils, part of the immune system, are white blood cells that can be associated with inflammation and related to allergies. One of the main identified risk factors for the development of eosinophilic esophagitis is allergies to foods.

Environmental factors have also been identified as a possible factor in acquiring eosinophilic esophagitis. The rationale for this is similar to environmental risk factors associated with asthma and inflammatory skin disorders. It is thought that not having enough exposure to bacteria and other microbes early in life may be an underlying cause of EoE

Living With Food Allergies

Esophagitis can occur as a result of chemotherapy or radiation therapy for treating cancer, particularly of the thorax. One of the more common causes is radiation treatment for lung cancer.

The esophagus is vulnerable to radiotherapy injury due to its continuous mucosal cell turnover, with mucosal inflammation and basal epithelial thinning progressing to denudation (wearing away) and ulceration. Several months may be required for healing, if any, to occur.

A variety of systemic (body-wide) illnesses may make you prone to developing esophagitis.

These may include:

Shared Symptoms and Variations

The problem with associating symptoms with a specific type of esophagitis is that symptoms of esophagitis are often associated with other physical symptoms. Mild acid reflux, for example, would present in a much less pronounced way than esophagitis due to ingestion of a caustic substance.

Many of the symptoms related to esophagitis include:

Symptoms of esophagitis, pain in particular, are particularly severe in cases oferosive esophagitis, in which your esophagus has begun to ulcerate or erode.

Diagnosing Esophagitis Type

Your healthcare provider will assess and test for certain types of esophagitis based on your symptoms, current situation, and medical history (recent cancer treatment, for example, would be a big clue).

You will probably need at least one of the following diagnostic procedures, as blood draws will not help differentiate what is causing your symptoms. Typically, an endoscopy would be the first test, but not always.

Endoscopy

Also known as an esophagogastroduodenoscopy (EGD), this is performed as an outpatient procedure. A gastroenterologist will look at your esophagus, stomach, and upper intestine with a scope. They will check for signs of inflammation or ulceration and attempt to identify any causes of your symptoms.

Biopsies are usually taken to look for any infectious causes.

You will be given conscious sedation, so you will need to have someone drive you home after the procedure.

If you ingested a caustic substance, you will need to have an endoscopy within 24 hours to evaluate damage to your esophagus. Sometimes, if the injury is thought to be very severe, endoscopy may be deferred until a later date to minimize risk of exacerbating the injury with the endoscope.

Barium Swallow Study

Abarium swallow studyis also known as an esophagography.A clinician will take X-rays of your esophagus while you ingest barium with some food.

The barium coats your esophagus, which then shows up white on imaging. This will allow your healthcare provider to see if you have any obstructions or narrowing in your esophagus.

The barium swallow study is helpful to help determine if your healthcare provider needs to considercanceras a possible cause of your symptoms. If cancer is being considered, acomputed tomography (CT)scan may also be ordered.

Esophageal Manometry

A third possibility is theesophageal manometryexam, which measures how well your esophagus is working. Your healthcare provider will insert a pressure-sensitive tube through your nose, down your esophagus, and into your stomach.

As your healthcare provider pulls the tube back out, you will be asked to swallow. The tube measures the pressure of the esophageal contractions.

Other Tests

It is possible that further type-specific testing may be necessary to confirm the diagnosis.

The lesions found during an endoscopy are generally white to yellow in coloration.Candidais often found to be plaque-like, while HSV or CMV is more likely to have ulcers.

With cases of EoE, a biopsy sample collected during endoscopy will reveal the presence of eosinophils—white blood cells that are part of your immune system and that are not normally present in the esophagus.That would prompt a gastroenterologist to refer you to an allergist forallergy testing, which can include:

Identifying the exposure(s) causing an allergic response in your esophagus is necessary to determine an avoidance plan that can reduce your symptoms.

In some cases, you may be able to identify the instigating foods to avoid as a result of the above tests. However, this may not always identify all the foods you should avoid. In this case, your healthcare provider may recommend afood elimination diet, which removes common foods from your diet.

Treatment Approaches

Given the range of possible causes behind the types of esophagitis, it’s easy to see why there is no one-size-fits-all approach to treatment.

The possibilities range from dietary changes to avoidance strategies, medications to surgery depending on the type of esophagitis.

Watch and Wait

If you do not have any adverse symptoms afteringesting a caustic substance, you may only be watched for a few hours. However, if you have symptoms of esophageal damage, you will need to be admitted to the hospital for medical management.

Proton Pump Inhibitors

Proton pump inhibitors (PPIs) like Prilosec (omeprazole) or Dexilant (dexlansoprazole) are indicated forreflux esophagitis.

You should be treated with a PPI for four to eight weeks. After at least four weeks, your healthcare provider should reevaluate your symptoms.

If after you have recurrent issues with esophagitis related to GERD or have Barrett’s esophagus, you will likely need ongoing PPI therapy.

Oral Solutions

Treatment ofesophagitis related to chemo and radiationwill involve viscous lidocaine to numb your esophagus.

As sucralfate, an antacid, can help treat any ulcers, many patients are prescribed “magic mouthwash”—a gargle that contains these two ingredients.

If the chemotherapy or radiation therapy causes permanent strictures or narrowing of your esophagus, you may need to undergo periodic endoscopies todilate your esophagus.

Corticosteroids

Whilecorticosteroidslike prednisone are commonly used for the treatment ofesophagitis related to systemic illness,you should always discuss the best treatment method with your healthcare provider.

Prednisone is, however, the treatment of choice if you are diagnosed withaphthous esophagitis.

In 2024, the Food and Drug Administration (FDA) approved Eohilia (budesonide suspension) for the treatment of EoE in people 11 years and older. It is the first and only approved oral treatment for EoE and is taken twice daily for 12 weeks.

Potassium-competitive acid blocker (PCAB)

Monoclonal Antibodies

Other Medications

If you are diagnosed with aCandidainfection, you’ll most likely be prescribed an anti-fungal medication. If you are diagnosed with aviral infection, like HSV or CMV, then your healthcare provider will prescribe an antiviral.

Medication Cessation

Treatment for any type ofmedication-induced esophagitisconsists of stopping the medication. If you are unable to stop the medication, your healthcare provider may order a liquid version.

In general, medication-induced esophagitis will resolve quickly without any long-term effects if the damage is stopped early. Typically you will see improvements in as soon as a few days.

Never stop taking a medication without your prescribing healthcare provider’s approval.

Dietary Changes

Cases ofEoEcan be addressed with changes to your diet so that what causes the allergic reaction is eliminated. Testing can help you identify what foods are at the heart of your esophagitis.

A Word From Verywell

While these seven types of esophagitis comprise the main causes of esophagitis, there are many other less common causes. Esophagitis can be very serious, and it’s important to understand what type you have so you can work with your healthcare provider to treat it correctly.

Chronic esophagitis can destroy the tissue of the esophagus. Given the organ’s role in the most basic bodily function—digesting food—it’s vital to monitor its health, particularly if you have other conditions that can contribute to esophagitis.

14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Diabetes and Digestive and Kidney Diseases.Acid reflux (GER and GERD) in adults.Furuta GT, Katzka DA.Eosinophilic esophagitis.N Engl J Med. 2015;373(17):1640‐1648. doi:10.1056/NEJMra1502863Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914Contini S, Scarpignato C.Caustic injury of the upper gastrointestinal tract: a comprehensive review.World J Gastroenterol. 2013;19(25):3918-30. doi:10.3748/wjg.v19.i25.3918Saleem F.Drug Induced Esophagitis. StatPearls [Internet].Baker S, Fairchild A.Radiation-induced esophagitis in lung cancer.Lung Cancer (Auckl). 2016;7:119-127. doi:10.2147/LCTT.S96443National Institutes of Health. MedlinePlus.Systemic.Careta MF, Romiti R.Localized scleroderma: clinical spectrum and therapeutic update.An Bras Dermatol.2015;90(1):62-73. doi:10.1590/abd1806-4841.20152890MedlinePlus.Esophagitis.Hazelwood RJ, Armeson KE, Hill EG, Bonilha HS, Martin-Harris B.Identification of swallowing tasks from a modified barium swallow study that optimize the detection of physiological impairment.J Speech Lang Hear Res.2017;60(7):1855-1863. doi:10.1044/2017_JSLHR-S-16-0117MedlinePlus.Esophageal manometry.Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: who is “guilty” when acid is found “not guilty”?.World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011Mermelstein J, Mermelstein AC, Chait MM.Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole.Clin Exp Gastroenterol.2016;9:163-172. doi:10.2147/CEG.S91602Kim SH, Jeong JB, Kim JW, et al.Clinical and endoscopic characteristics of drug-induced esophagitis.World J Gastroenterol.2014;20(31):10994-10999. doi:10.3748/wjg.v20.i31.10994Additional ReadingAmerican Academy of Allergy, Asthma, and Immunology website.Eosinophilic Esophagitis (EoE).

14 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Diabetes and Digestive and Kidney Diseases.Acid reflux (GER and GERD) in adults.Furuta GT, Katzka DA.Eosinophilic esophagitis.N Engl J Med. 2015;373(17):1640‐1648. doi:10.1056/NEJMra1502863Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914Contini S, Scarpignato C.Caustic injury of the upper gastrointestinal tract: a comprehensive review.World J Gastroenterol. 2013;19(25):3918-30. doi:10.3748/wjg.v19.i25.3918Saleem F.Drug Induced Esophagitis. StatPearls [Internet].Baker S, Fairchild A.Radiation-induced esophagitis in lung cancer.Lung Cancer (Auckl). 2016;7:119-127. doi:10.2147/LCTT.S96443National Institutes of Health. MedlinePlus.Systemic.Careta MF, Romiti R.Localized scleroderma: clinical spectrum and therapeutic update.An Bras Dermatol.2015;90(1):62-73. doi:10.1590/abd1806-4841.20152890MedlinePlus.Esophagitis.Hazelwood RJ, Armeson KE, Hill EG, Bonilha HS, Martin-Harris B.Identification of swallowing tasks from a modified barium swallow study that optimize the detection of physiological impairment.J Speech Lang Hear Res.2017;60(7):1855-1863. doi:10.1044/2017_JSLHR-S-16-0117MedlinePlus.Esophageal manometry.Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: who is “guilty” when acid is found “not guilty”?.World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011Mermelstein J, Mermelstein AC, Chait MM.Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole.Clin Exp Gastroenterol.2016;9:163-172. doi:10.2147/CEG.S91602Kim SH, Jeong JB, Kim JW, et al.Clinical and endoscopic characteristics of drug-induced esophagitis.World J Gastroenterol.2014;20(31):10994-10999. doi:10.3748/wjg.v20.i31.10994Additional ReadingAmerican Academy of Allergy, Asthma, and Immunology website.Eosinophilic Esophagitis (EoE).

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institutes of Diabetes and Digestive and Kidney Diseases.Acid reflux (GER and GERD) in adults.Furuta GT, Katzka DA.Eosinophilic esophagitis.N Engl J Med. 2015;373(17):1640‐1648. doi:10.1056/NEJMra1502863Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914Contini S, Scarpignato C.Caustic injury of the upper gastrointestinal tract: a comprehensive review.World J Gastroenterol. 2013;19(25):3918-30. doi:10.3748/wjg.v19.i25.3918Saleem F.Drug Induced Esophagitis. StatPearls [Internet].Baker S, Fairchild A.Radiation-induced esophagitis in lung cancer.Lung Cancer (Auckl). 2016;7:119-127. doi:10.2147/LCTT.S96443National Institutes of Health. MedlinePlus.Systemic.Careta MF, Romiti R.Localized scleroderma: clinical spectrum and therapeutic update.An Bras Dermatol.2015;90(1):62-73. doi:10.1590/abd1806-4841.20152890MedlinePlus.Esophagitis.Hazelwood RJ, Armeson KE, Hill EG, Bonilha HS, Martin-Harris B.Identification of swallowing tasks from a modified barium swallow study that optimize the detection of physiological impairment.J Speech Lang Hear Res.2017;60(7):1855-1863. doi:10.1044/2017_JSLHR-S-16-0117MedlinePlus.Esophageal manometry.Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: who is “guilty” when acid is found “not guilty”?.World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011Mermelstein J, Mermelstein AC, Chait MM.Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole.Clin Exp Gastroenterol.2016;9:163-172. doi:10.2147/CEG.S91602Kim SH, Jeong JB, Kim JW, et al.Clinical and endoscopic characteristics of drug-induced esophagitis.World J Gastroenterol.2014;20(31):10994-10999. doi:10.3748/wjg.v20.i31.10994

National Institutes of Diabetes and Digestive and Kidney Diseases.Acid reflux (GER and GERD) in adults.

Furuta GT, Katzka DA.Eosinophilic esophagitis.N Engl J Med. 2015;373(17):1640‐1648. doi:10.1056/NEJMra1502863

Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914

Contini S, Scarpignato C.Caustic injury of the upper gastrointestinal tract: a comprehensive review.World J Gastroenterol. 2013;19(25):3918-30. doi:10.3748/wjg.v19.i25.3918

Saleem F.Drug Induced Esophagitis. StatPearls [Internet].

Baker S, Fairchild A.Radiation-induced esophagitis in lung cancer.Lung Cancer (Auckl). 2016;7:119-127. doi:10.2147/LCTT.S96443

National Institutes of Health. MedlinePlus.Systemic.

Careta MF, Romiti R.Localized scleroderma: clinical spectrum and therapeutic update.An Bras Dermatol.2015;90(1):62-73. doi:10.1590/abd1806-4841.20152890

MedlinePlus.Esophagitis.

Hazelwood RJ, Armeson KE, Hill EG, Bonilha HS, Martin-Harris B.Identification of swallowing tasks from a modified barium swallow study that optimize the detection of physiological impairment.J Speech Lang Hear Res.2017;60(7):1855-1863. doi:10.1044/2017_JSLHR-S-16-0117

MedlinePlus.Esophageal manometry.

Grossi L, Ciccaglione AF, Marzio L.Esophagitis and its causes: who is “guilty” when acid is found “not guilty”?.World J Gastroenterol. 2017;23(17):3011-3016. doi:10.3748/wjg.v23.i17.3011

Mermelstein J, Mermelstein AC, Chait MM.Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole.Clin Exp Gastroenterol.2016;9:163-172. doi:10.2147/CEG.S91602

Kim SH, Jeong JB, Kim JW, et al.Clinical and endoscopic characteristics of drug-induced esophagitis.World J Gastroenterol.2014;20(31):10994-10999. doi:10.3748/wjg.v20.i31.10994

American Academy of Allergy, Asthma, and Immunology website.Eosinophilic Esophagitis (EoE).

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