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Erosive Esophagitis

By Kristle Lee Lynch, MD, Assistant Professor of Medicine, Perelman School of Medicine at The University of Pennsylvania

Erosive esophagitis is a condition in which areas of the lining of the esophagus are inflamed and worn away (eroded).

The esophagus is the hollow tube that leads from the throat (pharynx) to the stomach.

The most common cause of erosive esophagitis is

Corrosive substances, such as cleaning solutions, can erode the esophagus if they are swallowed accidentally or deliberately. Some pills (for example, aspirin or other nonsteroidal anti-inflammatory drugs [NSAIDs], alendronate, doxycycline, tetracycline, and certain large iron and potassium tablets) can cause painful erosions if they lodge temporarily in the esophagus.

Diagnosis

  • Esophagoscopy (upper endoscopy)

The diagnosis of erosive esophagitis is made by esophagoscopy (upper endoscopy). In this procedure, a flexible viewing tube called an endoscope is passed through the mouth and used to examine the esophagus.

Treatment

  • Treatment depends on the cause

For chronic acid reflux, doctors give proton pump inhibitors, which are drugs that reduce stomach acid production.

For corrosive substances, doctors treat depending on the substance swallowed. Most importantly, a person who has swallowed a corrosive substance should not be made to vomit because corrosive substances can cause as much damage returning up the esophagus as they did when swallowed. Because swallowed corrosive substances can cause life-threatening complications, people are often hospitalized and monitored by doctors in an intensive care unit (ICU).

Rarely, sores caused by corrosive substances or pills do not go away, leading to narrowing (stricture) of the esophagus. If strictures develop, they can be treated with various techniques for widening (dilating) the esophagus.