Esophagitis is generally labeled by the condition that causes it. In some cases, it may have more than one cause. Some of the most common types include:
Reflux esophagitis
A valve called the lower esophageal sphincter usually keeps the acidic contents of the stomach out of the esophagus. But sometimes this valve doesn't close properly or opens when it shouldn't. The upper part of the stomach can sometimes slide into the chest above the diaphragm, known as a hiatal hernia. If this happens, the contents of the stomach may back up into the esophagus (gastroesophageal reflux).
Gastroesophageal reflux disease (GERD) is a condition in which this backflow of acid is a frequent or ongoing problem. A complication of GERD is ongoing inflammation and tissue damage in the esophagus.
Eosinophilic esophagitis
Eosinophils (e-o-SIN-o-fils) are white blood cells that play a key role in allergic reactions. Eosinophilic esophagitis can occur if there is a high concentration of these white blood cells in the esophagus. This is most likely in response to an allergy-causing agent (allergen), acid reflux or both.
In many cases, this type of esophagitis may be triggered by foods such as milk, eggs, wheat, soy, peanuts and seafood. However, typical allergy testing does not reliably identify these culprit foods.
People with eosinophilic esophagitis may have other nonfood allergies. For example, sometimes allergens in the air, such as pollen, may be the cause. The most common symptom of eosinophilic esophagitis is food impaction or trouble swallowing, also called dysphagia.
Lymphocytic esophagitis
Lymphocytic esophagitis (LE) is an uncommon esophageal condition in which there are an increased number of white blood cells known as lymphocytes in the lining of the esophagus. LE may be related to eosinophilic esophagitis or to GERD.
Drug-induced esophagitis
Several oral medicines may cause tissue damage if they remain in contact with the lining of the esophagus for too long. For example, if you swallow a pill with little or no water, the pill itself or residue from the pill may remain in the esophagus. Medicines that have been linked to esophagitis include:
- Pain-relieving medications, such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others).
- Antibiotics, such as tetracycline and doxycycline.
- Potassium chloride, which is used to treat potassium deficiency.
- Bisphosphonates, including alendronate (Fosamax), a treatment for weak and brittle bones, called osteoporosis.
- Quinidine, which is used to treat heart problems.
Infectious esophagitis
A bacterial, viral or fungal infection in tissues of the esophagus may cause esophagitis. Infectious esophagitis is fairly rare and occurs most often in people with poor immune system function, such as people with HIV/AIDS or cancer.
A fungus usually present in the mouth called Candida albicans is a common cause of infectious esophagitis. Such infections are often associated with poor immune system function, diabetes, cancer, or the use of steroid or antibiotic medications.