Signs and Symptoms of Esophagitis

Esophagitis causes inflammation of the esophagus, the muscular tube in your throat that carries foods and liquids from your mouth to your stomach. Inflammation can cause irritation and swelling of the esophageal tissues, leading to symptoms like difficulty swallowing, chest pain, and a sore throat.

There are many types of esophagitis, which are categorized based on their underlying causes. While some cases of esophagitis can develop suddenly and cause severe discomfort, it's more common for symptoms to develop gradually and worsen over time.

Some people with esophagitis experience intermittent symptoms that come and go, while others may experience constant pain and discomfort.

Common Symptoms 

When you swallow, food moves from your mouth to your throat. The upper esophageal sphincter opens, allowing food to enter the esophagus (also known as your food pipe), where muscles contract to move food down your throat and into your stomach. When your esophagus becomes inflamed, this process can be harder and may cause several symptoms. 

While there are many possible types of esophagitis, each type does share some common symptoms. For example:

• Dysphagia (difficulty swallowing): Depending on the severity of inflammation and damage to the esophagus, difficulty swallowing may make it hard to swallow food, saliva, or liquids. Food may get stuck in your throat, and severe inflammation may lead to a complete inability to swallow. 
• Odynophagia (painful swallowing): Pain when swallowing may feel like a squeezing or burning sensation ranging from mild discomfort to intense pain.
• Sore throat: Inflammation in the esophagus may lead to a chronic sore throat that feels raw or scratchy.
• Chest pain: If esophagitis is causing discomfort, it may feel like pressure or squeezing in your chest or a burning sensation.

Symptoms by Type

There are several types of esophagitis, which have varying symptoms depending on their underlying cause. 

Reflux Esophagitis Symptoms 

Reflux esophagitis occurs when the lower esophageal sphincter (LES), a muscular valve at the end of the esophagus, weakens or relaxes, allowing stomach contents to flow into the esophagus. Over time, repeated exposure to stomach acids irritates the esophageal tissues and leads to reflux esophagitis—the most common form of esophagitis. Symptoms of reflux esophagitis include:

• Heartburn: A burning sensation behind the breastbone that typically develops within an hour after eating
• Acid regurgitation: A sour, acidic, burning sensation in the throat or back of the mouth that occurs when stomach contents rise into the esophagus
• Globus sensation: Feeling a lump in your throat or as if something is stuck in your throat
• Water brash: More saliva in the mouth that can develop in response to stomach acids in the esophagus

Although less common, some people with reflux esophagitis may also develop: 

• Chest pain
• Chronic cough
• Sore throat 
• Hoarseness (a raspy or strained voice)

Infectious Esophagitis Symptoms 

Infectious esophagitis occurs when an infection affects the esophagus and causes inflammation. Bacteria, viruses, fungi, and yeasts, such as Candida, herpes simplex virus (HSV), and cytomegalovirus can all contribute to inflammation.

People with conditions that weaken the immune system, such as HIV/AIDS, cancer, or diabetes, and those who take medicines that suppress or weaken the immune system may also have a higher risk of developing infectious esophagitis.

Common symptoms of this type of esophagitis include:

• Difficulty swallowing
• Pain when swallowing
• Unintentional weight loss
• Chest pain 
• Abdominal pain
  
• Diarrhea 
• Vomiting 

Depending on the type of microorganism (e.g., bacteria, virus, etc.) causing the underlying infection, you may also develop: 

• Fever 
• Chills 
• Sore throat 
• Sores in the mouth or back of the throat
• Lethargy (low energy) 
• Dark, tarry stools (poops)

Eosinophilic Esophagitis Symptoms 

Eosinophilic esophagitis is an allergic condition in which eosinophils (white blood cells that play a role in the immune system) build up in the esophagus and release substances that cause inflammation.

People with allergic conditions, such as hay fever (seasonal allergies), food allergies, asthma, and eczema, are more likely to develop eosinophilic esophagitis.

Symptoms of eosinophilic esophagitis include:

• Difficulty swallowing 
• Food that gets stuck in the esophagus
• Chronic throat pain 
• Chest pain 
• Stomach pain
• Loss of appetite 
• Vomiting 
• Heartburn 

Medication-Induced Esophagitis 

Medication-induced esophagitis, or pill esophagitis, develops when oral medications or supplements get stuck in the esophagus and damage esophageal tissues as they dissolve.

Pill esophagitis is most likely to occur when taking large-sized pills or gelatin capsules, which are more likely to get lodged in the esophagus. Timed-release medications are also more likely to injure the esophagus, as the slow-release formulas can continuously damage the tissues until the pill completely dissolves. 

Symptoms of medication-induced esophagitis can develop shortly after taking the medication and may gradually worsen. These include: 

• Chest pain 
• Painful swallowing
• Heartburn 
• Sore throat 

Radiation-Induced Esophagitis 

Radiation-induced esophagitis is a possible side effect of radiation therapy for cancers affecting the chest and neck. Radiation therapy can damage the lining of the esophagus, leading to esophagitis. Symptoms may develop within weeks after receiving radiation therapy, but in some cases, it can take up to a year for radiation-induced damage to the esophagus to cause symptoms.

If you develop this type of esophagitis, you may experience the following symptoms: 

• Difficulty swallowing
• Loss of appetite 
• Nausea
• Painful swallowing 
• Sore throat
• Chest pain 

Symptoms in Children 

Esophagitis can occur in children, though less frequently than in adults. Symptoms of esophagitis can present differently in infants and children, especially those too young to verbally express or communicate what they are experiencing. Here are some symptoms that infants and toddlers might experience if they develop this condition:

• Feeding difficulties or refusal to eat 
• Frequent spitting up or vomiting
• Difficult gaining weight as they develop
• Trouble sleeping
• Fussiness or irritability during feedings 
  

Symptoms in school-aged and older children may look different and include:

• Difficulty swallowing 
• Choking or gagging during meals 
• Chest or abdominal pain 
• Vomiting
• Throat pain 
• Sleep problems
• Loss of appetite 
• Nausea 
• Food avoidance (avoiding certain textures or types of foods)

When to Contact a Healthcare Provider 

If you're experiencing symptoms of esophagitis, it's important to contact your healthcare provider to get the treatment you need and prevent the risk of complications. It's a good idea to see a healthcare provider if:

• You experience esophagitis symptoms that last longer than a few days
• Over-the-counter (OTC) medications, such as antacids, don't relieve symptoms like heartburn 
• Difficulty swallowing prevents you from eating or drinking as much as you should 
• You develop a fever or mouth sores

Some symptoms prompt a more urgent trip to a healthcare provider, such as urgent care. Seek immediate medical attention if you experience any of the following: 

• Severe chest pain that lasts more than a few minutes 
• Inability to swallow or food is stuck in your esophagus 
• Vomiting blood 
• Bloody stools
• New or worsening abdominal pain 

A Quick Review 

Esophagitis causes inflammation of the esophagus. There are several types of esophagitis, each with a distinct underlying cause and unique symptoms. Common symptoms include difficulty swallowing, chest pain, and painful swallowing. While esophagitis symptoms can develop suddenly, in most cases, they develop gradually and worsen over time. 

If you have persistent symptoms, seeing a healthcare provider can help you reduce symptoms and promote healing.