Esophagitis

Esophagitis is inflammation of the lining of the esophagus, the muscular tube that connects the pharynx (throat) to the stomach. In children, it is usually the result of gastroesophageal reflux disease (GERD), eosinophilic esophagitis, infection or ingestion of corrosive substances (such as cleaning products or battery acid). Over time, esophagitis can lead to dysmotility, narrowing of the esophagus, or precancerous changes of the esophagus (Barrett's esophagus).

What are the symptoms of esophagitis?

Esophagitis is inflammation of the lining of the esophagus. This can lead to a variety of symptoms in children, including:

• heartburn
• chest pain
• coughing
• dysphagia (difficulty swallowing)
• pain when swallowing
• food getting stuck
• crossing growth curves
• avoidance of food textures

Left untreated, esophagitis may cause complications, such as:

• bleeding
• chronic respiratory illnesses
• failure to thrive
• esophageal strictures, narrowing of the esophagus that can make it difficult to swallow
• barrett's esophagus, a precancerous condition caused by long-term esophageal inflammation like GERD

What causes esophagitis?

Esophagitis is inflammation that typically occurs when your child's esophagus is exposed to irritating substances, whether that means corrosive products, food allergens or their own stomach acid. Your child is more likely to develop esophagitis if they have:

• GERD, which involves the chronic regurgitation of stomach acid
• eosinophilic esophagitis, an allergic reaction that can cause inflammation
• food allergies
• ingested corrosive substances, such as certain household cleaners and batteries
• ingested certain medications, including inhaled or swallowed steroids, doxycycline, tetracycline, iron supplements or nonsteroidal anti-inflammatory drugs
• compromised immunity
• infections, most commonly those involving Candida (yeast) or herpes simplex virus

How is esophagitis diagnosed?

Your child's doctor will conduct a physical examination and ask you and your child about any symptoms. They may also recommend certain tests to evaluate the esophagus, including:

• barium swallow x-ray (upper GI series)
• endoscopy
• esophageal manometry

How is esophagitis treated?

Treatment for esophagitis depends on the cause, but may include:

• proton-pump inhibitors or other medications to treat GERD
• elimination of allergens or medications to treat eosinophilic esophagitis
• oral steroids
• antibiotics, antivirals or antifungals to treat certain infections

How we care for esophagitis

Gastroenterologists at Boston Children's Hospital are skilled at diagnosing and treating patients with inflammation of the esophagus. There are different ways to manage this inflammation depending on the cause and the symptoms. Your care team will work out the best treatment plan depending on the cause from symptoms.