Corrosive Esophagitis

What is corrosive esophagitis?

Corrosive esophagitis is a condition where your esophagus is hurt or damaged by harmful substances. The damage may cause inflammation (swelling), scarring, and ulcers (tears). The esophagus is a soft hollow tube that connects your mouth to your stomach. Food and liquids pass through your esophagus to reach your stomach. The esophagus has muscles that help move food and liquids down into your stomach. Having your corrosive esophagitis treated may decrease the swelling and scarring in your esophagus.

What causes corrosive esophagitis?

• Radiation therapy: This is a procedure used to kill cancer cells (abnormal lumps of cells) or make them smaller. It uses strong x-ray beams to kill the abnormal cells. The power of these beams is set so that only the cancer cells get the strong x-rays. Sometimes, these beams may reach your esophagus and cause damage.
  
  
• Swallowing caustic substances: These are very strong chemicals or liquids that may damage your esophagus. Common chemicals that are swallowed include detergents, dishwashing liquids, and drain cleaners. Swallowing these will scar or break down tissues in your esophagus. Young children may swallow the substances by accident. Adolescents and adults may swallow them when trying to harm or kill themselves.
  
  
• Swallowing certain pills: Some pills may get stuck as you try to swallow them, and damage your esophagus. These pills may melt and release their contents in the esophagus causing damage. The pills that commonly cause this condition include antibiotics, pain medicines, and drugs for osteoporosis (weak bones). The pills may have harmful contents on their surface. These substances can damage your esophagus while the pill slides down it.

What increases my risk of having corrosive esophagitis?

• Age: Elderly people may need to take more medicines, and spend more time lying down. They also tend to have more problems with how their esophagus moves. The anatomy of an esophagus changes as a person ages. Any of these may cause pills to stay in the esophagus for a longer period of time.
  
  
• Esophagus problems: The esophagus has muscles that move food down into your stomach. Problems with these muscles may cause food or pills to get stuck in your esophagus.
  
  
• Dry mouth: Some medicines and diseases such as xerostomia (dry mouth syndrome) can cause a decrease in your saliva. Saliva protects the esophagus and allows food and liquids to pass down easily.
  
  
• Heart problems: Heart problems may cause your heart to become bigger. Your heart is found at the back of your esophagus. When your heart gets big, it may pinch the esophagus and block food or liquids passing through. This may also cause pills to get stuck and cause damage.
  
  
• Not taking pills correctly: Pills may get stuck in your esophagus when you do not drink enough water when taking them.

What are the signs and symptoms of corrosive esophagitis?

You may have any of the following:

• Chest pain: You may have very bad pain in the middle of your chest. The pain may be sudden or happen a few hours after taking a pill. The pain may also cause you to wake at night.
  
  
• Decreased appetite for food: You may not feel like eating if you have trouble swallowing food and liquids. You may not get enough nutrients, and you may lose weight and feel weak.
  
  
• Fever: You may have a fever caused by an infection or swelling in your damaged esophagus.
  
  
• Throwing up blood: You may throw up blood if tissues in your esophagus are badly damaged. You may lose a large amount of blood, and you may have anemia. When you have anemia, you can become very weak.
  
  
• Trouble swallowing: You may have pain and trouble swallowing foods or liquids. You may need to swallow many times before food or liquids go down your throat. This may happen when your esophagus is badly scarred or is very narrow.

How is corrosive esophagitis diagnosed?

Your caregiver may ask what symptoms you have and how bad they are. He may ask about any other health problems you have. He may ask what pills you have taken or if you have swallowed any chemicals or liquids. Tell your caregiver if you swallowed a chemical on purpose. Tell him if you are having treatments, such as radiation therapy. You may need one or more of the following:

• Barium swallow: This test is an x-ray picture of your throat and esophagus. The pictures let your caregiver see any scars, tears, or other problems inside your esophagus and stomach. Before having the test, you will need to drink a thick liquid with a special substance called barium. The barium will help your esophagus show up better on x-rays. Your caregiver will give you instructions on what to do for the test.
  
  
• Esophagogastroduodenoscopy: This is also known as an EGD. Caregivers use a long and flexible tube with a light and video camera in one end. This device will let them see inside your esophagus and stomach. Your caregiver will spray anesthesia medicine inside your mouth. This will stop you from throwing up and decrease any pain you might feel. Your caregiver will gently insert the tube to see your esophagus, stomach and your duodenum. The duodenum is the first portion of your intestine. Your caregiver will look for any bleeding, lumps, narrowing, scars, tears, or pill pieces.
  
  
• Biopsy: This is a procedure where your caregiver takes a small piece of tissue from your esophagus. Your caregiver may do this during an EGD. The sample will be sent to a lab for tests.

How is corrosive esophagitis treated?

You and your caregiver will work together to choose which treatment works best for you. You may also need to eat foods that are soft and easy to swallow while your esophagus heals. You may need one or more of the following, depending on the cause of your problem:

• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to treat or prevent infections caused by germs called bacteria.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation which is redness, pain, and swelling. There are many different reasons to take steroids. This medicine may help, but may also have side effects. Be sure you understand why you need steroids. Do not stop taking this medicine without your caregivers OK. Stopping on your own may cause a bad response.
    
    
  • Stomach acid medicines: These medicines make the food and acids in your stomach less harmful to tissues in your esophagus.
    
    
  • Anti-ulcer medicines: This medicine causes your stomach and esophagus to make a thick layer of mucus. This layer will protect the tissues from strong acids. Tears and wounds on your esophagus will heal better when they are covered by the mucus layer.
  
  
• Stopping some treatments: You may need to stop taking the pills that have harmed your esophagus. If you are receiving radiation therapy, it may also need to be stopped for a period of time. Stopping these treatments will give your esophagus time to heal. Do not stop any treatments without talking to your caregiver first.
  
  
• Treatment options: These may be needed if your esophagus is badly damaged or is bleeding.
  
  
  • Dilatation: A small balloon, dilator, or stent may be placed in your esophagus to dilate (widen) it. This is often done if there is a narrowing in a part of your esophagus. Your caregiver may need to repeat this procedure many times to help relieve your symptoms.
    
    
  • Surgery: Surgery may be needed if medicines and dilatation do not relieve your symptoms. A part of your esophagus may need to be removed. The removed area of your esophagus may be replaced by tissues from your colon.

What may I do to help prevent corrosive esophagitis?

You may do any of the following:

• Do not take your pills at bedtime or right before lying down. You should take them while standing up or sitting upright. Stay in an upright position for 10 to 15 minutes after taking your pills.
  
  
• If you have symptoms of corrosive esophagitis, avoid drinking coffee and eating spicy foods. Avoid drinking alcohol, sour fruit juices, and liquid products that may have tomato in them.
  
  
• Label bottles with harmful substances, and keep them out of the reach of children.
  
  
• Take medicines that come in liquid form if your esophagus is narrow. If no liquid form of your medicine is available, you may be able to crush the pill. The crushed pill can then be mixed with liquid to drink. Ask your caregiver for more information about how you should take your medicines.
  
  
• Take your pills one at a time, and swallow each one with 75 to 100 milliliters (ml) of liquid. This is equal to half a can of soda. This will help the pill slide down your esophagus quickly.

When should I call my caregiver?

Call your caregiver if:

• You have a fever.
  
  
• You have pain that does not decrease or go away after taking your medicine.
  
  
• You throw up and cannot keep food or liquids down.
  
  
• Your stomach feels very full, and you cannot burp or vomit (throw up).
  
  
• You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You are vomiting and it looks like coffee grounds or has blood in it.
  
  
• You suddenly have chest pain and trouble breathing.
  
  
• Your bowel movements are black, or are bloody.
  
  
• Your symptoms are getting worse.

Where can I find more information?

Contact the following for more information:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• National Digestive Diseases Information Clearinghouse (NDDIC)
  2 Information Way
  Bethesda , MD 20892-3570
  Phone: 1- 800 - 8915389
  Web Address: www.digestive.niddk.nih.gov
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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