What Are the Treatments for Erosive Esophagitis?

Erosive esophagitis is a condition that is most often the result of an underlying problem. Treatment options depend on the cause of erosive esophagitis and can include medication, medical procedures or surgery. In most cases, doctors agree that lifestyle modifications are an important part of the total treatment plan.

Erosive Esphagitis: a Definition

The esophagus is the muscular tube that connects the throat to the stomach. A sphincter muscle at the base of the esophagus controls the flow of food into the stomach and keeps stomach acids, bile salts and pancreatic digestive juices from backing up into the esophagus. If these digestive juices splash back onto the delicate tissue lining the esophagus, damage can occur. Left untreated, this condition can progress to erosive esophagitis, a potentially dangerous erosion and ulceration of the walls of the esophagus. The most common symptoms of erosive esophagitis are a burning sensation in the throat, difficulty in swallowing or a sensation that the throat is obstructed, acid reflux or heartburn, and evidence of bleeding in the stool or vomit. A diagnosis of the underlying cause of this condition is necessary before a treatment plan can be established.

Diagnosing the Problem

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Acid reflux or GERD is a major cause of erosive esophagitis, however there are other causes as well. Esophageal tissue can become damaged by exposure to radiation or chemicals. Motility problems that affect the correct muscular function of the esophagus can lead to damage. Bacterial infections or prolonged, excessive vomiting can also result in erosive esophagitis. A hole in the diaphragm, or a hiatal hernia, can also precipitate this condition. If your doctor suspects you have erosive esophagitis she may order an endoscopy, a procedure that examines the interior walls of the esophagus. As part of the endoscopy, she may remove tissue samples for further analysis and test for bacterial infections. Manomeotry, a test that measures the pressure of the esophageal muscles during swallowing, and barium X-ray are diagnostic tools that are used in charting muscular function and motility problems.

Treatments - Medication

Early-stage GERD can be treated with antacids like Tums and H2 blockers such as Tagamet. For GERD patients with erosive esophagitis, proton pump inhibitors (PPIs) like Prilosec and Nexium are regularly prescribed. These drugs work to stop the production of stomach acids. For some patients, a combination of H2 blockers and PPIs are the most effective treatment. In cases of severe inflammation, your doctor may also prescribe a course of steroids. Antibiotics are the correct protocol if lab tests indicate the presence of a bacterial infection. There are no oral medications that have shown long-term success with motility issues, however botox injections relax the muscles in the esophageal wall, giving patients greater ability to swallow. These injections are not a permanent solution, and most doctors recommend they be repeated on a yearly basis.

Surgical Intervention & Other Procedures

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Patients with constriction and motility problems may be candidates for pneumatic dilation, a procedure where a thin tube with a balloon at the end, is inserted into the esophagus and gently inflated. This technique stretches the esophageal passageway and allows for more normal function. A hiatal hernia is a hole in the diaphragm that allows stomach tissue to press against the muscles at the juncture of the stomach and esophagus. Surgerical repair is the most successful treatment for this condition. Fundoplication surgery reinforces weakened sphincter muscles between the esophagus and stomach. In this procedure, the fundus, or upper passage of the stomach is tightened around the lower portion of the esophagus and anchored in place, eliminating the splash-back of stomach acid.

What You Can Do

Your doctor will outline changes you can make in your daily routine that can be very helpful in your recovery. Some of the recommendations include avoiding spicy or acidic foods and beverages. Tobacco and alcoholic beverages are well documented irritants to esophageal issue. Switching to 5 or 6 small, light meals a day can reduce the stress on your digestive system and selecting foods that are soft and easy to eat is also advised. Use a straw to avoid gulping large quantities of liquid. Gravity is your friend, so elevate the head of your bed with 6- to 8-inch blocks. These simple life-style modifications can help speed your recuperation and prevent further problems.