Esophagitis Treatment​ in Hyderabad, India

PACE Hospitals is recognized as the best hospital for esophagitis treatment in Hyderabad, India, providing expert care for patients with difficulty swallowing, chest pain, heartburn, and acid reflux. Our team of gastroenterologists specializes in reflux, infectious, drug-induced, and eosinophilic esophagitis.

As the best esophagitis hospital in Hyderabad, we use advanced diagnostics like endoscopy, biopsy, and pH monitoring to design personalized treatment plans. Options include lifestyle changes, medications, dietary guidance, and minimally invasive or surgical procedures when required. Our focus is on reducing inflammation, relieving symptoms, and restoring normal digestive health.

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Esophagitis Treatment

Why Choose PACE Hospitals for Esophagitis Treatment​?

Esophagitis, or inflammation of the esophagus, is diagnosed through symptom assessment, physical examination, endoscopy, and sometimes biopsy. A gastroenterologist performs the physical exam and endoscopy to assess the esophageal lining. Biopsies may be taken to identify root causes, such as eosinophilic infiltration or infections.

The gastroenterologist considers the following before selecting the appropriate tests to diagnose esophagitis: 

• Medical history 
• Physical examination 

Medical history

An important first step in diagnosing esophagitis is reviewing the patient's medical history, with a particular focus on symptoms such as retrosternal chest pain, dysphagia (difficulty swallowing), odynophagia (painful swallowing), and recent medication use that may cause esophageal damage. A thorough history helps in effectively choosing additional diagnostic testing and management techniques. The following questions provide a systematic framework to evaluate the patient’s esophageal symptoms and associated issues.

• Do you experience chest pain or a burning sensation in your chest or throat?
• Do you have difficulty swallowing solids, liquids, or both?
• Do you feel pain when swallowing?
• Do you notice food or acid coming back up into your mouth?
• When did your symptoms start, and are they constant or intermittent?
• Do certain foods or activities make your symptoms worse or better?
• Are you currently taking any medications, especially antibiotics, painkillers, or pills that could irritate your esophagus?
• Have you been diagnosed with acid reflux, allergies, or asthma in the past?
• Do you smoke, drink alcohol, or consume spicy or acidic foods regularly?
• Have you experienced weight loss, vomiting blood, or black stools recently?
• Does anyone in your family have a history of esophageal diseases or allergies?

Physical examination 

Physical examination in esophagitis is often routine, especially in mild or reflux-related cases. Fever and tachycardia may be present in infectious forms. Patients may appear well or cachectic in severe or immunocompromised cases. Chest and abdominal exams are usually unremarkable, though wheezing can occur with reactive airway disease. Oral thrush may be seen in fungal infections. Lymph node, neck, and respiratory exams are typically normal. Diagnosis is confirmed by endoscopy and biopsy, not physical signs alone.

Diagnostic Evaluation of Esophagitis

Based on the above information, a gastroenterologist advises the diagnostic tests to detect esophagitis. The following are the tests that might be recommended to diagnose esophagitis:

• Laboratory tests 
• Complete blood count (CBC)
• Eosinophil Count
• IgE levels (Immunoglobulin E)
• HIV or immunocompromised status
• Biopsy
• Esophageal sponge test

• Imaging studies 
• Barium swallow (X-ray series)
• Esophageal pH testing

• Upper endoscopy (Esophagogastroduodenoscopy)

Laboratory tests 

• Complete blood count (CBC): It can be useful in the evaluation of esophagitis by providing supportive information. It may reveal anemia, which could suggest chronic blood loss due to esophageal inflammation or ulceration. Additionally, a rise in white blood cell count may indicate the presence of infection or ongoing inflammation, helping to guide further diagnostic and treatment decisions.
• Eosinophil count: The elevated levels may suggest eosinophilic esophagitis (EoE), an allergic inflammatory condition.
• IgE levels (Immunoglobulin E): They may be elevated in eosinophilic esophagitis or individuals with allergies.
• HIV or immunocompromised status: It can help assess immune function in patients suspected of having infectious esophagitis, such as that caused by Candida, Herpes, or CMV, especially in those with HIV (human immunodeficiency virus) or weakened immune systems.
• Biopsy: During endoscopy, small samples of esophageal tissue are collected and examined microscopically to recognise inflammation, infection, eosinophilic infiltration (especially in eosinophilic esophagitis), or other abnormalities. Biopsy is the gold standard for confirming the type and diagnosis of esophagitis.
• Esophageal sponge test: It is a less invasive, non-endoscopic method where a capsule attached to a string is swallowed to collect esophageal cells for analysis. It can assess inflammatory markers and eosinophil counts without requiring sedation.

Imaging studies

• Barium swallow X-ray: In this, the patient swallows a barium contrast solution, and X-rays are taken to visualize the esophagus. This test helps detect structural abnormalities such as strictures, narrowing, ulcers, or motility problems affecting the esophagus.
• Esophageal pH monitoring: It involves placing a probe in the esophagus to measure acid levels over 24 hours. This test is especially useful for diagnosing reflux esophagitis by quantifying acid exposure and identifying gastroesophageal reflux disease (GERD).

Upper endoscopy (Esophagogastroduodenoscopy)

This is the most essential diagnostic procedure, allowing direct visualization of the esophageal lining to detect redness, inflammation, ulcers, narrowing, or other changes. It also provides for biopsy sampling. EGD helps distinguish between different causes of esophagitis (e.g., reflux, infectious, eosinophilic).

Differential Diagnosis of Esophagitis

Esophagitis types often share similar symptoms like chest pain, swallowing difficulty, and heartburn, making symptom-based diagnosis difficult. Accurate diagnosis requires detailed history and tests, especially endoscopy and biopsy. The following are key differential diagnosis to consider:

• Gastroesophageal reflux disease (GERD) / Reflux esophagitis: A chronic condition where stomach acid frequently flows back into the esophagus, causing inflammation and irritation of the esophageal lining.
• Infectious esophagitis (Candida, HSV, CMV): It occurs mostly in immunocompromised individuals and is caused by infections like Candida (fungal), Herpes Simplex Virus, or Cytomegalovirus.
• Eosinophilic esophagitis: An allergic inflammatory condition marked by eosinophil buildup in the esophagus. It often presents with difficulty swallowing and needs differentiation from GERD.
• Pill-Induced esophagitis: It is caused by certain medications that become lodged in the esophagus, leading to localized irritation and inflammation.
• Radiation esophagitis: It results from radiation therapy to the chest or neck, causing inflammation and damage to the esophageal lining.
• Esophageal strictures and rings: The narrowing of the esophagus due to chronic inflammation or anatomical rings, often leading to progressive dysphagia (difficulty in swallowing).
• Esophageal malignancy (Cancer): The cancer of the esophagus can cause progressive dysphagia, weight loss, and pain, often requiring endoscopic and imaging evaluation.
• Achalasia: It is rare motility disorder where the lower esophageal sphincter fails to relax, and esophageal muscles lose coordinated movement, leading to difficulty swallowing, chest pain, and regurgitation.
• Diffuse esophageal spasm: It is a condition characterized by uncoordinated, powerful esophageal contractions that can cause chest pain and difficulty swallowing, often mimicking heart pain.
• Scleroderma: It is an autoimmune disease that can cause fibrosis and weakening of esophageal muscles, leading to poor motility and severe acid reflux due to a weakened lower esophageal sphincter.
• Crohn’s disease: It primarily affects the intestines. Crohn’s can involve the esophagus, causing inflammation, ulcers, and strictures that may result in pain and swallowing difficulties.
• Acute coronary syndrome and angina: The cardiac conditions that can mimic esophageal pain, requiring careful evaluation to rule out heart-related causes of chest discomfort.
• Peptic ulcer: It is a sore in the stomach or duodenal lining, usually due to H. pylori infection or the use of non-steroidal anti-inflammatory drugs (NSAIDs). It can mimic esophageal pain, especially when linked to acid reflux.
• Esophageal perforation or tear: It is a serious and potentially life-threatening condition where a hole forms in the esophagus, often due to trauma, forceful vomiting, or medical procedures.

Goals of Treatment for Esophagitis

Treatment for oesophagitis necessitates accurate diagnosis and specific measures to decrease inflammation and enhance patient health. The main goals of treating esophagitis are :

• To control symptoms such as chest pain, heartburn, and difficulty swallowing.
• To heal esophagitis (esophageal inflammation) and mucosal damage
• To prevent recurrent episodes of esophagitis
• To prevent other complications such as Barrett’s esophagus, strictures, bleeding, and progression to malignancy.

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Esophagitis, an inflammation of the esophageal mucosa, can result from a various causes including acid reflux, infections, medications, radiation, or eosinophilic infiltration. The clinical presentation and severity can vary widely, and effective treatment depends on identifying and treating the underlying cause. The treatment options include:

Non-pharmacological treatment

• Lifestyle and diet modifications: Avoiding trigger foods such as spicy, acidic, and caffeinated items helps reduce esophageal irritation and acid production. Consuming smaller meals and finishing eating several hours before bedtime can decrease reflux episodes.
• Weight management: Maintaining a healthy Body Mass Index (BMI) lowers intra-abdominal pressure, which in turn reduces the likelihood of acid reflux and esophageal irritation.
• Elevating head during sleep: Raising the head of the bed by several inches has been shown to decrease nighttime acid reflux by using gravity to remain stomach contents from flowing back into the esophagus.
• Avoiding tobacco and alcohol: Tobacco and alcohol are known to weaken the lower esophageal sphincter and cause direct irritation to the esophageal lining, worsening symptoms.
• Proper medication intake: Taking medications with ample water and remaining upright for at least 30 minutes afterwards helps prevent pill-induced injury to the esophagus.

Pharmacological therapy 

• Proton pump inhibitors (PPIs): These effectively reduce gastric acid secretion by irreversibly inhibiting the H+/K+-ATPase pump in parietal cells. This acid suppression promotes esophageal healing and reduces inflammation, with additional anti-inflammatory effects observed in eosinophilic esophagitis.
• H2-receptor antagonists: These drugs inhibit histamine action on H2 receptors of gastric parietal cells, decreasing acid production. They provide symptomatic relief and promote mucosal healing, although they are less potent and slower acting compared to PPIs.
• Steroids: Topical or systemic corticosteroids reduce eosinophilic inflammation in eosinophilic esophagitis by suppressing immune cell activation and cytokine production, thereby decreasing esophageal tissue inflammation and symptom severity.
• Monoclonal antibodies: The targeted biologics block specific inflammatory pathways involved in eosinophil recruitment and activation, providing symptom relief and histologic improvement in eosinophilic esophagitis patients refractory to conventional therapy.
• Antimicrobials: The antifungal agents treat Candida esophagitis by eliminating fungal infection. Antiviral medications are used for herpes simplex virus and cytomegalovirus esophagitis, respectively, targeting viral replication.
• Antacids: These act by neutralizing gastric acid in the esophagus, providing rapid symptomatic relief of heartburn and irritation, but they do not promote mucosal healing or address underlying inflammation.
• Analgesics: These are used primarily for pain control in severe esophagitis. Analgesics or pain killers help alleviate discomfort but do not treat the cause of inflammation.

Surgical management 

• Fundoplication: Fundoplication surgery involves wrapping the upper stomach around the lower esophagus to reinforce the lower esophageal sphincter (LES), preventing acid reflux. Long-term studies show it effectively relieves reflux symptoms and heals esophagitis in most cases, especially when the fundic wrap remains intact.
• Endoscopic dilation: Endoscopic dilation is used to treat esophageal strictures caused by chronic esophagitis. It involves widening narrowed esophageal segments using balloon or dilator tools, which improves swallowing and reduces obstruction. This minimally invasive procedure is often repeated to maintain esophageal patency and symptom relief.

Esophagitis Prognosis

The overall prognosis of esophagitis is favorable with prompt treatment, though outcomes vary based on the underlying cause. Recurrent cases may lead to anxiety and work absenteeism due to concerns over severe chest pain. If untreated, complications such as strictures, malnutrition, bleeding, perforation, and aspiration-related issues may occur. Immunocompromised patients are at higher risk for severe infections, causing pain, dysphagia, and weight loss. Patient education is essential, including advice to elevate the head of the bed, avoid lying down after meals, losing weight, and avoid caffeine, alcohol, smoking, and NSAIDs.

Frequently Asked Questions (FAQs) on Esophagitis Treatment

What is esophagitis?

Esophagitis is inflammation of the esophageal lining, often caused by acid reflux, infections, medications, or allergies. It results in symptoms like chest pain, heartburn, and difficulty swallowing. Inflammation can damage the mucosa and affect normal esophageal function. Early diagnosis and management help prevent complications and improve quality of life.

Can esophagitis cause high blood pressure?

Esophagitis affects only esophageal tissue and does not directly impact cardiovascular functions or blood pressure regulation. There is no clinical evidence relation between esophageal inflammation and high blood pressure (Hypertension). While discomfort from esophagitis might induce stress, it does not cause hypertension. Managing esophagitis focuses on healing the esophagus and symptom control.

What to eat with esophagitis?

A diet rich in bland, low-acid, low-fat foods is recommended for esophagitis. People need to avoid spicy, acidic (citrus, tomato), caffeinated, and fatty foods that worsen irritation. Foods like oatmeal, bananas, cooked vegetables, and lean proteins are soothing. Small, frequent meals can help reduce reflux and avoiding eating before bedtime can prevent nighttime symptoms.

Can esophagitis cause bleeding?

Severe esophagitis can cause erosions or ulcers in the esophageal lining, sometimes leading to bleeding. This bleeding may manifest as vomiting blood or black, tarry stools. Prompt medical evaluation is necessary as bleeding is a sign of severe mucosal damage that requires treatment to prevent complications.

How to cure reflux esophagitis naturally?

Natural management of reflux esophagitis includes lifestyle changes: losing weight, elevating the head during sleep, avoiding late meals, and eliminating foods and behaviours that trigger reflux, such as caffeine, alcohol, and smoking. These modifications reduce acid exposure, promote healing, and improve symptoms without medication.

How to treat esophagitis without medication?

Non-pharmacological treatment includes dietary changes to avoid irritants, weight reduction, quitting smoking, elevating the head during sleep, and avoiding lying down post-meals. These measures reduce reflux events and esophageal irritation, contributing to mucosal healing and symptom relief.

Is GERD and esophagitis the same?

Gastroesophageal Reflux Disease (GERD) is a condition where stomach acid refluxes into the esophagus. Esophagitis is the inflammation of the esophagus, which can be caused by GERD. Hence, GERD is a common cause but not synonymous with esophagitis, which may also arise from infections or other factors.

What does esophagus pain feel like?

Pain from esophageal inflammation is typically described as burning, squeezing, or sharp chest pain behind the breastbone. It may mimic cardiac pain, making clinical evaluation crucial. Pain can worsen with swallowing or reflux episodes.