A B C D E F G H I J K L M N O P R S T U V W

OESOPHAGITIS

How does Oesophagitis occur ?

If the muscle ring at the bottom of the gullet slides up through the diaphragm, it can no longer work properly as a valve: acid cannot be kept out of the gullet and oesophagitis occurs. This leads to the main symptoms. Oesophagitis can also occur after especially hot drinks and after alcohol binges. It is more common in smokers.

Why does Oesophagitis occur ?

A tendency to a sliding hiatus hernia and oesophagitis is not inherited. Overweight and pregnancy are the main factors which increase the abdomen pressure to produce it. Rolling hiatus hernia occurs because of a small hole in the diaphragm which has not closed. Usually this is due to an abnormality present since birth.

Treatment Involved for Oesophagitis

The doctor may be unsure of the diagnosis just on the basis of symptoms. He may want to exclude a peptic ulcer, which produces similar symptoms. A barium swallow x-ray, or an endoscopy, may be recommended to you. A barium swallow consists of swallowing liquid barium whilst x-rays are taken. Endoscopy consists of passing a narrow fibre-optic tube through the mouth into the stomach. The interior of the gullet and stomach can be clearly examined. Treatment consists of losing weight, if you are overweight. You should avoid tight clothing, sitting in deep armchairs and stooping, especially after meals. Lying down within 3 hours of eating needs to be avoided. Food should be taken frequently and in small amounts to avoid over-stretching the stomach. Avoidance of smoking is important in order to cut down acid production. Sometimes raising the head of the bed by 6 inches (using bricks) makes a difference. You are very likely to improve with these simple changes. Drugs are sometimes of benefit. Antacids (such as magnesium trisilicate or aluminium hydroxide) are drugs which neutralize the acid and reduce the irritation to the gullet. Alginate-containing liquids are taken after meals. They float on the surface of stomach contents and protect the inflamed end of the gullet. H 2 -blockers are given by tablet to reduce the production of acid. Anti-spasmodic drugs (like metoclopramide or domperidone) help the gullet to work better and strengthen the muscle ring. Omeprazole is the first of a new type of drug which reduces acid production. It is usually taken when symptoms are bad and is only occasionally used continuously. Drugs may be given only when symptoms are present, although H 2 -blockers are given more continuously. Surgery is used only if there is a blockage in the gullet due to scarring. This scarring is the long-term result of repeated inflammation. Sometimes a hiatus hernia needs to be dealt with surgically if medical treatment does not work.

During Treatment for Oesophagitis

Your symptoms will usually improve within a couple of weeks. Antacids can lead to diarrhoea or constipation and anti-spasmodics can produce muscle spasms, especially in the elderly. Older people may also occasionally become a little confused from H 2 -blockers. The doctor will want to check your response to treatment about 4 weeks after treatment starts.

After Treatment for Oesophagitis

The symptoms may return, especially if you do not correct the original causes like smoking and overweight.

If Oesophagitis is Left Untreated

Oesophagitis may not get better by itself. Then there is a risk of an ulcer forming. Rarely the gullet blocks off due to a band of scar tissue. This is called a stricture.

Effects on Family of Oesophagitis

They may be helpful in reminding you of the various measures needed to successfully treat this common problem.