GERD esophagitis is a common condition that causes acid indigestion and damage to the esophagus. Doctors can treat it with medication and lifestyle changes, but some cases require surgery.

A woman sitting on the sofa drinking out of a cup and eating an avocado sandwich.Share on Pinterest
Ilona Titova/EyeEm/Getty Images

In Western countries, 10–20% of the population develop GERD esophagitis, one of the most common diseases gastroenterologists encounter. Tropical Latin America and East Asia had the highest and lowest age-standardized prevalence rate, respectively.

The condition causes acid regurgitation and inflammation of the esophagus lining, resulting in symptoms such as indigestion and burning pain.

This article explores GERD esophagitis and its causes, symptoms, and risk factors. It explains how doctors diagnose and treat the condition, lists other causes of esophagitis, and answers some frequently asked questions.

GERD esophagitis is when the stomach contents back up (reflux) into the esophagus, causing inflammation and damage.

The esophagus is the muscular channel that carries food from the throat to the stomach. Gastroesophageal reflux disease (GERD) develops when the stomach’s acidic contents flow back into the esophagus. This process can erode the tissue lining the esophagus, causing unpleasant symptoms and sometimes complications.

Doctors may also refer to GERD esophagitis as reflux esophagitis.

The typical symptoms of GERD esophagitis may include the following:

  • heartburn, which someone feels as a burning sensation behind the sternum within 60 minutes of eating
  • acid regurgitation, which someone may experience as a sour taste or burning fluid in the mouth
  • pain that radiates toward the neck
  • a sense of a lump in the throat
  • increased salivary secretions

Less typical symptoms include the following:

  • a chronic cough
  • chest pain
  • asthma
  • dental erosions
  • sore throat
  • voice disorders or spasms in the vocal cords

However, some people with severe esophagitis — Barrett’s esophagus — may be symptom-free and have no heartburn.

Experts suggest that the body usually neutralizes any reflux of stomach contents and clears it by the natural movements of the esophagus. However, with GERD esophagitis, the following factors may cause the disease to develop:

  • dysfunction of the lower esophageal sphincter
  • presence of a hiatus hernia
  • impairment of esophageal peristalsis (movement through the esophagus) or usual acid defense mechanisms
  • less saliva due to inflammation of the salivary glands or other causes
  • excess intra-abdominal fat or pressure

According to experts, some groups of people may be more at risk of GERD esophagitis, including:

Research has shown that there’s a higher prevalence of GERD esophagitis diagnoses in white males over 50 years old with a history of GERD esophagitis. Older research suggests a combination of factors, including genetic and environmental variables, may be the cause.

Doctors diagnose GERD esophagitis if someone presents with typical symptoms. Additionally, doctors may use the following methods to differentiate the disease and make a diagnosis:

  • endoscopy
  • pH (acid) and reflux monitoring
  • excluding cardiac causes of chest pain
  • seeing how people respond to GERD medication

Doctors may treat GERD esophagitis with medication along with dietary and lifestyle changes.

Medications

The American College of Gastroenterology (ACG) advises that the main prescription medications that doctors use to treat GERD are H2 receptor antagonists (H2 blockers) and proton pump inhibitors (PPIs). These medications reduce the amount of acid the stomach produces, decreasing the symptoms of heartburn and regurgitation.

Diet

The ACG and other experts note that doctors may advise someone to avoid large meals, foods, and drinks that can trigger GERD or irritate the damaged lining of the esophagus. These include:

  • fats
  • chocolate
  • caffeinated drinks
  • citrus juice
  • tomato juice
  • alcohol
  • peppermint

Lifestyle changes

The following strategies may help relieve the symptoms of GERD esophagitis:

  • losing weight if a person is overweight or has obesity
  • avoiding smoking if a person smokes
  • raising the head of the bed with a foam wedge under the mattress
  • wearing looser clothing
  • avoiding lying down for at least 3 hours hours after eating

However, if a person’s GERD esophagitis does not respond to their doctor’s medical management plan or the person’s body cannot tolerate the recommended medications, they may need surgery.

The ACG explains that surgery may involve strengthening the barrier between the stomach and esophagus. Usually, a doctor or gastroenterologist will consider this option following testing.

Experts note that many people with GERD esophagitis do well with medications, but those who stop treatment may have a relapse of symptoms.

GERD may cause complications such as Barrett esophagus, stricture, or peptic ulcers. Doctors may recommend surgery to manage long-term conditions.

Other causes of esophagitis include the following:

The following are answers to some frequently asked questions.

Is reflux esophagitis serious?

Reflux esophagitis is one of the most common diseases that gastroenterologists encounter. Many people can manage the condition with medications and lifestyle changes.

What are the causes of GERD esophagitis flares?

People may experience symptom flare-ups if they stop taking their GERD medication or consume foods or drinks that trigger symptoms. In addition, stress is a risk factor, so stressful periods may cause a flare.

What other conditions could be similar to GERD esophagitis?

Experts explain that doctors may need to make a differential diagnosis of some conditions with symptoms similar to GERD esophagitis, such as dyspepsia, peptic ulcer disease, and coronary artery disease.

What are the complications of GERD esophagitis?

Complications may include peptic ulcer, anemia, and dental erosions. Furthermore, 10% of people develop Barrett’s esophagus, which is a risk factor for esophageal adenocarcinoma — cancer of the esophagus.

GERD esophagitis is a common condition that causes heartburn and damage to the lining of the esophagus. Doctors treat the disease using medication along with dietary and lifestyle changes.

However, sometimes GERD esophagitis may not respond to treatment, or a person is unable to take the medications doctors recommend, in which case they may need surgery.

If GERD esophagitis is left untreated, it may lead to complications such as peptic ulcers or Barrett’s esophagus, which may be a risk factor for esophageal cancer.