Esophagitis

James Metz, MD
Updated by: Lara Bonner Millar, MD
Abramson Cancer Center of the University of Pennsylvania
Last Modified: September 12, 2012

The esophagus is a muscular tube, which can be thought of as a "food pipe" that connects the throat to the stomach. Esophagitis is an inflammation of the esophagus that causes pain and discomfort with swallowing, or the sensation of a lump in the throat. Esophagitis is a common side effect of cancer treatment. Radiation therapy and chemotherapy may cause the cancer patient to develop esophagitis.

Radiation therapy may cause esophagitis in patients who are receiving treatment to the chest and neck area. This may include patients with esophageal cancer, lung cancer, Hodgkin's Disease, Non-Hodgkin's Lymphoma, and head and neck cancers. After 2-3 weeks of radiation therapy these patients may begin to notice discomfort with swallowing. Patients typically complain of burning in the neck and chest region. The discomfort will usually last through the completion of treatment with radiation therapy. The patient will start to notice improvement about 2 weeks after the completion of therapy. In most patients the esophagitis is resolved 4-6 weeks after the radiation therapy has finished.

Chemotherapy may also cause esophagitis. Certain chemotherapy drugs can cause diffuse irritation of the mucous membranes (mucositis). The esophagus is a muscular tube that is lined by a mucous membrane and may become irritated. Esophagitis usually occurs days after the administration of chemotherapy instead of weeks like the radiation therapy.

Patients who are on steroid treatments or have a suppressed immune system from their cancer treatments may develop an esophagitis due to a fungal infection (esophageal candidiasis). This is generally treated with anti-fungal oral medications. The esophagitis usually resolves over 1-2 weeks of treatment.

There are some ways for a patient to effectively deal with the symptoms of esophagitis:

Cut foods into small pieces and chew thoroughly before swallowing
Avoid hot or spicy foods
Avoid acidic foods such as tomato sauce and orange juice
Avoid tough, hard, and/or crunchy foods such as steak and potato chips
Drink plenty of cool liquids
Foods which are cold or at room temperature are easier to tolerate
Eat foods that will not distend or stretch the esophagus such as eggs, ice cream, milk shakes, etc.
Use nutritional supplements to maintain your weight (i.e. Carnation Instant Breakfast, Ensure, Boost, Scandishake)
Tell your physician about the symptoms. There are medications which may give relief of the symptoms