Esophagitis

Author: OncoLink Team
Content Contributor: James Metz, MD, Lara Bonner Millar, MD, and Allyson Distel, MPH
Last Reviewed: January 30, 2024

What is esophagitis?

The esophagus is a muscular tube that joins the throat to the stomach. Some people call it the food pipe. Esophagitis is an inflammation (swelling) of the esophagus that causes pain with swallowing or gives you the feeling of a lump in the throat. Esophagitis is a common side effect of some cancer treatments.

Which treatments may cause esophagitis?

Radiation therapy may cause esophagitis in patients who are getting treatment in the chest and neck area. This may be patients with esophageal cancer, lung cancer, Hodgkin's disease, non-Hodgkin's Lymphoma, and head and neck cancers. Esophagitis can happen after a few weeks of radiation from the tissue lining the esophagus being harmed.

After 2-3 weeks of radiation therapy, patients may feel discomfort with swallowing. Patients often say that esophagitis causes a burning feeling in the neck and chest area. For some patients, this side effect may affect eating and drinking. Your oncology team can help you find foods and liquids that you can eat comfortably. In some cases, patients may need a temporary (short-term) feeding tube to keep up with their nutrition and body weight until their esophagus heals.

The discomfort usually lasts through your radiation therapy treatment. Most patients will start to notice an improvement in these symptoms about 2 weeks after they are done therapy, as the tissue starts to heal. In most patients, the esophagitis has fully resolved by 4-6 weeks after radiation therapy is done.

Chemotherapy may also cause esophagitis. Certain chemotherapy medications can irritate the mucous membranes, called mucositis. The esophagus is a muscular tube that is lined by a mucous membrane and may become irritated. Esophagitis may occur days after having chemotherapy.

Patients who are on steroid treatments or have a suppressed immune system from their cancer treatments may get esophagitis which is caused by a fungal infection. This is called esophageal candidiasis. This is different than the esophagitis caused by the treatment and is most often treated with anti-fungal medications you take by mouth. Esophageal candidiasis often gets better after 1-2 weeks of anti-fungal treatment.

What can you do to manage esophagitis?

Some ways to manage esophagitis are:

  • Cut foods into small pieces and fully chew the food 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.
  • Avoid carbonated beverages and alcohol.
  • Drink plenty of cool liquids.
  • Popsicles and water/Italian ice can be soothing on your throat.
  • Foods that are cold or at room temperature are easier to tolerate.
  • Eat soft foods that will not distend or stretch the esophagus such as eggs, ice cream, milkshakes, etc.
  • Use nutritional supplements to maintain your weight. Talk to a dietitian if you are having trouble getting in the needed calories to maintain your weight.

When to contact your care team

If you are feeling esophagitis symptoms, contact your care team. They can prescribe medications and teach you ways to help manage these symptoms.

References

Baker, S., & Fairchild, A. (2016). Radiation-induced esophagitis in lung cancer. Lung Cancer (Auckland, N.Z.), 7, 119–127. doi:10.2147/LCTT.S96443

Medline Plus. Esophagitis. 2022.

NCBI. Nesheiwat Z et al. Radiation Esophagitis. 2023.

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