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Causes of chronic esophagitis
Last reviewed: 04.07.2025
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Alimentary chronic esophagitis
They occur as a result of constant trauma to the mucous membrane of the esophagus from hot, spicy, too cold, rough food, as well as from alcohol abuse.
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Occupational chronic esophagitis
They develop as a result of constant exposure of the esophageal mucosa to harmful industrial factors (vapors of concentrated acids, alkalis, heavy metal salts, etc.).
Chronic congestive esophagitis
Caused by constant and prolonged stagnation and decomposition of food in the esophagus. This is observed in diverticula, benign and malignant stenosis of the esophagus and achalasia of the cardia.
Allergic chronic esophagitis
They are caused by altered reactivity of the body, especially often in children, and develop with food allergies, sometimes bronchial asthma, achalasia of the cardia, and esophageal diverticula.
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Dysmetabolic chronic esophagitis
They occur with polyhypovitaminosis; iron deficiency in the body (sideropenic dysphagia or Plummer-Vinson syndrome); tissue hypoxia of any genesis (congestive heart failure, chronic respiratory failure); extensive skin burns (Batga-Vinson syndrome); with portal hypertension (due to impaired trophism of the esophageal mucosa).
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Peptic chronic esophagitis or reflux esophagitis
They develop as a result of constant reflux of gastric or duodenal contents into the esophagus .
Special forms of esophagitis
This group includes “idiopathic ulcerative esophagitis” (has some common morphological features with nonspecific ulcerative colitis) and nonspecific regional stenosing esophagitis.
Non-specific regional stenosing esophagitis ( chronic fibrous esophagitis ) is a special form of chronic esophagitis characterized by transmural non-specific granulomatous inflammation of the esophagus, thickening of its wall and almost complete obliteration of the lumen. The lesion of the esophagus resembles Crohn's disease, but unlike the latter, the cellular composition of the granuloma does not contain eosinophils and giant cells. The etiology of the disease is unknown.
The disease develops predominantly in young people (up to 25-30 years old) equally often in women and men.
The onset of the disease is gradual.
The main symptoms of chronic fibrous esophagitis:
- gradually increasing dystrophy when eating mainly solid food;
- retrosternal pain, which usually accompanies dysphagia;
- vomiting and regurgitation of food. The volume of vomit depends to a certain extent on the level of esophageal stenosis. If the stenosis is localized in the upper third of the esophagus, vomiting occurs immediately after eating, and the volume of vomit is relatively small. With distal stenosis, the volume of vomit is larger, since it contains food eaten recently, as well as the day before.
X-ray examination of the esophagus reveals a pronounced circular narrowing of the lumen. Due to the high degree of stenosis, barium enters the distal part of the esophagus in a very thin stream or (in the most severe cases) does not enter at all. Suprastenotic dilation of the esophagus is also characteristic.
Esophagoscopy reveals congestive esophagitis, which is manifested by hyperemia and loosening of the mucous membrane, contact bleeding, erosions, and, less commonly, granulation .
The disease progresses quite quickly. Complete obstruction of the esophagus occurs within 3-7 months from the onset of the disease.
Non-specific regional stenosing esophagitis must be differentiated from esophageal cancer. This is possible only on the basis of histological examination of targeted biopsies of the esophageal mucosa.
Specific chronic esophagitis
The cause of specific esophagitis may be tuberculosis, syphilis, candidomycosis. This group of esophagitis is rarely observed. The group of specific esophagitis may also include esophageal lesions in systemic scleroderma, although this is somewhat conditional, since the changes in the esophagus in this disease do not fully correspond to the generally accepted concept of esophagitis.
Traumatic chronic esophagitis
Trauma and foreign bodies can cause the development of chronic esophagitis, since the consequences of trauma are usually accompanied by an infectious and inflammatory process.