Medical expert of the article
New publications
Chronic nonspecific esophagitis
Last reviewed: 04.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Chronic nonspecific esophagitis, as a rule, develops from acute esophagitis and is practically based on the same etiological factors. They can be characterized by the formation of non-healing ulcers, the occurrence of long-term inflammatory processes with its cicatricial stenosis, tumors. Chronic esophagitis can be both nonspecific and specific (tuberculosis, syphilis, actinomycosis).
Read also: Chronic esophagitis
[ What causes chronic nonspecific esophagitis?
Chronic non-specific esophagitis usually occurs as a result of prolonged irritation of the mucous membrane, loss of its protective properties and infection with normal pathogenic or opportunistic microbiota, in rare cases - as a complication of acute esophagitis. In the initial period, the disease is almost asymptomatic and remains unnoticed for a long time. Minor but constantly accumulating consequences of microtraumas (traumatic genesis) caused by such reasons as insufficiently effective chewing process (chewing efficiency, according to dental calculations, is less than 40%), tachyphagia, constant use of too cold or hot liquid drinks and spicy dishes, abuse of tobacco smoking, strong alcoholic drinks, etc.
Infectious lesions constitute the etiologic group of chronic nonspecific esophagitis, as numerous as the group of traumatic chronic nonspecific esophagitis. The cause of these lesions, which occur secondarily, are chronic purulent-inflammatory processes in the nasal cavity or pyogenic forms of gum disease, periodontal disease, chronic caseous tonsillitis, in which infected secretions for a long time together with saliva enter the esophagus when it is swallowed and penetrate the mucous membrane, infecting it. The latter can also occur with retrograde infection in the esophagus in inflammatory diseases of the gallbladder, bile ducts, liver, duodenum, stomach, as well as in inflammatory processes in tissues located outside the esophagus, but tightly adjacent to it (pleurisy, mediastinitis, etc.).
Obstructive phenomena (strictures, cicatricial stenosis, long-term functional spasms, tumors, etc.) also contribute to the development of chronic nonspecific esophagitis, since they contribute to the stagnation of food masses in the esophagus, their decomposition, fermentation and putrefactive decay, which leads to irritation of the mucous membrane and its infection.
Chronic nonspecific esophagitis may occur as a result of vegetative-vascular dysfunctions of local and central genesis, as a consequence of neurotrophic dysregulation of the entire gastrointestinal tract, as well as as a result of prolonged reflux of acidic gastric contents, causing irritation and then peptic ulcers of the mucous membrane (peptic esophagitis). These disorders are especially common with gastric ulcers and after its resection, after various cardioplastic operations and the imposition of esophageal-gastric anastomoses.
Chronic non-specific esophagitis can be promoted by professional factors associated with the presence of caustic liquid vapors in the inhaled air, which, dissolving in the mucus of the oral cavity, are swallowed together with saliva and irritate the mucous membrane of the esophagus. Dust particles formed during abrasive processing of porcelain, earthenware, various metals, as well as, in the latter case, formed during electric welding, have a similar property. It should be noted that "chemical" chronic esophagitis occurs in workers in tobacco and vodka production, cooks, in the production of cement, gypsum, alabaster, etc.
Symptoms of chronic nonspecific esophagitis
The syndrome that occurs with chronic non-specific esophagitis is most often characterized by insufficiently clear, often transient signs, which, due to their vagueness at the initial stages of the disease, are not significant enough to establish a diagnosis of chronic esophagitis. The most common symptom is a burning sensation behind the breastbone or in the epigastric region, which occurs when the food bolus passes through the esophagus, sometimes accompanied by a sensation of slow movement of food. This sensation forces the patient to make additional swallowing movements and forced head movements with its forward tilt. To facilitate the swallowing movement, the patient is forced to constantly wash down each sip with a small portion of water while eating dense food.
With the progression of chronic nonspecific esophagitis, spontaneous or functionally dependent pain in the sternum may occur, especially when a dense food lump passes through the esophagus, often radiating to the back. With peptic esophagitis, straining, forward bending of the body or its extension facilitate the entry of gastric juice into the lumen of the esophagus, which causes increased heartburn and even pain in the area of the xiphoid process (pain symptom of position). With "chemical" esophagitis, pain occurs periodically, interrupted by long periods of remission. Another important symptom is belching mucus, sometimes with an admixture of blood, which indicates the appearance of neuromuscular dysfunction and disruption of the integrity of the mucous membrane vessels (ulcers) in the picture of chronic nonspecific esophagitis.
Long-term chronic nonspecific esophagitis, manifested by dysphagia, bleeding, and repeated infection of the esophagus, leads to a deterioration in the general condition of the patient, his emaciation, and the occurrence of pathomorphological changes in the tissues of the esophagus (retractile fibrosis of its walls, malignancy of the ulcerated mucous membrane).
Where does it hurt?
Diagnosis of chronic nonspecific esophagitis
The diagnosis is established by esophagoscopy, an X-ray examination of the esophagus and stomach. Esophagoscopy reveals signs typical for each form of chronic nonspecific esophagitis. Thus, in the case of an infectious nature of the disease, the mucous membrane is hyperemic and thickened, covered with a mucous or mucopurulent exudate of a greenish-gray color, and individual ulcers are often detected. In chemical esophagitis, similar changes in the mucous membrane are observed, with the only difference being that they are localized in the upper section of the esophagus. In esophagitis caused by food retention, in addition to the primary cause of stasis (diverticulum, stricture, spasm, etc.), hyperemia of the mucous membrane, its edema, hemorrhages into it and spastic contractures are detected. In chronic peptic esophagitis, the mucous membrane of the lower third of the esophagus is sharply hyperemic, edematous, covered with erosions and hemorrhages; the cardiac part is significantly inflamed and dilated, and the gastric mucosa can prolapse through it.
What do need to examine?
Who to contact?
Treatment of chronic non-specific esophagitis
Treatment of chronic nonspecific esophagitis is aimed primarily at eliminating the cause of the disease, the identification of which is realized during a comprehensive examination of the patient, including the study of his autonomic nervous system, the functional and organic state of the gastrointestinal tract and upper respiratory tract. If necessary, they resort to tube feeding, as well as to the elimination of anatomical defects of the esophagus and tumor diseases. Non-surgical treatment of chronic nonspecific esophagitis is the competence of gastroenterologists, surgical - the competence of thoracic surgeons.
Drugs