Oesophagitis

Oesophagitis is inflammation of the oesophagus (food pipe). It commonly results from acid reflux (GORD), but can also be caused by allergy (eosinophilic oesophagitis), infections, or medications that irritate the lining. Symptoms range from heartburn to painful swallowing or food getting stuck.

At The New Foscote Hospital, we provide consultant-led assessment and onsite gastroscopy (OGD) with biopsies to confirm the cause and guide targeted treatment. Oesophageal dilatation can be performed when safe and clinically indicated for strictures.

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Symptoms

• Heartburn and acid taste in the mouth
• Chest discomfort or pain on swallowing (odynophagia)
• Difficulty swallowing or food sticking (dysphagia)
• Chronic cough, hoarseness, throat clearing
• Nausea, bloating, or early fullness
• Iron-deficiency anaemia if there is chronic bleeding

Urgent help (999/A&E): food completely stuck, vomiting blood, black stools, severe chest pain, or signs of shock (fainting, clammy skin, rapid pulse).

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Common Causes

• Acid Reflux (GORD): stomach acid/pepsin inflame the oesophageal lining.
• Eosinophilic Oesophagitis (EoE): immune-mediated; often linked to atopy (asthma, eczema, allergic rhinitis) and presents with dysphagia/food bolus obstruction.
• Infectious Oesophagitis: usually in immunosuppressed patients (e.g., Candida, HSV, CMV).
• Pill-Induced Injury: certain tablets (e.g., doxycycline, bisphosphonates, potassium, iron) if taken with little water or before lying down.
• Caustic Injury (rare), radiation or post-surgical changes.

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Diagnosis At New Foscote Hospital

Your consultant will tailor investigations based on symptoms and risk factors:

• Onsite Gastroscopy (OGD): visual assessment, biopsies to confirm cause (e.g., eosinophils in EoE), and to grade severity.
• pH/Impedance Testing and manometry may be recommended in selected cases (arranged via our network).
• Blood tests where indicated (e.g., anaemia).

Endoscopy – Gastroscopy
Imaging & Diagnostics
Meet Our Consultants

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Treatment

Management depends on the confirmed cause:

Reflux Oesophagitis (GORD)

• Proton Pump Inhibitors (PPIs) as first line (dose and duration per severity).
• Alginates/antacids for breakthrough symptoms.
• Lifestyle: weight optimisation, smaller meals, reduce late eating, elevate head of bed, limit alcohol, caffeine, and trigger foods; stop smoking.
• Strictures: endoscopic dilatation with continued acid suppression.

Eosinophilic Oesophagitis (EoE)

• Topical swallowed steroids (e.g., budesonide viscous or fluticasone) as first line.
• Dietary strategies (e.g., targeted elimination) guided by a specialist.
• Dilatation for fibrostenotic narrowing when needed, alongside anti-inflammatory therapy.

Infectious Oesophagitis

• Antifungal/antiviral therapy according to the organism; address underlying immunosuppression where possible.

Pill-Induced Oesophagitis

• Medication review/substitution, strict advice on tablet technique (full glass of water; stay upright for 30 minutes).

Your consultant will provide a personalised plan and follow-up; repeat endoscopy may be advised to document healing or assess strictures.

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Recovery And Self-Care

• Take medicines exactly as prescribed and complete the full course.
• Optimise meal timing (avoid late meals) and maintain a healthy weight.
• Avoid lying flat soon after eating; consider bedhead elevation.
• Review long-term NSAID use with your prescriber.

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When To Seek Specialist Assessment

Book an appointment if you have:

• Persistent heartburn or chest/throat discomfort despite treatment
• Dysphagia (food sticking) or recurrent food bolus events
• Unexplained anaemia, weight loss, or nocturnal symptoms
• Long-standing reflux with new or worsening symptoms

Early investigation identifies the cause and prevents complications.