Lahey Health is now part of Beth Israel Lahey Health

by Jones P

Definition

An esophageal ulcer is a sore in the tube that connects your mouth and stomach.

Causes

An ulcer is an injury to the lining of the tube. It may be caused by one of the following:

  • Stomach acid that moves up into the throat
  • Medicine or other medical treatments
  • Infection of the throat that causes inflammation
  • Swallowing a hard, rough, solid, or dangerous item

Risk Factors

Things that increase the risk of ulcers include:

  • GERD–gastroesophageal reflux
  • Infections such as H. pylori infection or herpes simplex virus
  • Smoking
  • Regular alcohol use
  • Frequent use of certain medicines such as NSAIDs (aspirin, ibuprofen)
  • Chemotherapy
  • Radiation therapy in the area
  • Vomiting often

Symptoms

Symptoms may include:

  • Pain in center of the chest—feels like heartburn
  • Problems and pain with swallowing
  • Nausea
  • Vomiting—may have blood

Diagnosis

The doctor will ask about your symptoms and past health. A physical exam will be done. The doctor may suspect an ulcer based on the symptoms. To look for ulcers your doctor may suggest:

  • Endoscopy—a scope is passed down the throat. Images of the throat will be sent to a screen in the room.
  • Barium swallow—an x-ray that uses a special dye. It will help to highlight problem areas.

Treatment

An ulcer can heal with some time. Treatment will help to remove or control the cause. The area can be badly damaged if the cause is not managed. Some treatment options may include:

Medicine

  • Medicine to decrease stomach acid such as:
    • Proton pump inhibitors (PPI)—decrease production of acid
    • H2 blockers—if PPIs aren't effective
    • Over-the-counter antacids—neutralizes stomach acid
  • Antibiotics or antifungal medicine to treat infections
  • Stop or limit NSAIDS—medicine may be changed if needed

Lifestyle Changes

Changes will be based on causes. Steps may include:

  • Smoking is an irritant. It can also slow healing. The doctor will recommend tools to help you quit.
  • Alcohol may need to be stopped during recovery. If it was a cause it may need to be avoided or limited long term.
  • Certain foods may need to be avoided. It will not affect cure but may relieve symptoms until the ulcer heals.

Procedures

An endoscopy may be needed:

  • To stop bleeding in the ulcer
  • To treat ulcers that keep returning
  • To remove scar tissue or ease tightness caused by ulcers

Surgery may be needed to remove badly damaged areas.

Prevention

Prevention will depend on the cause. Smoking and alcohol can damage the area. Limit or avoid alcohol and do not smoke to keep the area as healthy as possible.

RESOURCES

American College of Gastroenterology  http://patients.gi.org 

American Gastroenterological Association  http://www.gastro.org 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

Canadian Digestive Health Foundation  http://www.cdhf.ca 

References

Esophageal ulcer. St Luke’s Health System website. Available at: https://www.saintlukeskc.org/health-library/esophageal-ulcer#. Accessed May 30, 2019.

Higuchi D, Sugawa C, Shah SH, Tokioka S, Lucas CE. Etiology, treatment, and outcome of esophageal ulcers: a 10-year experience in an urban emergency hospital. J Gastrointest Surg. 2003 Nov;7(7):836-42.

Peptic ulcer disease. Dynamed website: Available at:  https://www.dynamed.com/topics/dmp~AN~T116374/Peptic-ulcer-disease . Last Updated: April 2, 2018. Accessed May 30, 2019.

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