Erosive esophagitis

By Jason Wasserman MD PhD FRCPC
June 28, 2023

What is erosive esophagitis?

Erosive esophagitis is a type of injury that leads to the loss of cells on the inside of the esophagus. The loss of cells is called an erosion.

What causes erosive esophagitis?

The most common cause of erosive esophagitis is gastroesophageal reflux disease (GERD), a condition where acid from the stomach moves up into the esophagus. This condition is also called reflux esophagitis. Other causes of erosive esophagitis include prior radiation to the neck or chest, infections of the esophagus (for example Candida esophagitis or herpes simplex esophagitis), medications (for example chemotherapy), or severe eosinophilic esophagitis.

What are the symptoms of erosive esophagitis?

The most common symptoms of erosive esophagitis are difficulty swallowing and pain when swallowing food or liquids.

How is erosive esophagitis diagnosed?

The diagnosis of erosive esophagitis can be made after your doctor examines the inside of your esophagus with a camera called an endoscope. The affected area of the esophagus may appear white or red. During the examination, small samples of tissue will be removed in a procedure called a biopsy and the tissue will be sent to a pathologist for examination under the microscope.

What does erosive esophagitis look like under the microscope?

The cells that normally cover the inside of the esophagus are called squamous cells and they form a barrier called the epithelium. In erosive esophagitis, the squamous cells are dead or damaged which results in an erosion or loss of the normal epithelium. Inflammatory cells including large numbers of neutrophils are also typically seen in erosive esophagitis caused by GERD while eosinophils are seen in erosive esophagitis associated with eosinophilic esophagitis. Foreign material (non-biologic material not normally found in the esophagus) and multinucleated giant cells (very large cells with more than one nucleus) are often seen in erosive esophagitis caused by the ingestion of large pills, a condition called pill esophagitis.