Definition

What is an esophageal ulcer?

An esophageal ulcer is a type of peptic ulcer. It’s a painful sore located in the lining of the lower part of the esophagus, at the junction of the esophagus and stomach. Your esophagus is the tube connecting your throat to your stomach.

How common are esophageal ulcers?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of an esophageal ulcer?

The common symptoms of esophageal ulcer are:

  • Pain when you swallow or trouble swallowing
  • Pain behind your breastbone (heartburn)
  • Upset stomach (nausea) and vomiting
  • Vomiting blood
  • Chest pain

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes esophageal ulcers?

In the past, doctors thought ulcers were caused by stress or spicy foods. It’s now known that this is not the case, though these factors may aggravate an existing ulcer. Most often, an esophageal ulcer is caused by a bacterium known as Helicobacter pylori, or H. pylori for short. The bacteria damage the mucosal lining of the esophagus. This makes the esophagus more susceptible to damage by stomach acid.

A chronic condition known as gastroesophageal reflux disease (GERD) may also eventually lead to an esophageal ulcer. People with GERD have frequent acid reflux. Acid reflux occurs when stomach contents move backward into the esophagus. This can happen when the lower esophageal sphincter (the muscle that tightens to prevent food in the stomach from moving back up) is weakened or damaged so it doesn’t close properly. People with GERD experience acid reflux more than twice a week.

Smoking, excessive alcohol consumption, and frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also damage the mucosal lining of the esophagus and result in an ulcer. Genetics also play a role.

In people who have compromised immune systems, esophageal ulcers may be caused by other bacterial, fungal, or viral infections, including:

  • HIV
  • Candida overgrowth
  • Herpes simplex virus
  • Cytomegalovirus

Risk factors

What increases my risk for esophageal ulcers?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is an esophageal ulcer diagnosed?

Your provider will ask about your symptoms and health history. He or she will also give you a full exam. Tests will be done as well. These can include:

  • Upper endoscopy. This is done to see inside your esophagus. This lets your provider check for ulcers. During the test, an endoscope (scope) is used. This is a thin, flexible tube with a tiny camera and light on the end. The scope is placed into your mouth. It is then guided down the esophagus. Small brushes may be passed through the scope to loosen cells from the lining of the esophagus. Other tools may also be passed through the scope to remove tiny tissue samples (biopsy). These samples are then sent to a lab for study.
  • Barium swallow. This is done to take X-rays of your esophagus. This helps your provider check for ulcers. For this test, you’ll drink a chalky liquid that contains a substance called barium. The barium coats your esophagus so that it will show up clearly on X-rays.
  • Blood tests. These check for infection, such as HSV-1 and CMV in the esophagus. For a blood test, a small sample of your blood is taken and sent to a lab.

How is an esophageal ulcer treated?

Treatment of an esophageal ulcer depends on the cause. If your ulcer is caused by an infection with H. pylori, for example, your doctor will prescribe antibiotics to kill the bacteria. If your ulcer is caused by NSAID use, your doctor will tell you to stop taking NSAIDs. They might prescribe a different pain medication.

Your doctor may have you take over-the-counter H2 blockers such as Zantac or Pepcid to help decrease stomach acid. They may also prescribe a proton pump inhibitor (PPI) to protect your esophagus and allow it to heal. These drugs work by stopping the production of stomach acid in a different way. PPIs include:

  • Lansoprazole (prevacid)
  • Esomeprazole (nexium)
  • Pantoprazole (protonix)
  • Rabeprazole (aciphex)
  • Omeprazole (prilosec)

Listen carefully to your doctor’s instructions. You might have to take a PPI for an extended period of time. It’s important to take all medications as directed and finish all antibiotics so the ulcer has a chance to fully heal. Depending on the cause of your ulcer, you may need to take antifungal or antiviral medications as well.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage esophageal ulcers?

The following lifestyles and home remedies might help you cope with esophageal ulcer:

  • Finding ways to reduce stress, such as by exercising or taking a yoga class
  • Getting adequate sleep
  • Eating a diet high in fruits, vegetables, and whole grains, and low in processed or sugary foods
  • Eating smaller meals more frequently
  • Chewing gum after meals to help increase saliva and keep acid out of the esophagus
  • Staying upright for a couple hours after eating
  • Avoiding alcohol
  • Drinking lots of water
  • Refraining from smoking
  • Losing weight if you are overweight

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: December 27, 2017 | Last Modified: December 27, 2017

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