So, esophageal ulcers can pop up mainly because of gastroesophageal reflux, but they can also be triggered by ongoing inflammation or infections. What should you look out for if you think you might have one? And how do you deal with it? Dr. Guillaume Deest, a gastroenterologist from Châteauroux, breaks it down for us.
First off, the esophagus is basically the tube that connects your throat to your stomach. An esophageal ulcer is like a sore on the inner lining of that tube. Dr. Deest explains, “An ulcer is just a fancy way of saying there’s a loss of tissue on the surface of part of your digestive system. If it’s from reflux, it usually hangs out in the lower part of the esophagus, close to where it meets the stomach.”
Most of the time, these ulcers are caused by untreated reflux, but they can also be linked to inflammation, infections, or even cancer, though that’s less common.
What Are the Symptoms?
Sometimes, you might not even notice you have an ulcer, but when they do show up, the symptoms can be pretty vague. Dr. Deest says, “You might feel random pain or discomfort when you eat. It can also feel like a burning sensation in your stomach or chest. In rare cases, you might feel like food is stuck.” You could also experience cramps, nausea, or, in severe cases, even vomit blood.
What Causes an Esophageal Ulcer?
Reflux is the main culprit for these ulcers. Other things like smoking and drinking can make it worse. “Certain meds that boost acid production, especially anti-inflammatories, can also be a factor,” Dr. Deest adds. In rare cases, infections in people with weakened immune systems (like those going through chemotherapy) can cause ulcers too. But don’t worry, Helicobacter pylori, which is known for causing stomach ulcers, doesn’t cause esophageal ulcers. Fungal infections like candidiasis can affect the esophagus but won’t cause ulcers either. And while a hiatal hernia can lead to reflux, it doesn’t directly cause an ulcer.
How Do You Diagnose It?
To figure out if you have an esophageal ulcer, doctors usually go for an upper digestive endoscopy, especially depending on your age and medical history. Dr. Deest explains, “If your symptoms have been around for a while, a gastric fibroscopy can help rule out other issues, especially any precancerous changes.” Sometimes, they might also order blood tests.
Just a heads up, gastroesophageal reflux has four stages of damage. In the first two stages, the damage is pretty minor, so you don’t need to stress too much. But in stages three and four, where ulcers and precancerous changes can happen, you’ll need to keep a closer eye on things.
How to Treat an Esophageal Ulcer?
If your ulcer is due to reflux, doctors might give you some gastric bandages or proton pump inhibitors to help cut down on stomach acid. “These meds work really well most of the time. If they don’t, surgery might be an option, especially if there’s a hiatal hernia involved,” Dr. Deest says.
If your ulcer is caused by medication, it’s a good idea to chat with your doctor about switching things up.
What Complications Can Happen?
There are a couple of complications to watch out for. The main one is stenosis, which is when part of the esophagus narrows and makes it hard to swallow. The other, less common complication is digestive bleeding, which can show up as blood in your vomit or black stools, and that’s definitely a medical emergency.
Preventing Gastroesophageal Reflux
Since reflux is the main cause of esophageal ulcers, it’s smart to take steps to prevent it. Dr. Deest points out that things like being overweight, drinking too much, and smoking can ramp up acid production. It’s also a good idea to avoid big meals and to wait a few hours after eating before lying down.
