Esophageal Ulcer

An esophageal ulcer is an open sore in the lining of the esophagus. The esophagus is the tube that carries food and liquid from your mouth to your stomach.   

Causes of an esophageal ulcer

Esophageal ulcers can be caused by:

• GERD (gastroesophageal reflux disease). This condition occurs when stomach acid flows back into the esophagus. It is the most common cause of esophageal ulcers.
• Infection of the esophagus. This is caused by certain types of fungus and bacteria. It is also caused by viruses such as herpes simplex virus 1 (HSV-1) or cytomegalovirus (CMV).
• Irritants that damage the esophagus. These include cigarette smoke, alcohol lye and certain medicines.
• Certain types of treatments done on the esophagus. These include chemotherapy and radiation.
• Excessive vomiting.

Symptoms of an esophageal ulcer

Esophageal ulcer symptoms can include:

• Pain when you swallow or trouble swallowing
• Pain behind your breastbone (heartburn)
• Upset stomach (nausea) and vomiting
• Feeling of food sticking in your throat or not going down right
• Vomiting blood
• Chest pain

Diagnosing an esophageal ulcer

Your provider will ask about your symptoms and health history. He or she will also give you a full exam and perform some tests. 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 will 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. 

Treating an esophageal ulcer

Treatment focuses on giving the ulcer time to heal, easing symptoms, and preventing further damage. Treatment may include:

• Medicines to reduce the amount of acid your stomach makes
• Medicines to treat infection
• Quitting smoking and not drinking alcohol
• Avoiding irritating medicines (such as aspirin, ibuprofen, potassium, tetracycline, quinidine, iron and alendronate)

Recovery and follow-up

With treatment, an esophageal ulcer takes several weeks or longer to heal. A follow-up endoscopy may be done to check that the ulcer is healing. Let your provider know if your symptoms do not improve or if they return. If you have GERD, work with your provider to manage it. You can take steps to help keep your esophagus healthy and prevent future problems. 

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