Esophagitis – Precautions and Nutritional Management

Esophagitis usually occurs in the lower esophagus as a result of irritating effect of acidic gastric reflux on the esophageal mucosa. The common symptom is heartburn (burning epigastric substernal pain). Other symptoms are regurgitation and dysphagia.

Types of Esophagitis:

Acute Esophagitis: Caused by ingestion of an irritating agent, viral inflammation, or incubation of Ryle’s tube.

Chronic Esophagitis: It is a result of recurrent gastroesophageal reflux owing to hiatal hernia, reduced LES pressure, increased abdominal pressure, and recurrent vomiting. LES pressure is reduced due to pregnancy and also in women taking progesterone containing oral contraceptives. Certain foods like alcohol, peppermint, spearmint, chocolates, and caffeine-containing beverages lower the LES pressure.

The severity of the Esophagitis resulting from gastrointestinal reflux is influenced by the content of the gastric reflux, mucosal resistance, and clearing rate of esophagus as well as the rate of gastric emptying.

Nutritional Management of Esophagitis:

The objectives of nutritional care are to

  • Prevent irritation of the inflamed esophageal mucosa in the acute phase.
  • Prevent esophageal reflux
  • Decrease the irritating capacity or acidity of gastric juice.


  • Avoid foods that are known to cause heart burn.
  • Eat small, frequent meals to prevent stomach distention and resultant gastric acid secretion.
  • Avoid high-fat meals and decrease fat in diet.
  • Avoid chocolate, alcohol, and caffeine containing beverages such as tea, coffee, cola drink, etc.
  • Avoid peppermint and spearmint oils.
  • Avoid lying down, bending over immediately after meals.
  • Avoid eating with 2-3 hours of going to bed.
  • Avoid tight fitting clothing especially after meals.
  • Reduce weight if overweight.
  • Avoid or quit cigarette smoking.

One Comment on “Esophagitis – Precautions and Nutritional Management”

  1. A year ago an endoscopy confirmed a hiatal Hernia and very inflamed esophagus. But worse than the burning and acid reflux was the pain I had mid back, at my bra line, radiating out from my spine to rib area on my right side. Pain went from ‘stabbing’ pinpoint, to spasms, to throbbing, to dull aches….ever constant, no relief. I took pain pills, tried accupuncture, myofacia release treatment, ointments, heat, cold, massage, therapy and pain management to no avail. About a week after taking Nexium, it went away..magically. Since then I’ve had a heart attack and medication switched from Nexium to Tagament and now I have this horrible unexplainable pain again. I’ve searched the internet looking for similar symptoms, a cure, suggestions…zero help. Dr. is at a loss for explanation. I had no idea that this pain could be ‘internal’ orremotely related to acid reflux or GERD, but it stopped upon taking Nexeum. What’s causing the pain? How do I fix it. HELP!

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