What is Herpes Esophagitis & How is it Treated? | Causes & Symptoms of Herpes Esophagitis

What is Herpes Esophagitis?

Esophagitis is a condition that is caused when the lining of the esophagus gets inflamed. Acid reflux is the primary cause of esophagitis but on rare instances this can also occur as a result of herpes viral infection. Anatomically, esophagus is a part of the digestive system and is a pipe like structure that starts from the throat and goes all the way down to the stomach. The function of the esophagus is to carry food from the mouth to the stomach. When the lining of the esophagus gets inflamed due to a viral infection like the herpes simplex virus then it is termed as Herpes Esophagitis.[1]

What is Herpes Esophagitis?

Herpes Esophagitis is seen normally in people with a weak immune system, especially HIV. This condition is quite rare in healthy people but there have been some instances of it occurring in such individuals as well. Due to the rarity of the condition at times it becomes difficult to diagnose the condition. Generally, an endoscopic examination and other specialized tests are needed to come to a diagnosis of Herpes Esophagitis.[1]

However, the condition is benign and goes way in a few days. Antivirals in the form of acyclovir have been seen to hasten the recovery process. Herpes Esophagitis is mainly seen in people with HIV, cancer, burn injury, after an organ transplant, or after being on prolonged steroid therapy.[1]

What Causes Herpes Esophagitis?

As stated, the HSV or herpes simplex virus is the primary cause of Herpes Esophagitis. This virus mainly has two strains, namely HSV-1 and HSV-2. Both these viruses are extremely contagious and spread from direct contact.[2]

In fact, both HSV-1 and HSV-2 are the primary causes of genital herpes. Both these viruses are capable to cause Herpes Esophagitis; however, HSV-1 causes it more commonly. This happens when the virus spreads from other areas of the body like the mouth to the esophagus causing inflammation. This happens more in people with compromised immune system.[2]

What are the Symptoms of Herpes Esophagitis?

An individual with Herpes Esophagitis will experience problems with swallowing. There will also be nausea along with heartburn or pain in the chest. There will be sores around the mouth. In some cases, the patient may also develop fever due to Herpes Esophagitis. The cold sores on the mouth occur only with Herpes Esophagitis and not with other causes of the inflammation of the lining of the esophagus.[2]

How Is Herpes Esophagitis Diagnosed?

Due to the rarity of the condition, diagnosis of Herpes Esophagitis is at times tough. The diagnosis begins with taking a detailed history of the patient and inquiring in detail about the symptoms. Herpes Esophagitis can be suspected if the patient is found to have a weak immune system.[2]

To confirm the diagnosis, the physician will order further tests to rule out other causes of esophagitis. These tests will include blood tests to look for the presence of a virus, endoscopy to take a look at the esophagus for areas of inflammation. A biopsy will also be done to analyze the tissue lining of the esophagus. The results of these tests confirm the diagnosis of Herpes Esophagitis.[2]

How is Herpes Esophagitis Treated?

Herpes Esophagitis is a self-limiting condition in people with healthy immune systems and clears away within a couple of weeks. However, for people with a compromised immune system it usually requires administration of antiviral medications commonly acyclovir and famciclovir. If these medications are ineffective then stronger medications will be administered intravenously.[2]

If the patient has severe discomfort due to Herpes Esophagitis then pain medications may also be prescribed. People with Herpes Esophagitis will have to make certain lifestyle changes like

  • Abstaining completely from smoking
  • Avoiding foods or drinks that may trigger the symptoms of Herpes Esophagitis
  • Abstaining alcohol
  • Eating three to four small meals a day rather than two large meals
  • Keeping the head of the elevated while sleeping[2]


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