Esophageal Ulcer Symptoms
An esophageal ulcer refers to an ulceration (erosion or sore) of the esophagus, the flexible tube connecting the mouth to the stomach.
Esophageal Ulcers are typically lumped together with gastric (stomach) and duodenal (part of the small intestine) ulcers under the umbrella term peptic ulcers. However, there are some differences in the symptoms of esophageal ulcers and other peptic ulcers.
Esophageal Ulcer Symptoms
Symptoms of an Esophageal are similar to stomach ulcer symptoms:
- Burning stomach pain
- Nausea and (or) loss of appetite
- Unexplained weight loss
There are also a few symptoms unique to esophageal ulcers which are typically not seen in gastric ulcers:
- Difficulty Swallowing
- Esophageal strictures
The higher the ulcer occurs along the esophagus, the more intense the latter esophageal ulcer symptoms will be. An ulcer lower on the esophagus will generally mimic the first set of esophageal ulcer symptoms.
Esophageal Ulcer Causes
Esophageal ulcers are a very curious type of ulcer. First off, they are much rarer than other peptic ulcers, giving researchers less patients to work with and less incentive to study this condition.
Most ulcers occur as the result of H pylori bacteria, but this may not always be the case with esophageal ulcers. H pylori can colonize the esophagus, but may not necessarily lead to ulcer.
The cells of the esophagus are much different than those of the stomach and small intestine. The cells of the stomach and small intestine have natural defensive mechanisms against the acid and digestive enzymes they hold. H pylori disrupts these mechanisms in some way which leads to ulceration.
The esophagus does not have the same protective coatings as stomach acid is not supposed to regularly reach into the esophagus. However, gastroesophageal reflux disease (GERD, also known as chronic heartburn for the layperson) is becoming increasingly common. The acid reflux from GERD may lead to the development of an esophageal ulcer.
Esophageal Ulcer Treatment
Here is where the research gets very interesting: H pylori, the primary cause of peptic ulcers, can act as an acid suppressant in certain population; patients who are treated for H pylori infection have a much higher rate of contracted GERD and H pylori may even offer some sort of protective benefit for this population (1,2).
As a result, treating H pylori in at-risk groups could actually negatively impact the health of the esophagus (1,2). This bacterial infection, which is the primary cause of peptic ulcer disease, may actually offer a protective benefit for the esophagus.
As a result, Esophageal ulcer treatment typically consists of a proton-pump inhibitor. This medication is effective at not only reducing reflux but also promoting healing in the esophagus. Esophageal ulcers also may be treated with triple therapy for H pylori eradication, though this could possibly change over the next decade with more advancements in research.
Lifestyle changes to reduce occurrence of GERD such as weight loss and tobacco and alcohol cessation can help keep heartburn under control in the long term.
Esophageal Ulcer Symptoms: The Final Word
Compared to other types of ulcers, esophageal ulcer symptoms are more likely to occur in the chest. These symptoms can vary though so only via diagnostic testing can you know for sure exactly what type of ulcer you have and what the appropriate treatment is.
1. Ghoshal UC., & Chourasia D. Gastroesophageal Reflux Disease and Helicobacter pylori: What May Be the Relationship? J Neurogastroenterol Motil. 2010 Jul;16(3):243-50.
2. Atherton JC., & Blaser MJ. Coadaptation of Helicobacter pylori and humans: ancient history, modern implications. J Clin Invest. 2009 Sep;119(9):2475-87.