Erosive Oesophagitis
Erosive oesophagitis is a form of gastro-oesophageal reflux disease in which stomach acid repeatedly reaches the oesophagus and breaks down its inner lining. Unlike simple heartburn, where the lining stays intact, erosive oesophagitis produces visible ulcers or raw patches that can bleed and cause scarring if left untreated.
Key points
- Unlike simple heartburn, this form of reflux disease can leave raw, visible patches or ulcers on the lining that may scar or bleed.
- A weak or poorly timed lower oesophageal sphincter lets stomach acid wash upward repeatedly, eventually overwhelming the lining’s ability to repair itself.
- A persistent burning sensation behind the breastbone, difficulty swallowing, sour-tasting regurgitation and food seeming to stick in the chest are typical complaints.
- Dexlansoprazole’s dual-release design maintains acid suppression across day and night, with courses typically running several weeks depending on severity.
Why the lining erodes
The lower oesophageal sphincter acts as a one-way valve between the oesophagus and stomach. When it is weak or relaxes at the wrong moment, acid washes upward. Repeated exposure overwhelms the oesophagus’s limited capacity to repair itself, and erosions develop. Obesity, large meals, lying down shortly after eating, alcohol, smoking, and certain medicines can all impair the sphincter or increase stomach pressure. Rising rates of obesity and a shift toward richer diets have made erosive oesophagitis noticeably more common.
Recognising the symptoms
Persistent burning behind the breastbone is the most common complaint, often worse after meals or at night. Some people notice difficulty or pain swallowing, regurgitation of sour fluid, or a sense of food sticking in the chest. Hoarseness or a chronic cough can appear when acid irritates the throat. An endoscopy is needed to confirm erosions and grade their severity.
Seek prompt medical attention if you notice blood in vomit or black tarry stools, as these may indicate active bleeding from an erosion.
Acid suppression as the mainstay of healing
Proton-pump inhibitors are the primary treatment. They reduce acid production substantially enough for the oesophageal lining to regenerate. Dexlansoprazole is one such agent, with a dual-release formulation designed to provide prolonged acid control across the day and night. Courses typically run several weeks, with more severe grades of erosion requiring longer treatment to achieve full mucosal healing.
Dietary adjustments support recovery: smaller meals, avoiding triggers such as coffee, fatty foods, and citrus, and not lying flat for at least two hours after eating all reduce acid exposure between doses.