Esophagitis causes bleeding primarily through the erosion and ulceration of the esophageal lining due to inflammation.
Here's a breakdown of the process:
- Inflammation: Esophagitis, which is inflammation of the esophagus, weakens the lining of the esophagus. This inflammation can be caused by various factors.
- Erosion and Ulceration: The weakened esophageal lining becomes susceptible to damage. Factors such as stomach acid (in the case of GERD), certain medications, infections, or even physical trauma can erode the surface. Continued erosion leads to ulcer formation, which are essentially sores in the esophageal lining.
- Damage to Blood Vessels: As the erosion deepens into ulcers, it can reach and damage blood vessels in the esophageal wall.
- Bleeding: The damaged blood vessels then bleed into the esophagus. This bleeding can range from mild (resulting in blood-tinged vomit or stool) to severe (leading to significant blood loss).
The most common cause of esophagitis, gastroesophageal reflux disease (GERD), exemplifies this process:
- GERD: In GERD, the lower esophageal sphincter (LES) is weak or relaxes inappropriately.
- Acid Reflux: This allows stomach acid to flow back into the esophagus.
- Inflammation and Damage: The acid irritates and inflames the esophageal lining (esophagitis).
- Ulcer Formation & Bleeding: Over time, this chronic inflammation can lead to the formation of ulcers and subsequent bleeding.
Other causes of esophagitis, such as infections (e.g., Candida, Herpes) or medications (e.g., NSAIDs, bisphosphonates), can also lead to similar erosion and ulceration, resulting in bleeding.
