An esophageal ulcer is an open sore that forms in the lining of the esophagus.
The esophagus is the tube that carries food and drinks from your throat to your stomach. An ulcer develops when this lining is damaged by stomach acid, certain medications, or infections.
Esophageal Crohn disease is rare. According to a Mayo Clinic retrospective study, it was found in 0.2% of 12,367 patients in North America.
The esophagus is built to move food downward, not to handle strong stomach acid. Unlike the stomach, it does not have a thick protective lining.
When acid or digestive fluids flow back into the esophagus over time, the tissue can become irritated. This irritation can slowly wear away the surface and lead to an ulcer.
An esophageal ulcer can make eating and drinking painful. Many people feel a burning pain in the chest that can feel similar to heart pain.
If left untreated, an ulcer can cause serious problems, including bleeding or narrowing of the esophagus, which can make swallowing difficult.
A medical professional can easily identify an esophageal ulcer through proper diagnostic tests and provide a clear plan to heal the tissue and eliminate the discomfort. The board certified gastroenterologists at Charleston GI have extensive experience diagnosing and treating upper gastrointestinal conditions like ulcers.
Open five days a week with no referral needed, Charleston GI makes it simple to access expert care and protect your digestive health.
Esophageal ulcers develop when the protective lining of the esophagus is damaged. This exposes sensitive tissue underneath and allows a sore to form. Common causes include:
Chronic Acid Reflux
Gastroesophageal reflux disease (GERD):A long term condition where stomach acid repeatedly flows back into the esophagus. Over time, this acid can burn and wear down the lining.
Medication Irritation
Pill esophagitis:Some medications can irritate the esophagus if they get stuck or are taken with too little water. Common examples include aspirin and ibuprofen, certain antibiotics, and potassium supplements.
Infections
Fungal, viral, or bacterial infections:People with weakened immune systems are more at risk. Infections may be caused by organisms like Candida yeast, herpes simplex virus, or cytomegalovirus.
Environmental and Chemical Irritants
Swallowing corrosive substances:Accidental or intentional ingestion of harsh household chemicals or acidic liquids can severely damage the esophagus.
Smoking and alcohol use:Frequent smoking or heavy alcohol use weakens the esophageal lining and increases acid production, raising the risk of ulcers.
Risk Factors
Certain health conditions, habits, and medications can raise your risk of developing an esophageal ulcer:
Untreated GERD: Ongoing heartburn or acid reflux that is not managed can damage the esophagus over time.
Poor pill swallowing habits: Taking pills while lying down or without enough water can cause them to stick in the esophagus and irritate the lining.
Frequent NSAID use: Regular use of pain relievers like aspirin or ibuprofen can weaken the protective lining of the digestive tract.
Weakened immune system: Medical conditions or treatments that lower your immune defenses increase the risk of infection related ulcers.
Heavy alcohol and tobacco use: These habits relax the valve between the stomach and esophagus, making it easier for acid to flow upward and cause damage.
Symptoms
An ulcer in the esophagus often causes discomfort, especially when eating or drinking. Common symptoms include:
Painful swallowing (odynophagia): Sharp or burning pain in the chest or throat when swallowing food or liquids.
Difficulty swallowing (dysphagia): A feeling that food is getting stuck while moving down the chest.
Burning chest pain: Pain behind the breastbone that may feel like severe heartburn or even a heart problem.
Nausea and vomiting: Feeling sick to your stomach or vomiting. In some cases, vomit may contain small amounts of blood.
Acid regurgitation: A sour or bitter taste in the mouth caused by stomach acid backing up into the throat.
Unintended weight loss: Losing weight because eating becomes painful or difficult.
When to See a Doctor
Seek Medical Help Immediately If
You have severe chest pain that spreads to your arm or jaw
You vomit dark blood that looks like coffee grounds
You have black, tarry stools
See a doctor if you notice:
Ongoing pain or trouble swallowing
Heartburn or chest burning that does not improve with over the counter antacids
Choking sensations or a feeling that food is stuck in your throat
Unexplained weight loss with a poor appetite
A persistent cough or hoarseness, especially at night
A medical evaluation is important to heal the ulcer and rule out other serious upper digestive conditions. Gastroenterologists use visual tests to find the ulcer and create a treatment plan.
If symptoms are making it hard to eat or drink comfortably, do not delay care. The team at Charleston GI provides testing and personalized treatment for upper digestive issues. No referral is needed, so you can schedule an appointment directly.
Diagnostic Tests
Your evaluation will include a detailed look at your medical history, symptoms, and current medications, followed by a focused exam. Testing may include:
Upper Endoscopy (EGD)
The main test used to find an esophageal ulcer
A thin, flexible tube with a small camera is passed down your throat
Allows the doctor to directly view the lining of the esophagus
Small tissue samples (biopsies) may be taken to check for infection, inflammation, or abnormal cells
Additional Tests If Needed
Barium swallow:You drink a chalky liquid that coats the esophagus, making ulcers or narrowing easier to see on X-rays
Blood tests:Used to check for infection or anemia from hidden bleeding
Treatment
Acid suppression: Medications such as proton pump inhibitors (PPIs) or H2 blockers reduce stomach acid so the ulcer can heal.
Antibiotic or antifungal medications: Used if an infection is the cause, including fungal or viral infections.
Medication adjustment: Switching or changing how certain pills are taken to prevent esophageal irritation.
Dietary changes: Temporary diet changes to reduce irritation while the ulcer heals.
Prevention & Lifestyle
Take pills with plenty of water: Always swallow medications with a full glass of water and stay upright for at least 30 minutes afterward.
Manage reflux early: Control acid reflux with lifestyle changes or daily medication under a doctor’s guidance.
Elevate the head of your bed: Raising the head of the bed about 6 inches can help prevent nighttime acid reflux.
Avoid tobacco and alcohol: These substances irritate the esophagus and slow healing.
Foods & Drinks to Avoid or Limit
Citrus fruits and juices: Oranges, lemons, and grapefruit can increase irritation.
Tomatoes and tomato based sauces: Highly acidic and may worsen discomfort.
Spicy or heavily seasoned foods: Hot sauces, chili powder, and strong spices can irritate the ulcer.
Chocolate and peppermint: May relax the lower esophageal valve and allow acid to rise.
Carbonated and caffeinated drinks: Soda, coffee, and energy drinks can increase acid production.
Foods & Drinks OK to Consume
Lean proteins: Skinless chicken, turkey, fish, and tofu prepared without heavy spices or frying.
Soft, non acidic fruits: Bananas, melons, and applesauce that are gentle on the esophagus.
Cooked vegetables: Soft carrots, green beans, and potatoes that are easy to chew and swallow.
Oatmeal and whole grains: Warm, smooth options that provide nutrition without irritation.
Water: The safest option for hydration and helping clear stomach acid.
According to Mayo Clinic clinical documentation, esophageal ulcers are serious medical conditions that require targeted treatment.
If left untreated, complications may include:
Severe internal bleeding
Deep tissue perforation
Scar formation that permanently affects swallowing
With proper treatment, most esophageal ulcers heal successfully.
Early Symptoms and Pain Patterns
The National Institute of Diabetes and Digestive and Kidney Diseases identifies early symptoms as:
Burning or sharp pain behind the breastbone
Painful swallowing
Difficulty moving food downward
Chronic heartburn or sour regurgitation
Persistent dry cough
Clinical gastroenterology sources explain that an ulcer is an open sore on the esophageal lining. When food, liquid, or saliva passes over it, exposed nerve endings are irritated, causing sharp pain and involuntary muscle spasms. This pain is medically known as odynophagia.
Yes. According to Penn Medicine, esophageal nerves share pathways with the chest and upper back. Severe inflammation or deep ulceration can cause referred pain between the shoulder blades.
According to Harvard Health Publishing:
GERD causes diffuse, shifting burning discomfort
Esophageal ulcer pain is localized, sharp, constant, and worsens with swallowing
Conditions That Mimic Esophageal Ulcers
Academic medical centers note overlapping symptoms with:
Gastroesophageal reflux disease
Achalasia and other motility disorders
Eosinophilic esophagitis
Infectious esophagitis
Gastric ulcers
Gallbladder disease
Cardiac conditions such as angina or heart attack
Chest pain should always be evaluated medically.
According to the American Heart Association, it is impossible to reliably distinguish ulcer pain from a heart attack without medical testing.
Any sudden chest pain with:
Shortness of breath
Sweating
Radiation to jaw, neck, or arm
These concerns require emergency care.
Causes and Risk Factors
Yes. The Food and Drug Administration recognizes pill induced esophagitis.
Common offenders include:
NSAIDs such as ibuprofen
Antibiotics such as doxycycline and tetracycline
Pills can lodge in the esophagus and dissolve there, releasing caustic chemicals that damage tissue.
Medical guidance from the Centers for Disease Control and Prevention confirms that taking pills without enough water or lying down too soon afterward is a leading cause of medication induced esophageal ulcers.
According to the American College of Gastroenterology:
H. pylori can increase stomach acid that refluxes upward
Hiatal hernias weaken the lower esophageal sphincter
Both increase acid exposure and ulcer risk.
Yes. Studies indexed in PubMed show:
Nicotine relaxes the lower esophageal sphincter
Tobacco slows tissue repair
Alcohol damages the protective mucosal lining
Healing, Diet, and Lifestyle
According to the Academy of Nutrition and Dietetics, recommended foods include:
Clinical trials monitored by the National Institutes of Health show most ulcers heal in 4 to 8 weeks with proper acid suppression and lifestyle changes.
Integrative medicine reviews note that aloe vera, DGL licorice, and manuka honey may soothe symptoms but do not replace acid suppressing medications. They should only be used as supportive care.
Complications and Long Term Risks
According to the American Society for Gastrointestinal Endoscopy, this is a medical emergency.
Warning signs include:
Vomiting blood
Black tarry stools
Sudden weakness or low blood pressure
Perforation requires emergency surgery.
The Cleveland Clinic states that healing ulcers can form scar tissue, creating esophageal strictures that make swallowing difficult and may require dilation procedures.
According to the National Cancer Institute, ulcers themselves are not cancerous.
However, chronic acid injury can lead to Barrett’s Esophagus, which increases the risk of esophageal adenocarcinoma.
Anxiety, Sensations, and Daily Living
According to Johns Hopkins Medicine, globus sensation may be caused by:
Esophageal irritation from ulcers or reflux
Stress or anxiety related muscle spasms
A medical exam is needed to determine the cause.
Yes. Gastroenterology guidelines explain that lying flat allows acid to flow upward, directly bathing the ulcer and increasing pain.
Medical institutions recommend:
Elevating the head of the bed 6 to 9 inches
Using a foam wedge pillow at a 30 to 45 degree angle
Stacked pillows are usually ineffective.
Medications and Treatment Details
Academic pharmacology sources explain that PPIs like omeprazole reduce acid quickly, which can temporarily alter digestion and cause bloating, gas, or mild nausea during the first few weeks.
Sucralfate works by coating ulcer tissue.
Clinical guidelines state it must be taken:
On an empty stomach
At least 1 hour before meals or 2 hours after
Separate from other medications
Severe Symptoms and Nutrition
Clinical nutrition experts recommend:
Lukewarm chamomile tea
Diluted, non acidic liquids
Elemental nutrition shakes
Small, frequent sips
Avoid very hot or cold fluids.
Dietitians recommend:
Liquid or pureed diets
High calorie nutrition shakes
Smooth soups and blended foods
If weight loss continues, a gastroenterologist may consider temporary feeding tube support during healing.
Schedule Your GI Appointment Today — No Referral Needed
To learn more about treatment for GI tract issues in Charleston, SC, get in touch today! Charleston Gastroenterology is committed to a higher standard of caring – and we provide a range of medical treatments to help you feel your best.
To learn more about the causes, diagnostic tests, and clinical management strategies for esophageal ulcers, explore these trusted medical authorities and patient advocacy groups:
Mayo Clinic — Read comprehensive overviews on upper GI conditions, stricture complications, and the statistical prevalence of esophageal disorders.
Harvard Health Publishing — Learn how to differentiate between diffuse GERD discomfort and the localized, sharp pain patterns characteristic of an esophageal ulcer.
American College of Gastroenterology (ACG) — Explore clinical insights into how hiatal hernias and stomach acid production impact the structural integrity of the esophageal valve.
American Heart Association (AHA) — Review crucial guidelines on distinguishing benign gastrointestinal pain from urgent cardiac events like angina or a heart attack.
U.S. Food and Drug Administration (FDA) — Find consumer safety information regarding drug-induced esophagitis and the safe administration of common pills like NSAIDs and antibiotics.
National Cancer Institute (NCI) — Understand the relationship between chronic upper digestive tract inflammation, Barrett’s Esophagus, and long-term cellular health.
Local Gastroenterologist Support in Charleston, SC
Charleston GI: If you are ready to speak with a local specialist about your symptoms, you can schedule an appointment today. No referral is needed.
Medical Disclaimer
This page is for general educational purposes only and is not medical advice. It does not replace evaluation or care from a licensed healthcare provider. Screening recommendations and results vary by individual. Viewing this page does not create a doctor-patient relationship.
