What Is Herpes Esophagitis?
Herpes esophagitis is a viral infection of the esophagus
caused by the herpes simplex virus type 1 (HSV-1). The esophagus is the tube
that carries food and drink from your mouth to your stomach. Esophagitis is
inflammation of the esophagus. It can cause damage to the esophagus and throat
tissues, as well as difficulty swallowing and chest pain.
Esophagitis can be caused by a variety of factors, including
bacteria, fungi, or even acid reflux. Herpes esophagitis isn’t very common in
healthy people. People who have weakened immune systems, such as those who have
cancer, HIV, or AIDS, are at an increased risk of developing herpes esophagitis
if they’re infected with HSV-1.
If you have developed herpes esophagitis, your doctor will
watch you very closely and check for other illnesses or health problems.
How Is Herpes Esophagitis Spread?
There are several types of the herpes simplex virus. HSV-1,
the cause of most cases of herpes esophagitis, is the same virus that causes
cold sores. It’s generally passed through mouth-to-mouth contact.
HSV-1 is spread through infected saliva. You can develop a
throat infection through close contact with someone who has mouth ulcers, cold
sores, or eye infections. If you’re infected, it’s very important that you wash
your hands with warm water and soap to avoid spreading the virus to others. You
should avoid contact with those who have an active infection. If you know or
suspect that you’re infected, immediately contact your doctor and inform anyone
that you’ve had close contact with.
Herpes simplex virus type 2 (HSV-2) is another form of the
virus and is considered a sexually transmitted disease (STD). It’s spread
through skin-to-skin contact and causes genital herpes. HSV-2 very rarely causes
Cross-contact with HSV-2 can also cause infection in some
cases. Engaging in oral sex with someone who has an active herpes outbreak
could lead to herpes esophagitis in some people. If you’re having a herpes
outbreak, make sure to practice safe sex and to inform your partner. The key to
preventing it from being spread is catching it early on and beginning
Most people with strong immune systems won’t develop herpes
esophagitis, even after being infected by HSV-1. Your risk increases if you
- HIV or AIDS
- leukemia or other cancers
- organ transplants
- any illness that compromises your immune system
People who abuse alcohol or take a long-term antibiotic are
also at greater risk. Taking oral medications that can affect your esophageal
lining or cause your esophagus to become inflamed can also increase your risk.
Symptoms of Herpes Esophagitis
Symptoms of herpes esophagitis involve both the mouth and
other areas of the body. The primary symptoms include difficulty swallowing and
open sores in the mouth. These mouth sores are called “herpes labialis.”
Swallowing may also be painful due to the inflammation and ulceration of the
throat tissues. Other signs of infection may include:
- joint pain
- general malaise (not feeling well)
Diagnosing Herpes Esophagitis
Your doctor will ask you your medical history and look into
your esophagus to determine the cause of your symptoms. Bacteria, fungi, and a
range of other viruses can also cause infectious esophagitis. Other conditions
such as strep throat may mimic the symptoms of herpes esophagitis.
Throat cultures, mouth swabs, blood tests, and urine tests
are all diagnostic tools used to confirm herpes esophagitis. These tests can
identify the source of the infection. Your doctor will know that you have
herpes esophagitis specifically if the HSV-1 virus is found.
Treatment for Herpes Esophagitis
Medication can be used to treat esophagitis caused by the
herpes virus. Your healthcare provider will likely prescribe one of three
- acyclovir (Zovirax)
- famciclovir (Famvir)
- valacyclovir (Valtrex)
Over-the-counter or prescription pain relievers may also be
used to help ease the pain of herpes esophagitis. Your doctor might prescribe
medication on a long-term basis to prevent you from developing recurring infections.
What Is the Outlook for Herpes Esophagitis?
Recovery times vary depending on your state of health.
People with healthy immune systems usually respond quickly to treatment and
improve within a few days. People who have more complicated medical conditions
may need more time to heal because of their impaired immune system.
Scarring from the inflammation can sometimes make it
difficult to swallow. A more serious, life-threatening complication is
esophageal perforation, which is a medical emergency. Herpes esophagitis rarely
causes esophageal perforation. Most people with herpes esophagitis won’t have
serious long-term health issues.