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What Is Herpes Esophagitis (Herpes In The Throat)?

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A patient having an upper endoscopy
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Photo by Yuya Tamai, CC BY 2.0, via Wikimedia Commons

What is Herpes Esophagitis (Herpes in the throat)? The esophagus is the food pipe that runs from the back of your throat to your stomach. It carries food and drinks from your mouth to the stomach. Herpes esophagitis is an infection of this tube with the herpes simplex virus.

Overview

Esophagitis is the irritation and inflammation in your esophagus. Herpes Esophagitis (Herpes In Throat) is the viral infection in the esophagus that is caused by the herpes simplex virus. Have you ever heard about it? This is the virus that causes some cold sores on the lips or in the mouth. This virus can also cause infection in the esophagus.

Why Herpes Esophagitis (Herpes in the throat) Occurs?

Herpes esophagitis is caused by the herpes simplex virus (HSV), not by acid reflux. It can be a new infection or a reactivation of a virus that has been dormant in the body.

It mostly affects people with a weakened immune system. In healthy people it is rare and usually clears up on its own. Esophagitis in general has other causes too, including acid reflux (GERD), fungal infections such as Candida, certain pills, and allergies, but those are different conditions.

Herpes Esophagitis Can Cause?

Herpes esophagitis (Herpes in the throat) can cause:

  • painful swallowing (the most typical symptom)
  • difficulty swallowing
  • chest pain behind the breastbone or heartburn
  • fever and other flu-like symptoms
  • nausea
  • inflammation and sores (ulcers) that damage the lining of the esophagus

Types Of Herpes Esophagitis (Herpes in throat)

There are two types of Herpes Esophagitis (Herpes in the throat).

  • herpes simplex virus HSV 1
  • herpes simplex virus HSV 2

  1. Herpes simplex virus HSV 1

HSV-1 is the main cause of herpes esophagitis. It also causes cold sores. It spreads through mouth-to-mouth contact, such as kissing or sharing saliva.

You can catch HSV-1 through close contact with someone who has cold sores or other active herpes sores. It can also spread through oral sex.

Instructions:

  • wash your hands with soap and warm water
  • avoid kissing or sharing cups and utensils with someone who has an active cold sore
  • see your doctor promptly if swallowing becomes painful
  • avoid close contact with your partner while either of you has active sores

2. Herpes simplex virus HSV 2

It is another form of the virus and often considered a sexually transmitted infection (STI). It spreads through skin-to-skin contact and causes genital herpes.

HSV-2 seldom causes herpes esophagitis. Oral sex with someone who has an active HSV-2 outbreak can rarely lead to it. This virus normally spreads through vaginal, anal, or oral sex.

Instructions:

  • Inform your partners
  • practice safer sex
  • use condoms
  • Go to the doctor as soon as possible

Risk Factors

The major risk factor is a weak immune system, which may result from:

  • having HIV, leukemia, or lymphoma
  • receiving chemotherapy or radiation for cancer
  • taking immunosuppressant drugs or steroids, for example after an organ or bone marrow transplant
  • an organ transplant
  • diabetes

Symptoms

Its symptoms are:

  • painful or difficult swallowing
  • chest pain or heartburn
  • sores in the mouth or cold sores (in some people)
  • fever and chills
  • general malaise

Diagnosis

Doctors use these tests to confirm herpes esophagitis:

  1. an endoscopy, in which a thin, flexible tube with a light and camera is passed down the throat to look for inflammation and ulcers in the esophagus
  2. a biopsy, in which small tissue samples are taken during endoscopy and examined under a microscope and tested for the virus (for example, by PCR or viral culture)
  3. sometimes blood tests, including an HIV test, to look for a cause of a weakened immune system

These tests also help rule out other causes of esophagitis.

Treatment

Your doctor will give you

  1. medication:

2. or one of three antiviral drugs:

  • acyclovir (Zovirax)
  • famciclovir (Famvir)
  • valacyclovir (Valtrex)

Acyclovir is the most commonly used antiviral. Starting it early can shorten the illness. In healthy people the infection is usually short-lived. Antivirals treat the infection, but the virus stays dormant in the body and can come back.

Strategies to reduce pain:

Strategies that may help reduce irritation of the esophagus while it heals:

  • stop smoking
  • avoid foods, drinks, and medications that make the symptoms worse
  • avoid alcohol and caffeine
  • eat smaller, soft meals
  • keep the head elevated during sleep, by using more pillows

HP Thoughts: It’s not too late to make up for a health mishap as long as you give importance to proper well-being maintenance. Read our post to learn more: Health Practices for People Living with STIs.

Conclusion:

Herpes esophagitis is inflammation of the esophagus caused by the herpes simplex virus, usually HSV-1. It is uncommon and mostly affects people with weakened immune systems. It is not caused by acid reflux. Antiviral medicines prescribed by a doctor treat it well, though the virus can stay dormant in the body. See a doctor if swallowing is painful or difficult.

Sources

More in Throat Infections