Consuming extremely hot items can potentially cause damage to the delicate lining of the esophagus. This article explores how such thermal injuries occur and what to do if they happen.
Understanding Esophageal Burns
An esophageal burn, or thermal injury, involves damage to the inner lining of the esophagus, the muscular tube that transports food and liquids from the mouth to the stomach. The esophagus can be vulnerable to extreme temperatures when its delicate mucosa comes into direct contact with excessively hot solid or liquid foods. The severity of the burn depends on factors such as the temperature of the substance, the duration of contact, and the volume ingested.
Liquids often pose a higher risk than solids due to their uniform heat distribution and ability to quickly transfer heat along the esophageal lining. A temperature above 60°C (140°F) is considered hazardous enough to burn esophageal tissues.
Recognizing the Symptoms
Symptoms may appear immediately or shortly after consuming something too hot. Pain is a primary symptom, often described as a burning sensation or sharp pain in the chest or throat. Difficulty swallowing, known as dysphagia, and painful swallowing, or odynophagia, are also common indicators.
Other potential symptoms include hoarseness, chest discomfort, nausea, a sour taste in the mouth, or regurgitation. The severity of these symptoms can vary depending on the extent of the thermal injury.
Immediate Care and When to Seek Help
If an esophageal burn is suspected, immediate action can help manage the injury. Sipping cool water or milk can help to cool the affected area and provide some relief. It is advisable to avoid consuming solid foods, as they can further irritate the damaged lining. Do not attempt to induce vomiting, as this can exacerbate the injury.
Prompt medical attention is necessary if symptoms are severe or persistent. Seek professional help if there is severe pain that does not subside, persistent difficulty swallowing, bleeding (indicated by vomiting blood or black stools), or fever. A doctor might recommend an upper endoscopy, a procedure where a thin, flexible tube with a camera is inserted down the esophagus to visualize the extent of the damage.
Long-Term Considerations
While most single, mild esophageal burns heal without lasting issues, severe or repeated incidents can lead to long-term complications. One such complication is the development of esophageal strictures, which are narrowings of the esophagus caused by scarring during the healing process. These strictures can make swallowing increasingly difficult over time. In severe cases of thermal injury, surgical intervention, such as esophagectomy, might be necessary to address strictures.
Repeated thermal injuries can also contribute to chronic inflammation in the esophageal lining. This chronic inflammation, particularly from very hot beverages, may lead to cellular changes, such as the development of precancerous conditions like Barrett’s esophagus, which is a risk factor for esophageal adenocarcinoma. The World Health Organization (WHO) classifies beverages above 65°C as “probably carcinogenic to humans” due to potential for repeated micro-lesions. The link between a single episode of thermal injury and esophageal cancer remains uncertain, and such a risk typically develops only after prolonged exposure to scalding temperatures. The overall risk of esophageal cancer from hot food consumption is low, but consistent exposure to temperatures above 65°C is a recognized concern.
Preventing Esophageal Burns
Preventing esophageal burns involves conscious habits when consuming hot food and drinks. Allowing hot items to cool down before consumption is an effective strategy; for beverages, waiting at least five minutes after pouring can help them reach a safer temperature. Using a food thermometer to ensure liquids are below 60°C (140°F) is another practical measure.
Exercise caution with microwave-heated foods, as they can develop internal “hot spots” that are significantly hotter than the outer layers. Always stir microwave-heated food thoroughly and test the temperature before eating, especially when serving children. Being mindful when drinking from insulated cups is also advisable, as these containers can maintain high temperatures for extended periods, increasing the risk of accidental burns.