Difficult or painful swallowing, heartburn, mouth sores, nausea, vomiting, or a feeling of something being stuck in the throat may all indicate the presence of esophagitis. The continual acid reflux associated with severe heartburn, for example, is believed to be responsible for irritating the esophageal tissue into a state of esophagitis in some patients. Significantly, several studies have found a close relationship between incidence of esophagitis and prevalence of severe and frequent heartburn. Additionally, individuals with weakened immune systems are susceptible to infection from bacteria, virus, or other sources that can also ultimately cause esophagitis. Medications such as non-steroidal anti-inflammatory drugs may also irritate the esophagus if taken without water or food. Although esophagitis usually only consists of tissue irritation and inflammation, occasionally ulcers may also develop.