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Esophagus Disorders

  

The esophagus is the tube that carries food, liquids, and saliva from your mouth to the stomach. You may not be aware of your esophagus until you swallow something too large, too hot, or too cold. You may also become aware of it when something is wrong. The most common problem with the esophagus is gastroesophageal reflux disease, or GERD. It happens when a band of muscle at the end of your esophagus does not close properly. This allows stomach contents to flow back, or reflux, into the esophagus and irritate it. Over time, GERD can cause damage to the esophagus. Other problems include heartburn and cancer. Treatment depends on the problem. Some people get better with over-the-counter medicines or changes in diet. Others may need prescription medicines or surgery. 

INTRODUCTION

 

The esophagus is a tube. It carries food, liquids, and saliva from your mouth to the stomach. There are many problems that can affect the esophagus. Treatment depends on the cause. Sometimes over-the-counter medicines or changes in diet can help. Other times prescription medicines or surgery may be needed. This program will help you understand diseases and disorders that affect the esophagus. It talks about common disorders of the esophagus. It also covers symptoms and treatment options. 

THE ESOPHAGUS

 


The esophagus is part of the digestive tract. The digestive tract is made up of organs through which food and drinks pass. The esophagus is the tube that takes food to the stomach. Swallowed food goes from the mouth, through the esophagus, and to the stomach. The esophagus is located in the chest. It is about 10 inches long. The esophagus lies behind the heart and windpipe, which is also known as the trachea. The esophagus also passes through a large muscle just before connecting to the stomach. This large muscle is called the diaphragm. It separates the lungs from the abdomen and helps with breathing. There is a hole in the diaphragm that the esophagus passes through. The hole is known as the “hiatus.” The hiatus helps stop the backflow of juices from the stomach into the esophagus. At the bottom of the esophagus is a muscular ring. It is called the lower esophageal sphincter, or LES. This ring allows food to go to the stomach but not back up into the esophagus. It also keeps acid in the stomach from going back into the esophagus. 

SYMPTOMS

 

Many esophageal diseases and disorders have similar symptoms. The main symptoms are heartburn and pain in the chest or back. Other common symptoms include:

·         Difficulty swallowing.

·         Dry cough.

·         Food getting stuck in the esophagus.

·         Nausea.

 

Some esophageal diseases and disorders may also cause:

·         A hoarse voice.

·         Bad breath.

·         Bitter, acidic taste in the mouth.

·         Little or no appetite.

·         Painful swallowing.

·         Weight loss.

If you notice any of these symptoms or other changes, talk to your health care provider. Finding a problem early makes treatment easier in most cases. 

HEARTBURN AND GERD

 

Almost everyone has heartburn sometimes. Heartburn is a painful burning feeling in your chest or throat. Heartburn happens when stomach acid backs up into your esophagus. Often heartburn is caused by eating certain foods, such as:

·         Chocolate.

·         Citrus fruits.

·         Drinks with caffeine or alcohol.

·         Fatty and fried foods.

·         Garlic and onions.

·         Mint flavorings.

·         Spicy foods.

·         Tomato-based foods, such as spaghetti sauce, salsa, and pizza.

 

If you have heartburn more than twice a week, you may have GERD. GERD stands for gastroesophageal reflux disease. It is the most common disorder that affects the esophagus. GERD happens when the LES does not close properly. This allows stomach contents to flow back, or reflux, into the esophagus and irritate it. GERD can cause damage to the esophagus over time. Sometimes the stomach acid can travel all the way up the esophagus to the mouth. From the mouth, the acid juices can flow into the lungs. Cells outside the stomach can't tolerate these acids and can become damaged. The same foods that can cause heartburn can cause or worsen symptoms of GERD. GERD may also be caused by being overweight or pregnant. Other medical conditions such as hiatal hernias increase the chances of having GERD. Hiatal hernias cause the top part of the stomach to bulge up. This means the top part of the stomach is in the chest area. In these cases, the diaphragm can't help stop reflux. The first treatment for GERD is often lifestyle changes. For example, limiting certain foods that cause heartburn can help some people. Other lifestyle changes that can help are:

·         Eating small meals frequently throughout the day instead of eating large meals.

·         Eating at least two hours before bed.

·         Elevating the head of your bed about 6 inches.

·         Losing weight if you are overweight or obese.

·         Quitting smoking.

Sometimes medicines may be taken to decrease the acid in the stomach. Some medications are available over-the-counter. Others require a prescription. Rarely, severe cases of GERD may be treated with surgery. Different types of surgery are used. 

ESOPHAGITIS

 

The esophagus may also become inflamed or swollen. This is called esophagitis. The esophagus can become damaged from this inflammation. There are many different types of esophagitis. The types are categorized by the cause. Reflux esophagitis is the most common type. It is caused by acid reflux. GERD can cause long term inflammation of the esophagus. This can lead to tissue damage. Eosinophilic esophagitis is another type. It is caused by an allergic reaction, often due to a food. Special cells that respond to an allergic reaction are found in the esophagus. These cells are called eosinophils. They are a type of white blood cell. Certain medicines can cause drug-induced esophagitis. If taken with little or no water, medicines can get stuck in the esophagus. The medicine can irritate the esophagus and cause it to swell. Infectious esophagitis is the result of an infection. The infection may be caused by bacteria or viruses. It may also be caused by a fungus or parasite. It happens most often in people with weakened immune systems, such as people with HIV/AIDS or cancer. If left untreated, the inflammation can cause changes to the esophagus. This can affect how the esophagus works. For example, inflammation can cause the esophagus to narrow or tighten. This is called esophageal stricture. It can make it hard to swallow. Treatments for esophagitis depend on the cause. If it is caused by reflux, it may be treated with medicines or surgery for GERD. Eosinophilic esophagitis is often treated by avoiding the allergen. An allergen is what causes the allergic reaction. Medicines may also be used to reduce allergic reactions. Treatment for drug-induced esophagitis may include:

·         Drinking a large glass of water with a pill.

·         Not lying down for at least half an hour after taking a pill.

·         Using an alternative drug or taking a liquid version of the drug.

Antibiotics or other medicines may be used to treat infectious esophagitis. 

ESOPHAGEAL CANCER

 


Problems in the esophagus may also be caused by cancer. Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms new cells as you need them by replacing old cells that die. Sometimes this process goes wrong and a tumor forms. If a tumor is cancerous, cells from the tumor can invade other tissues throughout the body. Cancer cells can spread to different parts of the body through blood vessels and lymph channels. Cancers in the body are given names, depending on where the cancer started. Cancer that begins in the esophagus will always be called esophageal cancer. This is true even if it has spread to other places in the body. Esophageal cancer is a common type of cancer. People who are at risk for esophageal cancer include those who:

·         Are between 45 and 70 years of age.

·         Are overweight or obese.

·         Drink more than 3 alcoholic drinks a day.

·         Have a diet low in fruits and vegetables.

·         Smoke.

 

Having acid reflux or Barrett’s esophagus also raises the risk of getting esophageal cancer. It is important to find esophageal cancer early. Esophageal cancer can be difficult to treat. The earlier it is found, the more likely are the chances of successful treatment. Treatment for esophageal cancer may involve surgery, radiation therapy and chemotherapy. Often some combination of these treatments is used. 

SUMMARY

 

The esophagus is a tube. It carries food, liquids, and saliva from your mouth to the stomach. There are many problems that can affect the esophagus. Common problems include heartburn and GERD, esophagitis, and esophageal cancer. Treatment depends on the cause. Treatment may include medicines, surgery, or other treatments. It may also include radiation therapy or chemotherapy if the cause is cancer. Talk to your health care provider if you notice any abnormal changes or symptoms. Finding a problem early makes treatment easier in most cases.