Specialties

Esophageal Diseases and Disorders

Esophagus function

The esophagus is the tube that carries food and liquids from the mouth into the stomach. It is made of layers of muscles that contract and relax sending food downward. There is a ring of muscles at each end of the esophagus, called sphincters. These sphincters open to allow food to move food into the esophagus, close to prevent food from coming back into the mouth and control the release of food into the stomach.

Upon swallowing, the upper esophageal sphincter opens and the esophageal muscles contract to push food downward. The lower sphincter opens temporarily to allow food to pass into the stomach. Then the sphincter closes to prevent food and stomach acid from flowing backward up the esophagus.

The primary esophageal diseases and disorders

  • Cancer
  • GERD and Barrett’s esophagus
  • Hiatal Hernia and
  • Achalasia

GERD, Barrett’s Esophagus, Esophageal Cancer and Hiatal Hernia

GERD is gastroesophageal reflux. It is a common chronic disease where the stomach contents back up into the esophagus. The anatomical barriers that keep stomach acid from flowing upward are the lower esophageal sphincter and the diaphragm. Symptoms are heartburn, chest pain, and hoarseness.

A Hiatal Hernia is where the opening of the diaphragm is too large and the upper part of the stomach slides into the chest causing GERD. A hiatal hernia can be seen on an X-ray.

When GERD constantly irritates the esophagus, it can damage the lining of the esophagus and result in Barrett’s esophagus, a precancerous condition. About 8% of people with GERD go on to develop Barrett’s esophagus.

Esophageal cancer accounts for 4% of cancer deaths in the U.S. There are two types – either adenocarcinoma or squamous cell carcinoma. Squamous cell carcinoma symptoms include difficulty swallowing, chest pain, weight loss and painful swallowing. Squamous cell carcinoma is associated with alcohol and tobacco consumptions, some chemicals and vitamin deficiencies. Adenocarcinoma of the esophagus is primarily caused by Barrett’s esophagus.

Achalasia is a rare disease of the esophagus where people have difficulty swallowing because their throat muscles don’t relax and allow food to pay into the stomach. It is believed to be caused by a malfunction of the nerves in the esophagus.

In GERD and Achalasia, the problem is a malfunction of the esophageal sphincters.

Diagnosis

Barium Swallow

Barium swallow is test where x-rays of the esophagus are taken while the patient swallows a solution called barium. Esophageal contractions and the lower sphincter are visible in real time. With Achalasia the normal contractions are missing, and the esophagus is enlarged above the stricture of the lower sphincter.

Endoscopy

Endoscopy is a test that allows the surgeon to visualize the inside of the esophagus, the lower sphincter and the stomach. Using a thin flexible tube.

CT Scans and endoscopic ultrasound

Barrett’s esophagus is associated with H. Pylori bacterial infection, so test for this bacterium will be conducted.

Treatment

Treatment may involve a change in diet, medication, surgery and laser treatments. Chemotherapy and radiation are used to treat cancer. At Advanced Surgical and Bariatrics of NJ our team of elite surgeons is knowledgeable, attentive and thorough, kind, compassionate, and professional. You will receive a comprehensive evaluation and a personalized treatment plan.


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