Esophagus: Overview, Disorder Types, Causes & Treatments

The esophagus is the muscular tube that carries food and liquids from your mouth to the stomach. You won’t know about your esophagus until you swallow something too big, too hot, or too cold. You can even notice it when something goes wrong. You may feel pain or have trouble swallowing.

The most common problem with the esophagus is GERD (Gastroesophageal Reflux Disease). With GERD, a muscle at the end of your esophagus doesn’t close properly. This allows stomach contents to leak back up, or reflux, into the esophagus and cause irritation. Over time, GERD can damage the esophagus.

Other problems include heartburn, cancer and eosinophilic esophagitis. Doctors can use a variety of tests to make a diagnosis. These include imaging tests, upper endoscopy and biopsy.

Esophagus – Overview, Disorder Types, Causes & Treatments

What are Esophageal Disorders?

Esophageal disorders are a collection of conditions that affect how the esophagus works. Your esophagus — or food pipe — is the part of the digestive system that helps food move from your mouth to your stomach.

Various diseases can affect the esophagus, causing dysphagia or difficulty swallowing. The most common esophageal disorder is gastrointestinal reflux disease (GERD). GERD is a condition in which excessive stomach acid flows back up into the esophagus (acid reflux), causing inflammation.

Esophageal and Swallowing Disorders Include The Following:

  • Abnormal propulsion of food
  • Esophageal spasm
  • Dysphagia lucoria
  • Esophageal pouch (diverticula)
  • Eosinophilic esophagitis
  • Achalasia
  • Esophageal laceration (Mallory-Weiss syndrome)
  • Esophagus blockage
  • Esophageal rupture
  • Hiatus hernia
  • Esophageal webs
  • Gastroesophageal reflux disease (GERD)
  • Throat propulsion disorder
  • Esophagus injuries
  • Lower esophageal ring
  • Esophagus infection

What are The Symptoms of Esophagus Disorders?

Symptoms vary depending on the type of esophageal disorder. You can experience:

  • Abdominal pain, chest pain or back pain.
  • Chronic cough or sore throat.
  • Difficulty swallowing or feeling like food is stuck in your throat.
  • Heartburn (feeling of burning in the chest).
  • Wheezing or hoarseness.
  • Indigestion (burning feeling in the stomach).
  • Regurgitation (uptake of stomach acid or your esophagus into your mouth) or vomiting.
  • Unexplained weight loss.

How are Esophageal Disorders Diagnosed?

Your gastroenterology hospital will evaluate your symptoms and perform a physical exam. They can feel your neck while swallowing.

Diagnostic Tests for Esophageal Disorders Include:

  • Upper endoscopy examines the upper part of the digestive tract using a long, thin scope. Your provider may also take tissue samples for biopsy and look for signs of inflammation, cancer, and other diseases.
  • Gastrointestinal X-rays (barium swallows) use imaging to see how a liquid barium solution flows through the esophagus and digestive tract.
  • Esophageal manometry measures how well the muscles in your esophagus and lower esophageal sphincter work when you swallow a liquid.
  • The esophageal pH test measures the amount of stomach acid (pH level) in your esophagus.

How are Esophageal Disorders Treated?

Treatments vary depending on the condition. They may include:

  • Antacids, proton pump inhibitors, and histamine receptor (H2) blockers to reduce stomach acid.
  • Laparoscopic antireflux surgery (Nissen fundoplication) to treat GERD or a hiatal hernia by strengthening the lower esophageal sphincter.
  • Botulinum toxin (Botox┬«) injections to temporarily prevent esophageal spasms or to relax the sphincter muscles.
  • Heller myotomy and perioral endoscopic myotomy (POEM) treat achalasia and esophageal spasms.
  • Endoscopic dilation to open a narrowed esophagus or to relax a sphincter muscle.
  • Esophagectomy surgery to remove part or all of the diseased esophagus.

What Questions Should I Ask My Doctor?

You may want to ask your gastro doctor:

  • What type of esophagus disorder do I have?
  • What caused this esophageal disorder?
  • What is the best treatment for this type of esophagus disorder?
  • What are the risks and side effects of the treatment?
  • Am I at risk for other esophageal disorders?
  • What diet or lifestyle changes can I make to protect my health?
  • Should I pay attention to complications?

Treatment of esophageal disorders depends on the problem. Some problems get better with over-the-counter medicines or dietary changes. Others may require prescription drugs or surgery.