Your esophagus is like a laundry chute, except instead of dirty clothes, the chute transports food and liquids. This seemingly simple part of your anatomy is prone to several conditions, most of which call for professional medical attention to avoid malnutrition and other complications.
Our team of specialists at Rockland Thoracic & Vascular Associates treats a wide spectrum of esophageal conditions before they progress and lead to more serious problems. Here, we’ve highlighted some of the most common esophageal conditions along with their symptoms and treatments.
Anatomy of the esophagus
Your esophagus is part of your digestive tract. It looks like a long tube with two sphincters — one at the top and one at the bottom — to control the flow of food and liquid.
When you swallow, the upper esophageal sphincter (UES) opens to receive the chewed food, then closes. The muscles in your esophagus then contract and relax, squeezing the food down the tube.
Once it reaches the bottom, your lower esophageal sphincter (LES) opens to release the food into your stomach, and closes behind it.
Esophageal malfunctions may result from any of several conditions. We highlight some of them here.
Achalasia
The main symptom of esophageal achalasia is difficulty swallowing. In this condition, the muscles in your esophagus don’t contract and relax properly, so you can’t move the food down and out.
Although the reasons are not fully understood, the nerve cells deteriorate, and the muscle malfunctions.
Achalasia also affects the sphincter at the bottom of your esophagus. Ideally, your LES contracts to open and relaxes to close. But with achalasia, it doesn’t relax, so it stays open, allowing acid from your stomach to flow back into the esophagus. This is known as gastrointestinal acid reflux (GERD).
Achalasia only affects about 1 in every 100,000 people each year. In addition to difficulty swallowing and GERD, achalasia causes:
- Regurgitation
- Choking
- Coughing
- Sensation of a lump in your throat
- Malnutrition and weight loss
Treatments include dilation of your esophagus to stretch the LES, Botox® injections to relax the LES, and surgical myotomy to divide the LES muscles.
Since achalasia puts you at high risk for esophageal cancer, you should seek treatment as soon as you notice a problem.
Barrett’s esophagus
Everyone gets heartburn now then, but if yours is frequent and chronic, you may develop Barrett’s esophagus, an irreversible condition that occurs when long-term GERD changes the lining of your esophagus.
It’s hard to self-diagnose Barrett’s esophagus because the symptoms are essentially the same as acid reflux. For that reason, it’s easy to brush the symptoms off as the price you pay for a lasagna dinner. But there are a few distinguishing characteristics of Barrett’s esophagus:
- Burping
- Burning in your upper abdomen
- Bitter taste in your mouth
- Bad breath
It may help to think of them as the four Bs of Barrett’s esophagus. These symptoms typically kick in about an hour after you eat, last for several hours, and get worse when you lie down.
If this describes your symptoms, we urge you to come in for an evaluation, as Barrett’s esophagus is another condition with a high risk of esophageal cancer.
We treat Barrett’s esophagus with either radiofrequency (RF) ablation, which uses RF energy to heat up the diseased tissue and destroy it, or mucosal resection to surgically trim the diseased tissue and suction it away.
Esophageal cancer
For many years, the primary cause of esophageal cancer was smoking, but today, we see more cases that stem from severe acid reflux and complications from obesity.
When caught early, both types of esophageal cancer can be treated successfully with surgery. Unfortunately, symptoms are stealthy and often don’t show up until advanced stages. A few warning signs to watch for include:
- Trouble swallowing
- Throwing up undigested food
- Severe heartburn
- Vomiting blood
- Passing blood in the stool (black)
- Chronic coughing
- Hoarse voice
- Unexplained weight loss
Since some of these symptoms overlap with other esophageal conditions, we encourage all our patients to come in for a thorough exam for any new, changing, or chronic symptoms.
If you have an advanced stage of esophageal cancer that has progressed beyond the window of effectiveness for surgery, we may recommend radiation or chemotherapy.
Other esophageal conditions
In addition to what we’ve listed above, other esophageal conditions include:
- Schatzki’s ring
- Ulcers
- Esophagitis
- Esophageal varices (enlarged veins)
- Esophageal web (membrane tissues that narrow your esophagus)
- Mallory-Weiss tear (a tear in your esophagus)
Our experienced team of specialists at Rockland Thoracic & Vascular Associates can diagnose and treat any esophageal condition you may have, but early detection and treatment are always key to a successful outcome.
If you have any concerning symptoms, contact us at any of our five locations in the Washington Heights section of Manhattan, New York City; in Pomona, Goshen, and Fishkill, New York; and in Englewood, New Jersey.