The functions of the esophagus are probably known to everyone. According to this simple, at first glance, organ, the food swallowed by a person moves into the stomach. As it turned out, the diseases of the esophagus, the symptoms of which will be considered in the article, are quite complex and diverse, since it is easily inflamed and painfully reacts to all the errors in our diet.
It is interesting that a person, detecting signs of any disease of the named organ, most often relates them to problems with the work of the stomach, heart or diseases of the spine, and in order to correct the situation, we will try to get to know them better.
What is dysphagia?
First, let's look at the symptoms that accompany almost every esophageal disease.
The first of these is dysphagia. These are violations of the swallowing process, which are caused by functional problems or organic obstacles to the movement of food through the esophagus.
This violation characterizes the feeling that food is stuck at the moment of swallowing or passing to the stomach. By the way, it must be distinguished from aphagia, which is a sign of complete obstruction of the esophagus and requires emergency care.
Heartburn
Another symptom of the disease the stomach and esophagus is a sensation of sternal burning, which spreads to the neck, and sometimes to the hands. As a rule, heartburn is accompanied by regurgitation (discharge) of gastric contents, as well as the sensation that a warm wave rolls up to the throat.
Heartburn worsens after eating, in cases where the patient leans forward, takes a horizontal position or physically strains. And its intensity can be reduced if you simply swallow saliva, take a few sips of water, or take antacids (neutralizing the effect of hydrochloric acid).
Frequent and severe heartburn is a sure sign of problems with the functioning of the esophagus: for example, reflux of bile or hydrochloric acid, impaired ability of the organ to stretch, as well as inflammation of its mucous membrane (esophagitis).
Odinophagy
The soreness of the swallowing act that occurs behind the sternum is odnophagy, as a rule, due to damage to the mucous surface of the esophagus. It should be distinguished from spastic chest pain associated with pushing a hard lump of food. Odinophagy is a nonspecific symptom, which means that it is difficult to determine which pathology in the described organ caused the pain.
For reflux esophagitis, this symptom is not characteristic, but it can be detected with infectious esophagitis (especially with its candidal and herpetic species). With a chemical burn, ulcer and cancer, pain in the esophagus is also observed - the causes of a similar symptom in these cases lie on the surface.
Atypical chest pain
Atypical pain is different from heartburn or odynophagia. Unlike the latter, by the way, it can also occur with reflux esophagitis, as well as in cases of impaired motility of the esophagus, for example, with esophagospasm. This symptom manifests itself both with food and spontaneously.
A constant and excruciating pain in the esophagus, the causes of which we will consider later, may be a sign of cancer or ulcer of the esophagus. By the way, in the same patient it can have a different character, sometimes patients even find it difficult to describe their feelings.
In some cases, this chest pain may be associated with atypical disorders in the motility of the esophagus. Moreover, patients may also experience behavioral disorders, depression, panic and psychosomatic disorders, and anxiety.
Regurgitation
This symptom was already mentioned in the description of heartburn, since it is a concomitant symptom. Usually, regulation occurs without nausea and contractions of the diaphragm and, as a rule, accompanies many diseases of the esophagus and stomach.
Symptoms of throwing gastric contents into the oral cavity accompany pathologies such as stricture or esophageal diverticulum. And with gastroesophageal reflux, the appearance of a bitter or sour taste in the mouth also attaches to the regulation, due to the failure of the esophageal sphincter.
The described symptom is dangerous when gastric contents enter the respiratory system, which can cause not only a coughing fit, but also choking. Sometimes regurgitation can trigger the development of aspiration pneumonia.
How are the main diseases of the esophagus: achalasia
Signs of esophageal disease, expressed in pain and heaviness behind the sternum, belching, reflux, swallowing problems, nausea, heartburn, bad breath due to rotting food in the esophagus, may indicate the occurrence of achalasia.
This disease is also called "cardiospasm" and is a neuromuscular pathology, which is accompanied by a violation of the opening of the sphincter, located in the lower part of the esophagus and called cardiac. As a result of this, food cannot enter the stomach, thereby causing the symptoms listed above.
The causes of this disease are unknown. And in some cases, its appearance is sudden, and in others - it develops gradually. The patient often adapts to the manifestations of achalasia, reducing their intake of large amounts of water, gymnastic exercises, etc.
But the further development of pathology requires a serious answer to the question of how to treat the esophagus. To do this, apply methods aimed at eliminating the barrier to the passage of food - cardiodilation (balloon expansion of the sphincter) or cardiomyotomy (surgical dissection of the muscles of the sphincter). Medication, as a rule, is auxiliary in nature.
Symptoms and treatment of esophagospasm
Esophageal diseases, the symptoms of which we are considering, can also develop with the normal functioning of the sphincter. In this case, a spasm occurs in this organ, which, as a rule, is a consequence of digestive organs diseases or nervous disorders.
With this pathology, the patient complains of pain of varying strength at the time of passage of food through the esophagus and problems with swallowing. By the way, sometimes these pains occur between meals and then they are easily confused with signs of angina pectoris.
When examining the esophagus with this disease, as a rule, its deformation is detected, caused by muscle spasms. These diseases of the esophagus require treatment mainly conservative, and, in addition, the appointment of a sparing diet and antispasmodic drugs, as well as sedatives and nitrofuran agents. In the case of persistent disorders, the patient requires balloon dilatation or surgery.
What is reflux esophagitis?
This disease is also called peptic esophagitis and is characterized by throwing the contents of the stomach into the esophagus. The reason for this phenomenon is the failure of its lower sphincter. The prolonged action of gastric juice and bile is aggressive in nature and leads to inflammatory processes and ulceration of the mucosa, which, when scarring, causes narrowing of the esophagus.
As a rule, this disease proceeds slowly and is quite often observed in infants.
In this disease of the esophagus, symptoms usually manifest as heartburn and a burning sensation in the sternum, which can occur or intensify when leaning forward, lying down, while smoking or drinking alcohol.
Esophagitis can be complicated by bleeding (most often hidden), aspiration pneumonia, and cicatricial changes in the esophagus.
To diagnose this pathology, esophagogastroscopy and x-ray with barium are performed . And the treatment is aimed at eliminating the underlying cause of esophagitis (pylorospasm, hiatal hernia or pyloroduodenal stenosis). The patient is also prescribed drugs that reduce acidity ("Ranitidine" and "Famotidine"), antacid and antispasmodic drugs. The diet for esophageal disease is sparing, and the nutrition is fractional.
Diaphragmatic hernia
Sometimes through congenital and acquired defects in the diaphragm, the abdominal organs move into the chest cavity - this condition is defined as a diaphragmatic hernia. Most often, it develops in the esophageal opening of the diaphragm. As mentioned above, a symptom of this pathology is reflux esophagitis, as well as hidden bleeding and anemia.
How to treat the esophagus in this case solves the exact diagnosis using x-ray and endoscopic examination. As a rule, therapy is conservative in nature, aimed at reducing reflux. In cases of narrowing of the esophagus or bleeding, surgical intervention is indicated.
Barrett's Esophagus Disease
With sore throat, behind the breastbone, throwing the contents of the stomach into the oral cavity, heartburn, acid taste in the mouth, chronic cough and hoarseness, one can speak of an esophageal disease called Barrett metaplasia.
The reason that provokes the development of this disease has not yet been established, but it has been found that this rather serious complication occurs against the background of gastro-reflux esophagitis (GREB). In addition, this particular pathology may be the impetus for the development of a cancerous tumor.
Barrett metaplasia is accompanied by degeneration of the mucosal surface cells - the cells of the esophagus mucosa are replaced by cells of the intestinal mucosa. By the way, it is this condition that is considered precancerous, regardless of the fact that cancer of the esophagus is a rather rare disease.
Barrett metaplasia: diagnosis and treatment of esophageal disease
Symptoms, the treatment of which requires accurate diagnosis, with Barrett metaplasia are necessarily confirmed by additional studies in the form of endoscopy and biopsy.
For this, a special thin tube is inserted into the patient’s throat, with which you can examine the esophagus, and then a tissue sample is taken from it for subsequent analysis of the state of the cells.
When treating Barrett's esophagus, attention usually focuses on the treatment of GREB, which provokes metaplasia, as well as on the prevention of cancer. Therapy is of the same nature as for the treatment of GREB (antacids and antireflux drugs), but is more intense. If it, together with diet therapy does not bring relief, as well as in cases of infringement of a hernia, the patient is shown a surgical intervention called fundoplication (the formation of an artificial valve).
Esophageal Cancer
Esophageal diseases, the symptoms of which are considered in the article, are complex diseases, but the most serious pathology is undoubtedly cancer.
In the development of a cancerous tumor in the esophagus, chronic inflammatory processes in this organ, caused by chemical, thermal or mechanical irritation, play an important role. And smoking and alcohol abuse increase the risk of cancer by 12 times!
As a rule, at the very beginning, the disease is asymptomatic, and this process can last up to 2 years. When the tumor grows to such a size that because of it the lumen in the esophagus narrows, the patient shows signs of problems with the passage of food through the named organ. The growth of dysphagia is a characteristic symptom of the development of the tumor process. And if at the beginning of the disease he appears only when swallowing poorly chewed or dense foods, then subsequently the patient can only use foods in liquid or semi-liquid form.
To these signs is added a worsening of the general condition: lethargy, loss of appetite, weight loss. During the sharp stages of narrowing of the lumen, profuse salivation also appears in the esophagus.
In some patients, the development of the tumor is accompanied by painful sensations in the back or behind the sternum. As a rule, they arise at the moment of swallowing and after some time they themselves disappear. Rarely, such pains are permanent.
Esophageal Cancer Treatment
Treatment of diseases of the esophagus affected by a cancerous tumor boils down to surgery, radiation and chemotherapy. In the first case, the patient’s esophagus is completely or partially removed. This mainly depends on how common the process is. In addition, in the areas of metastasis, lymph nodes are removed. But this method of treatment may be contraindicated for some patients (for example, with cardiovascular pathologies or impaired respiratory system functions).
Radiation therapy is the only method that can be used to treat most patients with esophageal cancer (in 40% of cases, it can help to eliminate the severe clinical manifestations of the disease). Chemotherapy is mainly used for a low-grade form of cancer.
There is also a combination treatment, in which conducting radiation therapy before surgery seriously affects the reduction of local relapses, as well as reduces the development of the tumor.
Benign tumors
Among the benign neoplasms in the esophagus are epithelial and non-epithelial tumors. These are quite rare pathologies, and their feature is the slow course of the disease and the absence of severe symptoms.
As a rule, these tumors develop from the wall of the esophagus and sometimes fall into its lumen. The most common among them are leiomyomas, and cystic neoplasms are in second place.
The main symptoms in the presence of benign tumors are slowly growing dysphagia, as well as (with the development of polyps) a sensation of the presence of a foreign body, which causes nausea and vomiting.
Most often, such tumors are detected by chance during an X-ray examination.
Like many diseases of the esophagus, the treatment of benign neoplasms is reduced to their surgical removal, in order to avoid possible complications associated with tumor growth. As a rule, removal takes place without damage to the mucous membrane of the esophagus and has a favorable prognosis.
Mallory Weiss Syndrome
In diseases of the esophagus and stomach, the symptoms are often manifested by vomiting or urging on it. Sometimes the patient at this moment has a rupture of the mucous membrane in the esophageal-gastric junction. This pathology in medicine is called Mellory-Weiss syndrome.
As a rule, its manifestation is severe chest pain, and blood appears in the vomit. And although the majority of victims stop bleeding on their own, such a patient should be urgently hospitalized to avoid serious complications.
As a rule, vasoconstrictors are used to treat the syndrome, as well as, if necessary, electrocoagulation.
Esophageal malformations
Sometimes diseases of the larynx and esophagus are directly related to abnormalities in the development of the latter - with an underdevelopment of its shape, size or incorrect position.
As a rule, such pathologies are manifested in narrowing of the esophagus, the presence of congenital esophageal-tracheal fistulas, and sometimes in the complete absence of the described organ. Unfortunately, pathologies of the esophagus can condemn the newborn even to starvation, so surgical intervention is required to get rid of them.