The openings at the top of the esophagus at the back of the throat and at the bottom of the esophagus at the entrance to the stomach are closed off by muscles called sphincters (called the upper esophageal sphincter and the lower esophageal sphincter). The sphincters open in order to let food and liquid pass through but then close up again to prevent any materials from backing up from the stomach into the esophagus and from the esophagus to the mouth.
Diagnosis of Esophageal Diseases
Tests that may be used to diagnose diseases of the esophagus include barium X-rays (or barium swallow), upper endoscopy, pH monitoring, and an esophageal manometry study.
During a barium swallow, X-rays are taken of the esophagus after barium solution is swallowed. In an upper endoscopy, a tube with a camera and a light on the end is passed through the mouth and into the esophagus.
The pH of the esophagus is measured with a special instrument that is passed into the esophagus.
Esophageal manometry involves using a narrow, flexible, pressure-sensitive tube to measure pressure created by the muscles in the esophagus and the valves in the top and bottom portions of the esophagus.
Common Diseases of the Esophagus
The following diseases can affect the esophagus.
Crohn’s Disease
The esophagus can be affected by Crohn’s disease, though it is very rare and estimated to occur in less than 1% of patients. Symptoms of Crohn’s disease in the esophagus can include trouble swallowing or painful swallowing and heartburn.
If Crohn’s disease in the esophagus is suspected, an upper endoscopy may reveal ulcers, fistulas, or strictures in the esophagus. Treatment for Crohn’s disease in the esophagus can include medication, esophageal dilation, enteral nutrition, and surgery.
GERD
One fairly common condition that can affect the esophagus is gastroesophageal reflux disease (GERD). In GERD, the sphincter between the esophagus and the stomach is weakened, which allows the food and digestive juices in the stomach to enter back into the esophagus.
Many people experience an occasional bout of heartburn or indigestion, but GERD is diagnosed when reflux is occurring more than two times per week. Over time, GERD can lead to more serious conditions such as an ulcer or strictures.
Other Diseases
Diseases and conditions of the esophagus include:
Achalasia Barrett’s esophagus Cancer Esophageal ring (Schatzki’s ring) Esophageal ulcer Esophageal varices Esophageal web Esophagitis Gastroesophageal reflux disease (GERD) Heartburn Mallory-Weiss tear Plummer-Vinson syndrome
