Esophagus

A specialist doctor in the field of any disorder or infection of the digestive system is known as the gastroenterologist. It also includes the infection of the stomach, esophagus or food pipe, large intestine, small intestine, liver, pancreas, bile duct, gall bladder, and pancreatic duct. The gastroenterologist will help to analyze any disease or disorder and create a treatment plan accordingly. 

GERD (gastroesophageal reflux disease) occurs when the acid in the stomach repeatedly flows back into the tube which connects the esophagus and mouth. This acid reflux or the backwash may inflame the lining of the esophagus. This generally takes place due to the relaxed LES or the lower esophageal sphincter or the valve between the stomach and food pipe. Too much intake of carbonated or caffeinated beverages, smoking, and alcohol consumption may lead to gastroesophageal reflux. Other factors are stress, lack of proper sleep, and poor dietary habits. 

The most general symptom of GERD (gastroesophageal reflux disease) is acid indigestion or heartburn. It generally feels like a burning chest pain that begins behind the breastbone and moves towards the throat and neck. It gives a feeling like the food is returning in the mouth along with a bitter or an acid taste. The heartburn pain may be around for 2 hours. It becomes worse after eating. Bending or lying down may also cause heartburn. Heartburn pain may be mistaken for a heart attack or a heart disease but there are many differences in both types of pain. Pain caused by heartburn doesn’t usually worsen with any kind of physical activity while the pain due to heart problems usually worsen with exertion. Other symptoms like vomiting, nausea, bad breath, difficulty in swallowing may also be accompanied by heartburn. 

GERD (gastroesophageal reflux disease) can be cured with the help of medication. But if the medications don’t work or when the patient shows critical GERD symptoms, surgery like Fundoplication is one of the options. The surgeon covers up the top of the stomach around the LES or the lower esophageal sphincter to tighten the muscles and to avoid reflux. 

If the person has constant signs and symptoms, he or she should visit gastroenterologist. If the patient experiences difficulty in swallowing, frequent coughing, back or chest pain along with belching, and throat burn kind of symptoms then he or she should visit the doctor immediately. The pain caused by burping or swallowing that spreads out to the back is a cardinal symptom of esophageal problems and the patient should immediately consult a gastroenterologist. 

Many conditions affect the esophagus. The major ones include: 

Achalasia: which is a disorder of the food pipe or the esophagus where the sphincter or the muscle, which is at the base of the pipe and opens into the stomach, does not relax or contract as needed due to the nerve damage or there exists other cause of obstruction. 

Barrett's Esophagus: Frequent reflux of the acid of the stomach inflames the esophagus which may change its structure. 

Esophageal Cancer.

Gastroesophageal Reflux Disease (GERD)

Gastroparesis.

Swallowing Disorders: This includes trouble in swallowing (dysphagia) or pain while swallowing (odynophagia). 

Endoscopy is a type of method wherein a flexible thin tube attached with a camera enters the patient’s body through the mouth. This method is a minimalistic invasive way to detect and treat gastrointestinal diseases. This procedure may be done using local anesthesia or with general anesthesia. 

Dr. (Col) V.K.Sharma

Dr. Amitabh Dutta

Dr. Chandrasekhar Jyothiraj

Dr. Mohit Shetty

Dr. Shubahyu Banerjee

Dr. Manoj Gupta

Asian Institute of Gastroenterology, Hyderabad.

Apollo Hospitals, Greams Road.

BLK Super Specialty Hospital.

Indraprastha Apollo Hospital, New Delhi.

Manipal Hospital, Bangalore.

Fortis Memorial Research Institute, Gurgaon.

Aster CMI, Hebbal.

Wockhardt Hospitals

These specialist doctors initially detect and treat GI diseases in both women and men. They carry out endoscopic procedures that use special instruments to watch the GI tract and analyze. They do not execute surgery. They would refer the case to the surgeon if any surgery is needed. 

There is no particular reason but frequent inflammation of the esophagus may lead to the changes which cause esophageal cancer. The role of these risk factors such as smoking, GERD (gastroesophageal reflux disease), Barrett’s esophagus, consumption of alcohol, obesity, bile reflux, trouble in swallowing due to the esophageal sphincter which doesn’t relax – Achalasia, constant drinking of hot liquid, any kind of radiation treatment on the upper abdomen or chest, etc may cause cancer development. 

The survival rate of patients having cancer in the esophagus is around 47%. The survival rate for patients having infection which has spread to the regional lymph nodes or the surrounding organs or tissues is around 25%. If the infection or cancer has spread to other parts of the body then the survival rate is around 5%. 

Barrett’s esophagus is linked with an increased risk of growing esophageal cancer. Though the risk of growing esophageal cancer is quite small, it’s very important to go for standard checkups with imaging and widespread biopsies of the esophagus to check for dysplasia or the pre-cancerous cells. 

Diagnosis of esophageal cancer is carried out with a double-contrast barium esophagram. This test shows irregular thinning, ulceration, stiffness of the esophagus, sudden angulations of the esophagus. The Endoscopy process is more sensitive to identify esophageal cancer since it allows direct visualization of the area which is affected and biopsy and/or brush cytology of the affected tissue can be done in an endoscopic procedure. Also, a EUS- endoscopic ultrasound is a technical low-risk process that allows imaging at nearer proximity to identify even the slightest mucosal changes. Screening endoscopy is carried out on patients who face an increased risk of forming esophageal cancer like Barrett’s esophagus.