Reflux, Barrett’s esophagus, esophageal pain, achalasia, sagging lower esophageal sphincter are some of the common esophageal diseases that endanger people’s health. Esophageal pain is similar to chest pain with various problems while swallowing food. We want to study this disease and effective treatment methods for it.
The esophagus is the connection between the throat and the stomach, which directs the chewed food in the mouth to the stomach, which is inside the abdomen. This organ does not play a significant role in the digestion and absorption of food, but its health and existence, like all organs of the body, is essential, and if it becomes ill, it can cause harm and sometimes endanger the patient’s health.
Because heart disease is so important, and if neglected, it may even cost patients their lives. If a patient complains of chest pain, they must first make sure they do not have a heart problem. But the most common cause of chest pain is still esophageal disease. Some people also have a sensitive esophagus and feel pain in the esophagus for no reason. Sometimes chest pain is due to cramping or contraction of the esophageal muscles, which is seen in movement disorders such as achalasia and spasm (contraction).
The following is a list of esophageal problems:
Reflux
Definition: There are 2 sphincters in the esophagus; The upper sphincter is located after the throat and opens when food is swallowed, then the food goes to the stomach with smoky movements. Before entering the stomach, there is another end of the sphincter that must be opened to allow food to pass into the stomach. If the end sphincter has a problem, the person will have a condition called reflux or the return of food from the stomach to the esophagus.
Prevalence: This disease is very common
Symptoms: Patients describe GERD in the form of heartburn, heartburn, and chest pain. Some may feel the bitterness or return of swallowed food to the mouth after eating or when bending over and lying down.
Treatment: GERD is usually relieved by drinking water or eating stomach syrup.
Esophageal pain
Definition: There are nerve endings in the end of the esophagus and under the mucosa.
Symptoms: In people with GERD, the acid may go under the mucosa, irritate the nerve endings, and cause pain.
Mary Bart
Definition: In Bart esophagus, gastric mucosa grows in the esophageal tube. On endoscopy, the white mucosa of the esophagus is pink. Of course, a sample of this tissue must be taken and sent to a pathology laboratory to confirm such a change.
Follow-up: Patients with Barrett’s esophagus should have endoscopy and biopsy every 2-3 years.
Treatment: If certain cellular changes are seen, the area is burned or removed in a special way. This disease does not hurt at all.
Ashlazi
Definition: Achalasia is a disease in which the lower esophageal sphincter does not open when food reaches it.
Pathogenicity: The cause is damage to the esophageal nerves. This disease is caused by the herpes virus or herpes on the lips. In some genetically predisposed people, the virus damages the esophageal nerves and causes the esophageal sphincter to close, but eventually the esophagus dilates and food gets stuck in the esophagus.
Symptoms: Food entanglement becomes more severe in these patients when they eat in a hurry or become nervous. Such patients prefer to eat alone because sometimes they have to return food with a finger. Some patients also develop bad breath and chew when food returns to the mouth.
Treatment: Achalasia is the opening of the sphincter with a balloon by endoscopy. However, sometimes the surgeon cuts the annular muscles of the esophagus with a larascopy to loosen the lower esophageal sphincter a little. Of course, this may cause coughing and even food returning to the trachea and lungs and causing lung disease.
Loosening of the lower esophageal sphincter
Definition: The cause of sagging lower esophageal sphincter may be congenital or associated with a diaphragmatic hernia. A diaphragmatic hernia usually occurs after the age of 60. This is actually a burnout process, but a diaphragmatic hernia can make symptoms worse in people with gastroesophageal reflux disease.
Danger symptoms: Obesity, weight gain, pregnancy, overeating, wearing tight clothing, lying down immediately after eating and taking certain medications are also causes of esophageal valve relaxation.
Pathogenicity: The esophageal valve opens and closes again for a few seconds after food enters the stomach. Stomach acid that rises or saliva that enters the esophagus from the mouth is mixed and neutralized. Of course, the force of gravity in the sitting position of the person also neutralizes the acid. In patients with GERD, the esophageal valve stays open longer and food returns more often.
Pharmacotherapy: Treatment of patients is diet modification and medication. Patients should avoid sour, spicy, fatty, fried and bulky foods, alcohol and cigarettes, orange juice, strong tea, carbonated beverages and coffee. Also, eat 3 hours before bedtime and do not lie down immediately after eating. Stomach acid inhibitors such as omeprazole, pentaprazole, and. Are prescribed to patients.
The duration of medication is long and the dose of medication should be reduced gradually and with the advice of a doctor. Patients should use special beds that bend from the waist up so that the head and torso are at a higher angle when sleeping. In other words, the size of 2 bricks above the trunk. Endoscopy is recommended for patients for whom drug treatment is ineffective, over 50 years old, or more than 5 to 10 years after the onset of symptoms.
Prognosis: A small percentage of patients may develop mucosal changes in the esophagus called Barrett’s esophagus. These lesions can progress to precancerous lesions. (It is very unlikely and patients should not worry too much about it.)
Esophageal muscle contraction, reflux
Inflammation of the esophagus causes painful swallowing and food entanglement
Difficulty Swallow
Definition: May be due to malignancy. When the diameter of the esophagus reaches less than 13 mm, the person has difficulty swallowing food or gets stuck in his esophagus. Difficulty swallowing can have many causes.
Causes: Causes such as esophageal motility diseases, esophageal ulcers and esophageal stricture due to caustic substances have been discussed in the past, but in addition to the above causes, we must also pay attention to esophageal cancer that causes swallowing disorders. Esophageal cancer is characterized by a lump in the middle of the esophagus. Unfortunately, it has no symptoms, and when it does, the person has difficulty swallowing and the disease has progressed.
Risk factors: This cancer is more common in smokers and alcoholics after the age of 50-60, but parts of Iran such as the Caspian Sea coast, Turkmen port and the northeast are areas where esophageal cancer is more common in their population. These people have both a genetic background and eat foods that are carcinogenic.
Pathogenicity: The carcinogenic substance called acetaldehyde is abundant in the diet of the people of these areas. This substance is caused by the metabolism of alcohol. In addition to alcohol and cigarettes, acetaldehyde is found in soft, loose or large fruits that are too sweet, leftovers and unprotected foods, foods cooked on charcoal or in the oven, such as charcoal or blackened kebabs, and breads that Their heat source is charcoal and diesel, and the bread dough is placed directly on it (the best way to bake bread is to use electric and electric heat or machine bread). Of course, with a few consumption of these foods, nothing happens to the person, but if a person is accustomed to consuming such foods for a long time, it means tens of years.
Risk factors: He also has a good genetic background, his risk of developing esophageal cancer increases. Hot foods are sometimes said to cause esophageal cancer, which is somewhat true. Of course, there is a weak relationship between the two. Poor oral hygiene also causes bacteria in the mouth to produce stalagmites and carcinogens. Regular consumption of fresh vegetables and fruits protects the esophagus.
Treatment: Most patients with esophageal cancer present in the advanced stages of the disease and surgery may not be very helpful. In these cases, doctors try to keep the patient alive with radiotherapy and chemotherapy, but definitive treatment is usually not possible. For this reason, people who have a genetic predisposition to esophageal cancer or live in areas where esophageal cancer is common use an early diagnostic method to find esophageal cancer cells called endoscopy.
Screening: In northern Iran, Turkmen port and Gorgan, Meshkinshahr and Ardabil province, people with a high risk of developing this type of cancer have been trained for 40-50 years and older to go for endoscopy themselves.
Disseminated spasm
Definition: In diffuse esophageal spasm, weak and regular smoky movements disappear and the esophagus experiences very strong and prolonged contractions.
Pathogenicity: The contraction of the esophagus prevents food from moving and staying still.
Symptoms: These patients also have severe chest pain and food gets stuck in their esophagus. This pain is also often confused with heart pain.
Voice in the esophagus
Definition: Some patients feel the esophagus ring.
Causes: These sounds may be due to air reflux. Sometimes it is a nerve tic that the patient subconsciously pushes the food upwards.
Treatment: This condition is not dangerous at all and does not require treatment.
Inflammation of the esophagus
Definition: Esophagitis or inflammation of the esophagus is usually caused by reflux or recurrence of esophageal acid, but rarely fungal diseases such as thrush and monilia may also affect the esophagus and cause inflammation.
Risk factors: Patients with weakened immune systems, such as those with AIDS, patients undergoing chemotherapy, or people with cytomegalovirus and herpes may also develop esophagitis. Inflammation of the esophagus causes painful swallowing and food entanglement.
Diagnosis: Patients should undergo endoscopy and biopsy to determine the exact cause of the inflammation.
Esophageal stricture
Definition: Occasionally malignant diseases, severe and prolonged reflux, past irritant contact with the esophageal wall, or injuries to the esophagus by taking certain pills.
Symptoms: Narrowing of the esophagus and food stagnation become so severe that the patient can not lift or swallow food at all and feels suffocated.
Treatment: This is a medical emergency and the doctor must guide the bite out or into the stomach through endoscopy.
