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Esophageal Disorders

Normal Esophageal Function

The esophagus is the tube that allows passage of food and liquids from the mouth to the stomach. In a healthy individual, swallowing involves coordinated muscle contractions of the mouth and esophagus. 

There is a specialized muscle at the top (superior esophageal sphincter SES) and at the bottom of the esophagus (lower esophageal sphincter LES). Both sphincters open/ relax to allow entry of food or liquid into the esophagus and stomach respectively. The lower esophageal sphincter then closes/ contracts to prevent backwards movement (reflux) of stomach contents back into the esophagus. Normally, this sphincter opens and closes outside of swallowing, to allow for ‘venting’. These are called TLESr or transient lower esophageal sphincter relaxations. These episodes occur sporadically and do not harm the esophagus.

In order for food or liquid to be delivered to the LES, a complex and elegant muscular action of the esophagus occurs, to propel food down the esophagus and into the stomach.

There are a number of disorders that can occur within the esophagus, and investigation may include any number of tests. The SHCEC has state-of-the-art technology, which allows for the diagnosis and management of esophageal disorders, which include:

  • Gastroscopy
  • 24 hour pH testing & Bravo Capsule (48 hour pH testing)
  • Impedance
  • Manometry
  • Dilation
  • Endoscopic Mucosal Resection (EMR)
  • Radiofrequency Ablation (RFA)

Disorders of the Esophagus

There are a number of common disorders arising from the esophagus and upper gastrointestinal tract:

  • GERD or gastroesophageal reflux disorder
  • NERD or non-erosive reflux disorder
  • Dyspepsia or ‘indigestion’
  • Barrett’s esophagus
  • Dysphagia (difficult swallowing)

Some less common disorders include:

  • Achalasia
  • Cricypharyngeal Bar
  • Diffuse Esophageal Spasm
  • Eosinophilic esophagitis
  • Esophageal cancer
    • Adenocarcinoma of the esophagus
    • Squamous cell carcinoma of the esophagus
  • Hypertensive LES
  • Nutcracker Esophagus
  • Scleroderma Esophagus

For more information on procedures and disorders of the esophagus, see Patient Education and Resources

Motor or motility dysfunction – the esophagus doesn’t “move” normally. This leads to difficulty swallowing or dysphagia. This may be because of abnormal muscle function within the esophagus, while. others have too much pressure in the esophagus that causes pain and makes it hard to swallow food. Some individuals lack motor function while others have poor relaxation of the sphincter between the esophagus and the stomach.

 

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