From the throat, food comes down to your stomach through the esophagus, an 8-inch long muscular tube lined with mucosa. It is situated in front of the spine, just behind the heart and the trachea. It passes through the diaphragm just before entering the stomach.
Esophagus muscles are divided into two: the upper esophageal sphincter (UES) and the lower esophageal sphincter (LES).
Located above the esophagus, the UES is a group of muscles responsible for keeping food and other contents from entering the trachea or windpipe. It is controlled consciously by the body, whenever you breathe, eat, vomit, or even so much as belch.
On the other hand, the LES is a group of muscles below the esophagus, adjoining the stomach. When closed, the LES keeps acidic contents in the stomach from backing up.
Esophagus conditions and diseases
Heartburn is a sensation familiar to many people, whether or not they have a healthy lifestyle. It happens when the LES is not closed completely, forcing acid and other stomach contents to go backwards into the esophagus, a process known as reflux.
Frequent reflux or GERD (gastroesophageal reflux disease) may lead to esophageal ulcer, wherein the walls of the esophagus become eroded. Chronic reflux may also cause the esophagus to narrow down, a condition known as esophageal stricture. Meanwhile, irritation from reflux is known to cause inflammation of the esophagus or esophagitis.
Excessive vomiting can likewise tear the walls of the esophagus. Such a gash, named Mallory-Weiss tear, causes the esophagus to bleed, spilling blood into the stomach. Patients may vomit blood as a result.
Meanwhile, patients with cirrhosis tend to suffer from varices or bulging veins in their esophagus. These veins are potentially fatal when they bleed.
Tissue sometimes accumulates in the upper esophagus. This mass of pent-up tissue is called an esophageal web; it is benign and causes no symptoms. However, an esophageal web may be a symptom of Plummer-Vinson syndrome, a condition caused by iron-deficient anemia, among others.
An esophageal ring, a.k.a Schatzki’s ring, is also an accumulation of tissue in the esophagus, but around its lower end. This condition can cause trouble in swallowing. Other than that, esophageal rings do not bear any symptoms.
Esophageal cancer is as rare as heartburn is common. But it is life-threatening. You stand to get this disease if you are a heavy smoker and drinker. Those with chronic reflux are also prone to this cancer. Though unusual, Barrett’s esophagus, a condition caused by chronic reflux, may worsen into esophageal cancer.
Even rarer than cancer is achalasia, a disease in which the LES does not loosen up normally. As a result, achalasia patients regurgitate their intake and have trouble swallowing.
Treating esophagus conditions
To reduce acid in your body, consequently treating GERD, ulcers and esophagitis, take antihistamines, e.g. H2 blockers. In the same way, you can use proton pump inhibitors, which switch off stomach pumps responsible for producing acid. Conversely, histamine stimulates acid release in the stomach. For a more natural approach, we recommend the FDA-registered Acid Free-Flux, a natural remedy for pain and burning in the stomach, chest or throat due to heartburn or acid indigestion.
As for a web, ring or stricture, doctors pass down a balloon into the esophagus, where they then inflate it. They do this to cure difficulty in swallowing, an oft-associated symptom of these conditions.
As for esophageal varices, doctors wrap special rubber bands around them by using an endoscope. The bands compel the varices to clot, preventing them from bleeding profusely.
For Plummer-Vinson syndrome, you would need iron replacement. You would also need to have the resultant esophageal webs dilated by a doctor.
For esophageal cancer, the first line of treatment usually consists of esophagectomy or surgical removal of the esophagus.
Tests for esophagus conditions
Endoscopy for the esophagus, known as esophagogastroduodenoscopy (EGD), involves the insertion of a camera-equipped probe or endoscope into your mouth. The endoscope in turn magnifies images of the organ and as far as the duodenum in the small intestine.
Doctors use another probe to monitor acidity or pH conditions in the esophagus. This method allows doctors to detect GERD quickly.
Instead of esophagus biopsies, many modern hospitals are increasingly using confocal laser endomicroscopy.
To accurately identify the reason why a patient is having trouble swallowing, doctors may use a barium solution. The person is made to imbibe it, after which the doctor takes X-ray images of the esophagus and the stomach.
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