Esophagus

Esophagus Surgery in Surat

Esophagitis

Esophagitis is an inflammation of the lining of the esophagus, the tube connecting the throat to the stomach. Symptoms include heartburn and pain while swallowing. Treatment and ways to limit discomfort are discussed.

What is esophagitis?

Esophagitis is an inflammation (swelling) of the lining of the esophagus, the tube that connects the throat to the stomach. If it is not treated, esophagitis can become very uncomfortable, causing difficulty in swallowing, and ulcers or scarring of the esophagus. Barrett’s esophagus, a complication of acid reflux, is a risk factor for cancer of the esophagus.

What causes esophagitis?

Esophagitis is an irritation of the esophagus caused by any of the following:

  • A backflow of acid fluid from the stomach to the esophagus (GERD)
  • Vomiting
  • Medications such as aspirin and anti-inflammatories
  • Viruses, fungi, bacteria, or diseases that weaken the immune system
What are the symptoms of esophagitis?

Symptoms of esophagitis include:

  • Difficult and/or painful swallowing
  • Heartburn
  • Acid regurgitation (bringing food back up to the mouth from the stomach)

If you have any of these symptoms, you should contact your healthcare provider.

How is esophagitis diagnosed?

Once your doctor has performed a thorough physical examination and reviewed your medical history, there are several tests that can be used to diagnose esophagitis. These include:

  • Endoscopy: A long, flexible lighted tube called an endoscope is used to look at the esophagus.
  • Biopsy: A small sample of the esophageal tissue is removed and sent to a laboratory to be examined under a microscope.
  • Barium X-ray: X-rays are taken of the esophagus after the patient drinks a barium solution. Barium coats the lining of the esophagus and is visible on X-ray. This enables doctors to view abnormalities of the esophagus.
How is esophagitis treated?

Treatment for esophagitis depends on its cause. While medications that block acid production may be recommended, other medications may be prescribed for cases of esophagitis that are caused by infection. While you are being treated for esophagitis, you can take the following steps to help limit discomfort:

  • Avoid spicy foods such as those with pepper, chili powder, curry and nutmeg.
  • Avoid acidic foods and beverages such as tomatoes, oranges, grapefruits and their juices. Instead, try nectars and imitation fruit drinks with vitamin C.
  • Include more soft foods such as applesauce, cooked cereals, mashed potatoes, custards, puddings and high-protein shakes in your diet.
  • Take small bites and chew your food thoroughly.
  • Avoid alcohol and tobacco.
What is the prognosis (outlook) for people who have esophagitis?

The causes of esophagitis usually respond to treatment; however, some causes, such as acid reflux, may require long-term treatment.

GERD

A digestive disease in which stomach acid or bile irritates the food pipe lining. This is a chronic disease that occurs when stomach acid or bile flows into the food pipe and irritates the lining. Acid reflux and heartburn more than twice a week may indicate GERD. Symptoms include burning pain in the chest that usually occurs after eating and worsens when lying down. Relief from lifestyle changes and over-the-counter medication is usually temporary. Stronger medication may be required.

Symptoms

People may experience are usually self -diagnosable symptoms including burning pain in the chest that usually occurs after eating and worsens when lying down. Also people may experience gastrointestinal symptoms such as belching, heartburn, nausea, and regurgitation. Also common symptoms are  bitter taste, discomfort in upper abdomen, or dry cough.

Treatment 

 

 

 In this disease they have two types of treatment. 

 

  1. Self – care

( i ) Elevated head of bed:- Reduce the likelihood of acid reflux or developing pneumonia      

                                from saliva entering the airways.  

( ii ) Dietary modification:- Adjusting diet to prevent or treat disease.

( iii ) Weight Loss:- Can improve cardiovascular health and reduce the risk of 

       complications related to obesity. 

 

  1. Medications

( i ) Antacid:- Counteracts the effects of stomach acid.

( ii ) Proton pump inhibitor:- Decreases acid release in the stomach.

( iii ) Antidiarrheal:- Reduces frequency and urgency of bowel movements.

 

Esophageal Stricture

What is an esophageal stricture?

An esophageal stricture is an abnormal tightening or narrowing of the esophagus. Your esophagus is a muscular tube that connects the throat to the stomach, carrying food and liquid. A stricture narrows the esophagus, making it more difficult for food to travel down the tube. In severe cases, even drinking liquid can be difficult.

Esophageal strictures can be:
  • Cancerous: These strictures get worse quickly.
  • Benign (not cancerous): Benign strictures tend to progress slowly.
What are the types of esophageal strictures?
  • Simple strictures are smaller, leaving a wider opening in the esophagus. They are usually straight and symmetrical. Their surfaces and margins (borders) are smooth.
  • Complex strictures are longer and leave a narrower opening. They are not straight or symmetrical and have uneven surfaces and margins.
How does an esophageal stricture affect me?

People with esophageal strictures may have pain or difficulty swallowing.

Who is at risk for esophageal strictures?

Risk factors for esophageal strictures include:

  • Alcohol use.
  • Cancer in the neck area.
  • Gastroesophageal reflux disease (GERD).
  • Hiatal hernia.
  • Peptic ulcer disease.
  • A history of dysphagia (difficulty swallowing).
Are esophageal strictures common?

Esophageal strictures are not common. They can occur at any age but usually affect people older than 40 years.

What causes esophageal strictures?

Conditions or treatments that cause inflammation or scarring in the esophagus can lead to strictures:

  • Eosinophilic esophagitis: This allergic reaction/immune system problem causes inflammation in the esophagus, possibly leading to strictures.
  • Esophageal cancer: When abnormal cells divide or grow out of control in esophageal tissue, the tumour can cause strictures.
  • Gastroesophageal reflux disease (GERD): With GERD, stomach acid can flow backward. The acid damages the lining of your esophagus. This type of stricture is called a peptic stricture.
  • Radiation Therapy: Treatment for cancer in the head, neck or chest can cause strictures up to a year and a half later.
  • Surgery: A procedure in the esophagus can leave inflammation and scarring, causing a stricture.
  • Other Causes: Ulcers, some medications (for example, some antibiotics and non-steroidal anti-inflammatory drugs), certain infections and accidentally swallowing chemicals can also cause strictures.
What are the symptoms of an esophageal stricture?

An esophageal constriction may cause:

  • Burning sensation in the neck or throat.
  • Difficulty swallowing (dysphagia).
  • Feeling of food getting stuck in your throat.
  • Frequent episodes of choking.

Talk to a healthcare provider if you experience any of these symptoms. Strictures can lead to malnutrition and dehydration. Your provider can figure out what’s causing the strictures, so you get the right treatment and feel better.

Achalasia Cardia

Achalasia is a rare disorder that makes it difficult for food and liquid to pass from the swallowing tube connecting your mouth and stomach (esophagus) into your stomach.

Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people mistake this for gastroesophageal reflux disease (GERD). However, in achalasia the food is coming from the esophagus, whereas in GERD the material comes from the stomach.

There’s no cure for achalasia. Once the esophagus is paralyzed, the muscle cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery.

Symptoms

Achalasia symptoms generally appear gradually and worsen over time. Signs and symptoms may include:

  • Inability to swallow (dysphagia), which may feel like food or drink is stuck in your throat
  • Regurgitating food or saliva
  • Heartburn
  • Belching
  • Chest pain that comes and goes
  • Coughing at night
  • Pneumonia (from aspiration of food into the lungs)
  • Weight loss
  • Vomiting
Causes

The exact cause of achalasia is poorly understood. Researchers suspect it may be caused by a loss of nerve cells in the esophagus. There are theories about what causes this, but viral infection or autoimmune responses have been suspected. Very rarely, achalasia may be caused by an inherited genetic disorder or infection.

Treatment

Endoscopic surgery or laparoscopic surgery can be done for this condition where myotomy (release of muscular spasm) is done using surgical intervention. Patients usually have immediate relief after surgery and he or she can go back to routine working life within 24 hours.

Motility Disorder

The esophagus functions solely to deliver food from the mouth to the stomach where the process of digestion can begin. Efficient transport by the esophagus requires a coordinated, sequential motility pattern that propels food from above and clears acid and bile reflux from below. Disruption of this highly integrated muscular motion limits delivery of food and fluid, as well as causes a bothersome sense of dysphagia and chest pain. Disorders of esophageal motility are referred to as primary or secondary esophageal motility disorders and categorized according to their abnormal manometric patterns.

Hiatus Hernia

A condition in which part of the stomach pushes up through the diaphragm muscle. In hiatus hernia, part of the stomach pushes into the chest cavity. It enters via an opening where the food tube (oesophagus) passes on its way to the stomach.

Symptoms

Hiatus hernias can have no symptoms. In some cases, they may be associated with heartburn and abdominal discomfort. People may have pain in the abdomen or chest. Also they may have gastrointestinal problems like belching, heartburn, hiccup, nausea, regurgitation, vomiting or throat irritation.

Treatment

Treatment depends on severity. Hiatus hernias may not require any treatment. Some are treated with drugs and a few types need surgical repair. 

(1) Self – care

( i ) Weight Loss:- Can improve cardiovascular health and reduce the risk of complications related to obesity. 

(2) Medication

( i ) Antacid:- Counteracts the effects of stomach acid.

( ii ) Proton pump inhibitor:- Decreases acid release in the stomach.

(3) Surgery

( i ) Nissan Fundoplication:- Surgery to strengthen the value between the stomach and the esophagus.                  Makes it harder for stomach acid to go up the oesophagus. 

( ii ) Hernia Repair:- Surgical repair of a weak spot on the abdominal wall so that the intestines can’t push               through.

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