Diseases of the esophagus: symptoms and treatment

Functions of the esophagus are probably known to everyone. According to this simple, at first glance, body swallowed by human food moves into the stomach. As it turned out, the diseases of the esophagus, the symptoms of which will be considered in the article, are quite complex and diverse, as it easily inflames and painfully reacts to all the errors in our diet.

It is interesting that a person, revealing signs of any illness of the named organ, most often relates them to problems with the work of the stomach, heart or spine diseases, and in order to correct the situation, let's try to get to know them better.

What is dysphagia?

First, let's look at the symptoms accompanying almost every disease of the esophagus.

The first of these is dysphagia. This is a violation of the swallowing process, which is caused by functional problems or organic obstacles on the way of food movement through the esophagus.

This disorder characterizes the sensation that food is stuck during ingestion or passage to the stomach. By the way, it must be distinguished from aphagia, which is a sign of complete obstruction of the esophagus and requires urgent care.

Heartburn

Another symptom of the disease Stomach and esophagus is a feeling of a chest pain that spreads to the neck and sometimes to the arms. As a rule, heartburn accompanies regurgitation (ejection) of gastric contents, as well as the feeling that a warm wave is rolling up to the throat.

Heartburn intensifies after eating, in cases when the patient leans forward, takes a horizontal position or physically strains. And its intensity can be reduced if you simply swallow saliva, take a few sips of water or take antacid (neutralizing effect of hydrochloric acid) funds.

Frequent and severe heartburn is a sure sign of problems with the functioning of the esophagus: for example, reflux of bile or hydrochloric acid, a violation of the ability of the body to stretch, as well as inflammation of its mucosa (esophagitis).

Odynophagia

The soreness of the act of swallowing, which occurs behind the sternum, is that lone phage is usually caused by a lesion in the mucosa of the esophagus. It should be distinguished from spastic chest pain associated with pushing hard lumps of food. Odynophagia is a nonspecific symptom, which means it is difficult to determine which pathology in the organ described was the cause of the pain.

For reflux esophagitis, this symptom is not characteristic, but it can be detected with infectious esophagitis (especially with its candidal and herpetic variety). At a chemical burn, an ulcer and a cancer also there is a pain in an esophagus - the reasons of a similar sign in the given cases lay on a surface.

Atypical pain in the thorax

Atypical pain differs from heartburn or loneliness. In contrast to the latter, by the way, it can occur with reflux-esophagitis, as well as in cases of motor disorders of the esophagus, for example, with esophagospasm. This symptom manifests itself during meals, and spontaneously.

Constant and painful pain in the esophagus, the reasons for which we will consider later, may be a sign of cancer or ulcers of the esophagus. By the way, in the same patient it can have a different character, sometimes the patients even find it difficult to describe their feelings.

In some cases, this chest pain can be associated with atypical disorders in the esophageal motility. In this case, patients can also observe behavioral disorders, depression, panic and psychosomatic disorders and anxious mood.

Regurgitation

This symptom has already been mentioned in the description of heartburn, as it is a concomitant symptom. Usually, the regulation occurs without nausea and contractions of the diaphragm and, as a rule, accompanies many diseases of the esophagus and stomach.

Symptoms of thumping gastric contents into the oral cavity accompany pathologies such as stricture or diverticulum of the esophagus. And with gastroesophageal reflux, the addition of a bitter or sour taste in the mouth to the regulation is also due to the inadequacy of the esophageal sphincters.

This symptom is dangerous to the ingestion of gastric contents into the respiratory system, which can cause not only an attack of cough, but also suffocation. Sometimes regurgitation can trigger the development of aspiration pneumonia.

How are the main diseases of the esophagus manifested: achalasia

Signs of the esophagus, expressed in pain and heaviness behind the sternum, the appearance of belching, reflux, swallowing problems, nausea, heartburn, bad breath from the rotting food in the esophagus may indicate the occurrence of achalasia.

This disease is also called "cardiospasm" and is a neuromuscular pathology, which is accompanied by a violation of the opening of the sphincter located in the lower part of the esophagus and called cardiac. As a result, food can not enter the stomach, causing the above symptoms.

The causes of this disease are unknown. And in some cases, its appearance is sudden, and in others it develops gradually. The patient often adapts to manifestations of achalasia, reducing their intake of large amounts of water, gymnastic exercises, etc.

But the further development of pathology requires a serious answer to the question of how to treat the esophagus. To do this, methods are used to eliminate the barrier to food - cardiodilation (balloon expansion of the sphincter) or cardiomyotomy (surgical dissection of the sphincter muscles). Drug treatment, as a rule, is of an auxiliary nature.

Symptoms and treatment of esophagospasm

Diseases of the esophagus, the symptoms of which we are considering, can develop and with the normal functioning of the sphincter. In this case, there is a spasm in this organ, which, as a rule, is a consequence of diseases of the digestive organs or nervous disorders.

With this pathology, the patient complains of pain of varying strength at the time of passage of food through the esophagus and problems with swallowing. By the way, sometimes these pains arise between meals and then they are easily confused with signs of angina pectoris.

When examining the esophagus with this disease, as a rule, its deformation is revealed, caused by muscle spasms. These diseases of the esophagus require treatment, mainly, conservative, and, in addition, it is necessary to appoint a sparing diet and antispasmodics, as well as sedatives and nitrofuran agents. In the case of persistent disorders, the patient needs balloon dilatation or surgical intervention.

What is reflux esophagitis?

This disease is also called peptic esophagitis and is characterized by pellet contents of the stomach in the esophagus. The reason for this phenomenon is the insufficiency of its lower sphincter. Prolonged action of gastric juice and bile is aggressive and leads to inflammatory processes and ulceration of the mucosa, with scarring of which there is a narrowing of the esophagus.

As a rule, this disease occurs slowly and is quite often observed in infants.

In this disease of the esophagus, the symptoms are usually manifested in the form of heartburn and a burning sensation in the retrosternal area that can arise or increase with tilts forward, in a prone position, at the time of smoking or drinking alcohol.

Esophagitis can be complicated by bleeding (most often hidden), aspiration pneumonia and scar changes in the esophagus.

To diagnose this pathology, esophagogastescopy and X-rays with barium are carried out . And the treatment is aimed at eliminating the main cause that causes esophagitis (pilorospasm, hernia in the esophagus of the diaphragm or pyloroduodenal stenosis). The patient is also prescribed drugs that reduce acidity ("Ranitidine" and "Famotidine"), antacids and antispasmodics. Diet with a disease of the esophagus is sparing, and food is fractional.

Diaphragmatic hernia

Sometimes, through the congenital and acquired defects in the diaphragm, the abdominal organs move into the thoracic cavity - this state is defined as the diaphragmatic hernia. Most often it develops in the esophageal aperture of the diaphragm. As already mentioned above, the symptom of this pathology is reflux-esophagitis, as well as latent bleeding and the state of anemia.

How to treat the esophagus in this case, resolves the exact diagnosis by X-ray and endoscopy. As a rule, therapy is conservative, aimed at reducing reflux. In cases of narrowing of the esophagus or bleeding, surgical intervention is indicated.

Barrett's esophagus disease

With pain in the throat, behind the sternum, casting the contents of the stomach into the mouth, heartburn, acid taste in the mouth, chronic cough and hoarseness of the voice, one can speak of a disease of the esophagus, which has the name of Barrett's metaplasia.

The cause, which provokes the development of this disease, has not yet been established, but it is found out that this rather serious complication occurs against the background of gastro-reflux-esophagitis (GREB). In addition, it is this pathology that can be an impetus for the development of a cancerous tumor.

Metablasia Barrett accompanies the degeneration of cells of the mucous surface - the cells of the esophagus mucosa are replaced by cells of the intestinal mucosa. By the way, it is this condition that is considered precancerous, regardless of the fact that esophageal cancer is a fairly rare disease.

Barrett Metaplasia: Diagnosis and Treatment of Esophageal Disease

Symptoms, the treatment of which requires accurate diagnosis, with Barrett metaplasia is necessarily confirmed by additional studies in the form of endoscopy and biopsy.

To do this, a special thin tube is inserted into the throat, through which the esophagus can be examined, and then a tissue sample is taken from it for subsequent analysis of the condition of the cells.

In the treatment of Barrett's esophagus, attention is usually focused on the treatment of GREV, which provokes metaplasia, and also on the prevention of cancer. The therapy has the same character as for the treatment of GREB (antacids and antireflux medications), but is more intense. If it, together with diet therapy does not bring relief, as well as in cases of infringement of the hernia, the patient is shown a surgical intervention called fundoplication (formation of an artificial valve).

Cancers of the esophagus

Diseases of the esophagus, the symptoms of which are discussed in the article, are complex diseases, but the most serious pathology is undoubtedly cancer.

In the development of a cancerous tumor in the esophagus, an important role is played by chronic inflammatory processes in this organ caused by chemical, thermal or mechanical stimulation. And smoking and alcohol abuse increase the risk of cancer 12 times!

As a rule, at the outset the disease is asymptomatic, and this process can last up to 2 years. When the tumor grows to such a size that the lumen in its esophagus narrows, the patient shows signs of problems with the passage of food through this organ. The increase in dysphagia is a characteristic symptom of the development of the tumor process. And if at the beginning of the disease it appears only when ingested poorly chewed or dense food, then the patient can subsequently use only products in liquid or semi-liquid form.

These signs are added to the deterioration of the general condition: lethargy, loss of appetite, weight loss. In the acute stages of the narrowing of the lumen in the esophagus, salivary salivation also appears.

In some patients, tumor development is accompanied by painful sensations in the back or behind the breastbone. As a rule, they occur at the time of swallowing and after a while they themselves disappear. Rarely, such pains are permanent.

Treatment of cancer of the esophagus

Treatment of diseases of the esophagus affected by a cancerous tumor is reduced to surgical intervention, radiation and chemotherapy. In the first case, the patient completely or partially removed the esophagus. It depends, in the main, on how widespread the process is. In addition, in the areas of the appearance of metastasis, lymph nodes are removed. But this method of treatment may be contraindicated for some patients (for example, in cardiovascular pathologies or impaired functions of the respiratory system).

Radiation therapy is the only method that can be used to treat the majority of patients with esophageal cancer (in 40% of cases it can eliminate severe clinical manifestations of the disease). Chemotherapy, in general, is used for a low-grade form of cancer.

There is also a combination treatment, in which radiotherapy before surgical intervention seriously affects the reduction of local relapses, and also reduces the development of the tumor.

Benign tumors

Among benign neoplasms in the esophagus include epithelial and non-epithelial tumors. These are rather rare pathologies, and their peculiarity is the slow course of the disease and the absence of severe symptoms.

As a rule, these tumors develop from the esophageal wall and sometimes fall into its lumen. The most frequent among them are leiomyomas, and on the second place are cystic neoplasms.

The main symptoms in the presence of benign tumors is slowly increasing dysphagia, and (with the development of polyps) the sensation of the presence of a foreign body, which causes nausea and vomiting.

Most often, such tumors are detected by chance, during the X-ray study.

Like many diseases of the esophagus, the treatment of benign neoplasms reduces to their surgical removal, in order to avoid possible complications associated with tumor growth. As a rule, the removal takes place without damaging the mucosa of the esophagus and has a favorable prognosis.

Mellory-Weiss Syndrome

In diseases of the esophagus and stomach, the symptoms are often manifested by vomiting or urges on it. Sometimes the patient at this time there is a rupture of the mucosa in the esophageal-gastric passage. This pathology in medicine is called the Mellory-Weiss syndrome.

As a rule, its manifestation is severe pain in the chest, and vomit masses appear blood. And although most of the victims bleeding stops on their own, such a patient should be urgently hospitalized to avoid serious complications.

As a vaccine, for the treatment of the syndrome, vasoconstrictors are used, as well as, if necessary, electrocoagulation.

Malformations of the esophagus

Sometimes the diseases of the larynx and esophagus are directly related to anomalies in the development of the latter - with the underdevelopment of its shape, size or wrong position.

As a rule, similar pathologies are manifested in the narrowing of the esophagus, the presence of congenital esophageal and tracheal fistulas, and sometimes in the total absence of the organ described. Unfortunately, the pathology of the development of the esophagus can doom the newborn even to starvation, so surgical intervention is required to get rid of them.