Athens Vein & Thoracic Specialists offers an extensive background in successful diagnosis and treatment for diseases of the esophagus.
The esophagus is a muscular tube that extends from the neck to the abdomen
and connects the back of the throat to the stomach. It can be affected by a number of diseases including:
- Gastroesophageal Reflux Disease (GERD)
- Hiatal Hernia
- Esophageal Cancer
- Achalasia and Esophageal Motility Disorders
The most common symptom of an esophageal disorder is heartburn, a burning sensation located under the breast bone that usually occurs after eating or at night. Occasional heartburn is common and no cause for alarm. Heartburn that is more frequent or interferes with your daily routine may be a symptom of a more serious condition that requires medical care. Tips To Control Heartburn
A circular muscle called the lower esophageal sphincter (LES) lies between your esophagus and stomach. This muscle is in charge of closing your esophagus after food passes to the stomach. If this muscle is weak or doesn’t close properly, the acid from your stomach goes into your esophagus, causing a burning sensation in your chest. Many people suffering from acid reflux may have a more serious condition called gastroesophageal reflux disease or GERD.
Like heartburn, GERD is a condition in which the contents of the stomach refluxes, or flows back into the esophagus due to a problem with the LES and causes inflammation of the esophagus. Unlike heartburn, this condition occurs on a regular basis (one to two times a week) and the pain isn’t relieved with antacids or other over-the-counter medication. Medications to control GERD symptoms: Pros and Cons
Symptoms of GERD may include:
- the feeling that the contents of the stomach have come back up to the throat or mouth
- chest pain
- dry cough
- asthma-like symptoms
- trouble swallowing
If left untreated, GERD can lead to more serious conditions within the upper digestive tract including esophageal cancer. Minimally invasive treatment options such as Nissen Fundoplication can be performed to alleviate GERD symptoms and prevent progression of esophageal disease. When is Surgery Needed to Correct Acid Reflux?
Occasionally a hiatal hernia may be associated with GERD. When a hiatal hernia is associated with GERD, severe heartburn may result.
A hiatal hernia is caused by an opening in the diaphragm, a flat muscle that separates the chest from the abdomen, allowing a portion of the stomach to protrude into the chest. Although most cases of GERD are caused by a weakened valve, this condition can cause the LES to fail.
In Barrett’s esophagus, the tissue lining of the esophagus changes to tissue that resembles the lining of the intestine and may develop in up to 20 percent of patients with GERD. Barrett’s esophagus is associated with an increased risk of developing esophageal cancer so it’s important to have regular checkups. With routine examination, your doctor can discover precancerous and cancer cells early before they spread and when the disease is easier to treat. Treatment options include periodic endoscopy to monitor the cells in your esophagus and minimally invasive surgical options to destroy any abnormal tissue.
Most of the length of the esophagus is lined with squamous cells, and if they degenerate into a malignant tumor can develop into a type of cancer called squamous cell cancer. The very bottom portion of the esophagus and the region where the esophagus and stomach join are lined with columnar cells that can give rise to malignant tumors called adenocarcinomas. Cancer of the lower esophagus has become more prevalent in recent years, due largely to an increase in the incidence of gastroesophageal reflux disease (GERD).
If an esophageal cancer is diagnosed, an individualized treatment plan needs to be devised and usually begins with proper staging. Staging is the process that physicians use to determine how advanced the cancer is and whether the cancer has spread. Depending on the type of cancer, specific staging tests are performed aimed at investigating the most common areas for that cancer to spread which dictates further treatment. Treatment often includes a combination of esophagogastrectomy surgery, chemotherapy and/or radiation therapy.
ACHALASIA and ESOPHAGEAL MOTILITY DISORDERS
In esophageal motility disorders, the muscular contractions of the esophagus become discoordinated or weak, interfering with movement of food down the esophagus. Achalasia is the most common esophageal motility disorder that is treated surgically. It is characterized by the absence of muscular contractions in the lower half of the esophagus and by failure of the valve at the bottom of the esophagus to open and let food into the stomach.
People with achalasia experience a progressive difficulty in eating solid food and in drinking liquids that can take years to evolve. They often experience regurgitation, have spasm-type chest pain and sometimes lose weight when their condition becomes advanced.
Heller myotomy is the preferred minimally invasive surgery used to treat Achalasia.