Diseases of the Oesophagus
Manifested by dysphagia (difficulty swallowing); pain (colic spasmodic substernal pain); aspiration or regurgitation of food and liquids
Gastro-oesophageal reflux disease (GERD):
Retrograde movement of gastric contents from stomach into oesophagus (normal process that can happen several times a day, but may become pathologic); commonest cause of indigestion – more commonly know as heartburn.
Four factors may be involved in pathogenesis – transient lower oesophageal sphincter relaxation; a lower resting pressure of the sphincter; a decreased ability of the oesophagus to clear itself of reflux material; and a delay in gastric emptying
Clinical features – ‘heartburn’ is most common symptom, especially after going to bed
Management – antacids; cessation of smoking; reduced consumption of alcohol; reduction in dietary fat; smaller meals; weight reduction if overweight; avoid lying down for 3 hrs after eating; elevation of head of bed; avoidance of foods that precipitate; drugs (eg: esomeprazole, lansoprazole)
Oesophagitis:
Inflammation of oesophagus caused by infection, reflux of gastric juice (peptic oesophagitis) or exogenous irritants (eg chemicals)
Hiatal Hernia:
Protrusion of part of stomach through hiatus of diaphragm into thoracic cavity. Affects up to 30% of population; often asymptomatic; often causes heartburn and regurgitation.
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