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)
Inflammation of oesophagus caused by infection, reflux of gastric juice (peptic oesophagitis) or exogenous irritants (eg chemicals)
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.