Esophagus
- Disorders of Esophageal Motility:
- Cricopharyngeal dysfunction is caused by a failure of the upper esophageal sphincter to relax properly. Symptoms include dysphagia (difficulty to swallow), reflux of undigested food. Zenker's diverticulum can develop causing tracheal compression. Cricopharyngeal myotomy is the treatment of choice. Achalasia is an esophageal disease which consists of failure of the lower esophageal sphincter to relax during swallowing. Symptoms include dysphagia, followed by regurgitation and weight loss. Diagnosis is made by barium swallow, esophageal manometry and endoscopy. Nonsurgical treatment consists of pneumatic dilatation with the endoscope. Surgical treatment is esophagomyotomy (Heller procedure).
- Diffuse esophageal spasm is a disorder of esophageal motility that consists of strong nonperistaltic contractions. Symptoms consist of chest pain, usually occurs spontaneously. Medical and surgical treatment.
- Gastroesophageal Reflux:Is secondary to dysfunction of the lower esophageal sphincter, which results in recurrent reflux of the gastric contents into the lower esophagus. Symptoms are substernal pain, heartburn and regurgitation. Diagnosis is made by endoscopy (Reveals degree of esophagitis), manometry, 24-hour pH measurement. Medical treatment : Diet, weight reduction, antacids, proton pump inhibitors (Esomeprazol, etc.). Surgery in patients refractory to medical treatment. Additional problems such as hiatal hernia, Barrett's esophagus, severe esophagitis. Anti-reflux surgery can be performed open or laparoscopically.
