Esophageal Disorders Surgery
The esophagus, a muscular tube approximately 10 inches (25 cm) long, extends from the bottom of the throat, called the hypopharynx, to the stomach. It lies behind the trachea (windpipe) and in front of the spine. Functionally, the esophagus is a tube-like structure that transports food and liquids from the mouth to the stomach. This process, called peristalsis, involves a series of well-coordinated wavelike muscle contractions, allowing food to travel from the esophagus and into the stomach. However, disruptions in this coordinated movement can lead to various esophageal motility disorders.
There are two sphincters or areas that open and close in the esophagus, namely:
- Upper esophageal sphincter: As a person swallows, this ring-shaped muscle opens so that food and liquid can enter the esophagus, where these edibles are propelled downward through peristalsis movement. The upper esophageal sphincter also prevents air from entering the stomach.
- Lower esophageal sphincter: This is a special ring of muscle near the esophagus's lower part that controls food movement from the esophagus into the stomach. It closes between meals to prevent gastric content, such as stomach acid and digestive juices, from flowing back up the esophagus from the stomach to the mouth.
The most common issue related to the esophagus is GERD (gastroesophageal reflux disease). In individuals with GERD, the muscle at the end of the esophagus fails to close properly, allowing stomach contents to flow back into the esophagus and cause irritation. Over time, GERD can lead to damage in the esophagus.
Additional problems include heartburn, cancer and eosinophilic esophagitis. Doctors employ various diagnostic tests, including imaging studies, upper endoscopy and biopsies. Treatment approaches vary based on the specific problem, with some cases improving through over-the-counter medications or dietary adjustments, while others may require prescription drugs or surgical intervention.
Minimally invasive esophagectomy is a surgical procedure designed to remove part or the entire esophagus. After removal, the esophagus is reconstructed using a segment of the stomach or large intestine. This surgery is primarily performed to address esophageal cancer, but it can also be used when the esophagus fails to function as it should.
In minimally invasive esophagectomy, surgeons make small incisions in the upper abdomen, chest or neck and insert a laparoscope (a viewing scope) and surgical tools through these incisions to carry out the procedure. Some medical centers employ robotic surgery, which enables surgeons to remotely control a small scope and instruments inserted through tiny skin incisions while viewing a monitor. Surgeons usually complete a minimally invasive esophagectomy within three to six hours.
What Are Symptoms of Esophagus Problems?
Esophagus disorders can manifest with various symptoms. Here are some common signs to watch out for:
- Heartburn: Despite its name, heartburn does not affect the heart. Instead, it manifests as a burning sensation in the lower chest, often accompanied by a sour or bitter taste in the throat and mouth. This discomfort typically arises after consuming a large meal or while reclining. Heartburn can vary in intensity, ranging from mild to severe. The severity may be influenced by the type and quantity of food consumed. The primary indicator of heartburn is the burning sensation in the throat and chest, caused by the regurgitation of acidic liquid from the stomach into the esophagus. This reflux can lead to difficulty swallowing, coughing and hoarseness. Several factors can worsen heartburn, such as overeating, bending over, lying down, pregnancy, stress and specific foods.
- Chest pain: Most patients experiencing chest pain usually have an esophagus problem after ruling out cardiac, muscular and pulmonary issues. Esophageal chest pain primarily causes nerve sensitivity disturbances and muscle and mucosal dysfunction. The most frequent cause is GERD, which can manifest as chest pain, heartburn or difficulty swallowing. Additionally, esophageal chest pain may occur due to strong spasms caused by motility disorders of the esophagus.
- Dysphagia: This condition affecting swallowing can lead to difficulties ingesting solid foods, liquids and saliva. In severe cases, individuals may be unable to swallow altogether. Dysphagia can hinder the intake of sufficient calories and fluids necessary for proper bodily function. Acid reflux can harm the esophagus, resulting in scar tissue formation. Scarring may narrow the esophageal opening, which can worsen dysphagia. To minimize the risk of occasional swallowing difficulties, eat slowly, take small bites and chew food thoroughly. Early acid reflux treatment can also reduce the likelihood of scar tissue development in the throat.
- Globus: A persistent or occasional non-painful feeling of a lump or foreign object in the throat. It tends to be long-lasting, challenging to treat and prone to recurrence. Globus sensation often eases with eating and typically does not coincide with dysphagia or odynophagia (painful swallowing).
If you experience any of these symptoms, seeking medical evaluation for proper diagnosis and management is essential. Remember, early detection and appropriate treatment are crucial for maintaining esophageal health.
What Kind of Doctor Do You See for Esophagus Issues?
A gastroenterologist is a medical specialist who focuses on diseases related to the digestive system and liver. They receive specialized training in endoscopy, which involves using narrow, flexible tubes with built-in video cameras to examine the inside of the intestinal tract. Gastroenterologists also learn advanced endoscopic procedures like polypectomy (removing colon polyps), dilation of narrowed areas in the esophagus and intestines and hemostasis (stopping bleeding). They interpret findings and biopsy results to recommend appropriate treatments and prevent cancer. Some gastroenterologists also receive additional training to perform nonsurgical procedures, such as removing stones from the bile ducts and treating gastrointestinal tumors. The American College of Gastroenterology and the American College of Physicians designate exceptional gastroenterologists as "Fellows," the suffixes FACG and FACP are added to denote these honors.
Find a Gastroenterologist in Nacogdoches
HealthCare is Better Together. If you are experiencing pain or discomfort related to a gastrointestinal condition, have been recently diagnosed or know someone who has been diagnosed, the Nacogdoches Medical Partners may be able to help. Our goal is to help you better understand your gut health. Our dedicated team of experienced gastroenterologists performs gastrointestinal endoscopy and colonoscopy.
To schedule a complimentary consultation today, call 855-260-4374 or click on this patient portal link to request an appointment online.
