Diseases of the Esophagus

May 11, 2011

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Esophagus   It is invaluable in the human body. Thanks to him we have everything necessary for the work of other bodies, because the food consumed by us, gives us the energy to live. But this body, like the rest of our body is exposed to diseases that not only bring pain, but also psychologically hard to bear, as accompanied by belching, heartburn , Unpleasant odor. Such diseases affect not only the health of the whole body, but also the daily life of the patient. The most common diseases are caused by esophageal motility disorders or organ tumors, cysts and benign tumors and cancer. About the main diseases of the esophagus, their symptoms, diagnosis and treatment will be discussed further.

Esophageal disease and symptoms

For esophageal motility disorders are diseases such as achalasia . esophageal spasm of the esophagus . peptic esophagitis . chalasia cardia   and difragmentalnye hernia . These diseases have several different nature of the flow and symptoms.

Achalasia Or cardiospasm   It refers to neuromuscular diseases. It is a violation of the reflex opening of the lower esophageal sphincter during the passage of food. The causes of this disease of the esophagus are not known, it appears between the ages of 20-40 years, more frequently in women. Complications of the disease is most often caused by the long delay of food in the esophagus. In adults, a common complication is inflammation of the esophagus, which in turn can cause cancer of the esophagus like, and the upper part of the stomach. Children are more common complications such as pneumonia, lung abscess and other respiratory diseases, caused by the ingress of food.

Symptoms of achalasia   are characterized by the triad. The first manifestation of the disease of the esophagus - a violation of swallowing, or dysphagia . This symptom can occur suddenly or gradually, increasing after a nervous excitement. In some cases, there is a paradoxical dysphagia when rigid and dense food passes normally, and no liquid. Dysphagia may also depend on the temperature of food. The second symptom of achalasia is regurgitation They occur when the overflow of the esophagus when there is a sharp contraction of the muscles. The third symptom is pain Caused by a spasm of the muscles of the esophagus when it is full. Chest pain goes away after the passage of food into the stomach. These symptoms are also joined by nausea, belching air, a burning sensation in the esophagus, excessive salivation.

Esophageal spasm of the esophagus   - Spasm of the esophageal wall, is not accompanied by dysfunction of the lower sphincter of food, is caused by nerve disorders. Esophagism often seen in men of middle and old age can be a symptom of other disorders of the digestive tract.

Symptomatic esophageal spasm   esophagus is chest pain that is often mistaken for symptoms angina . Pain can occur not only during the meal, but also between the methods. They come in varying intensity and duration. In addition to pain is a disease characterized by impaired swallowing paradoxical nature, the volatility of the symptoms are different from other esophageal spasm esophageal diseases and tumors of the esophagus.

Peptic esophagitis Or reflux esophagitis   caused by failure of the lower esophageal sphincter of food, resulting in casts of stomach contents back into the esophagus. The same for a chalasia and cardia, but it is often caused by a hiatal hernia. In connection with such emissions gastric juice, bile, pancreatic juice suffers esophageal mucosa. There is inflammation, ulcers, scarring in the esophagus, which loaned. This disease of the esophagus is very slow, in some cases it can be detected in infants.

Symptoms of reflux esophagitis - a burning sensation in the chest, heartburn, pain, belching. Some symptoms are worse in the torso in the supine position, while smoking or alcohol intake. Belching may cause the development of aspiration pneumonia. This occurs by ingestion of gastric contents into the respiratory tract, especially at night regurgitation accompanied by a cough. Complications of the disease can be bleeding   and scarring.

Diaphragmatocele   - Moving body from the abdominal cavity into the chest cavity. Hernias can be congenital, acquired or traumatic defects, most often seen in patients with eating hernia aperture they may be Moving   or paraesophageal . This disease has a very meager symptoms. The main symptoms of diaphragmatic hernia - anemia and hidden bleeding.

Benign esophageal tumors grow slowly and almost asymptomatic. Most often they are found by chance, in some cases, the patient can feel the growing swallowing disorder that develops over several years.

In contrast to the benign tumors and cysts, esophageal cancer has more severe symptoms and are diagnosed at times more often than other diseases of the esophagus. Cancer is 60-80% of all diseases of the esophagus, is the sixth in incidence between the ages of 50-60 years old, more common in men in this age group smoking and abusing alcohol. Here are some reasons that cause esophageal cancer: complications dysmotility authority, namely achalasia, Barrett's esophagus, papilloma   and scarring, which can be after burn the esophagus   caustic substances.

First, esophageal cancer manifests a sense of discomfort and pain in the chest of the patient, dysphagia, increased salivation, weight loss. The first one or two years the symptoms of esophageal cancer is practically not observed, then as long as the tumor starts to narrow the esophagus, gradually increasing dysphagia, pain intensified.

Diagnosis of diseases of the esophagus

Diagnosis of Esophageal Disease in the early stages is carried out using ezofagotonokimografii . Esophagus investigated using a multichannel probe to open cans or catheters, which detect changes in the esophagus and reduce the pressure therein. Most often, such a study is carried out when it detects the symptoms of achalasia.

X-rays makes it possible to detect the deformation of the esophagus because of its muscle spasm. Such studies are prescribed for suspected esophageal spasm, esophageal reflux esophagitis, diaphragmatic hernia and tumors of the esophagus. When symptoms of reflux oesophagitis is appointed within the esophageal pH monitoring and esophageal motility study, which makes it possible to set the pH in the lower esophagus and the lower esophageal sphincter dysfunction. To detect gastroesophageal reflux sometimes prescribed x-ray with barium, the patient should be lying down on his back with a raised foot end.

Of course, an important role in the diagnosis of diseases of the esophagus plays a patient survey, which the attending physician must conduct before you assign any investigation. Many of the symptoms of diseases of the esophagus may be a manifestation of other diseases. It is therefore very important to ensure that this does not diseases of the digestive system That require urgent surgical intervention.

Treatment of diseases of the esophagus

Conservative treatment of diseases of the esophagus is appointed in the early stages of diseases such as achalasia, reflux esophagitis and uncomplicated diaphragmatic hernia.

If achalasia appointed nitropreparatov . ganglioplegic . nifedipine   and other similar drugs, calcium antagonists. But the main treatment of this disease is kardiolatatsiya. This method is borrowed by the expansion space in the esophagus using balloon pneumatic kardiodilatatora. Such treatment is contraindicated in patients with achalasia, portal hypertension, which is accompanied by esophageal varices, patients with severe esophagitis, blood diseases. If contraindications apply alternative methods.

Conservative treatment of esophageal spasm   is sparing diet, prescribing nitro, sedative and antispasmodic drugs. If there is no positive effect of surgical treatment, which is rassekanii muscle layer of the esophagus. It is important to begin treatment as soon as the first symptoms of esophageal spasm of the esophagus, as in this case, the probability of avoiding surgical treatment is much higher.

Treatment of reflux esophagitis is aimed at reducing intra-abdominal pressure, symptoms of esophagitis, weight loss up to age norm. Compulsory appointed mechanically and chemically sparing diet, split meals. Because the drug is prescribed H2-receptors: ranitidine . famotidine Which reduces gastric acidity, and are assigned antispasmodic drugs and enveloping means. Apply prokinetiki   to increase the compressive force of the lower esophageal sphincter and the gastric emptying time. Surgical treatment is indicated for axial hiatal hernia, bleeding and stenosis.

Treatment of diaphragmatic hernia sliding nature carried out conservatively, reducing the symptoms of gastroesophageal reflex. Surgical treatment is carried out for complications, such as bleeding, narrowing of the esophagus, the ineffectiveness of conservative treatment. The last complication is more common in patients with congenital defects and failure of the lower esophageal sphincter.

Talking about the conservative treatment of esophageal cancer is not necessary. This happens because diagnosis of disease at early stages when it does not give a positive effect. Radical treatment is carried out directly as a preparation before the operation. In the early stages of the disease positively affect purely radiation therapy or surgery, in the later only their combination.

The use of chemotherapy and radiotherapy prior to surgery improves outcomes in several times. Irradiation is carried out a few weeks before surgery, the method of remote gamma-therapy. Surgical intervention is dependent on the location of the malignant tumor. If struck the lower part of the esophagus, it is removed together with the upper part of the stomach, lousy remainder of the esophagus into the stomach stump. With the defeat of the middle portion, the esophagus is removed completely, carried out pre-suturing the stomach wall to the abdominal wall and create a fistula to enter the tube feeding.

After one or two years after the removal of the esophagus, in the absence of recurrence of the esophagus is reduced, replacing it with the small intestine. Relapse can happen, provided ineffective radiotherapy. The mortality rate of this disease is associated not so much with metastasis as the depletion of the body on the basis of the primary tumor. On this, the sooner discovered a malignant disease of the esophagus and underwent surgery, the better prognosis of treatment.