Common 💪Oesophageal❤️ Disorders🙏 Explained 🌹Simply

Описание: Disorders of the Oesophagus – Detailed Description
Introduction
The oesophagus is a muscular tube that connects the pharynx (throat) to the stomach. It plays a vital role in the digestive system by transporting food and liquids from the mouth to the stomach through coordinated muscular contractions known as peristalsis. Although it appears to be a simple passage, the oesophagus performs complex physiological functions involving neural control, sphincter regulation, and mucosal protection.
Disorders of the oesophagus occur when there is impairment in its structure, motility, or protective mechanisms. These disorders can lead to symptoms such as difficulty swallowing, chest pain, regurgitation, heartburn, or even malnutrition. Oesophageal diseases range from mild inflammatory conditions to severe motility disorders and malignancies. Understanding these disorders is essential for accurate diagnosis, treatment, and prevention of complications.
Anatomy and Function of the Oesophagus
The oesophagus is approximately 25 cm long in adults and is divided into three parts:
Cervical Oesophagus – Located in the neck region
Thoracic Oesophagus – Passes through the chest
Abdominal Oesophagus – Short segment entering the stomach
Layers of the Oesophageal Wall
The oesophageal wall consists of four layers:
Mucosa – Inner protective lining
Submucosa – Contains glands and blood vessels
Muscularis propria – Responsible for peristalsis
Adventitia – Outer connective tissue layer
Sphincters of the Oesophagus
Upper Oesophageal Sphincter (UES): Prevents air entry during breathing
Lower Oesophageal Sphincter (LES): Prevents reflux of stomach acid
Proper functioning of these sphincters is essential. Dysfunction leads to many oesophageal disorders.
Classification of Oesophageal Disorders
Oesophageal disorders can be broadly classified into:
Inflammatory Disorders
Motility Disorders
Structural Disorders
Infectious Disorders
Neoplastic Disorders (Tumors)
Functional Disorders
1. Gastroesophageal Reflux Disease (GERD)
Definition
GERD is a chronic condition in which stomach acid flows back into the oesophagus due to weakness of the lower oesophageal sphincter.
Causes
Weak LES tone
Obesity
Pregnancy
Smoking
Fatty or spicy foods
Hiatal hernia
Symptoms
Heartburn (burning chest pain)
Acid regurgitation
Sour taste in mouth
Chronic cough
Difficulty swallowing
Complications
If untreated, GERD can lead to:
Oesophagitis
Ulcers
Barrett’s oesophagus
Stricture formation
Management
Lifestyle changes (diet modification, weight reduction)
Proton pump inhibitors (PPIs)
Avoid lying down after meals
2. Oesophagitis
Oesophagitis refers to inflammation of the oesophageal lining.
Types
a. Reflux Oesophagitis
Caused by prolonged acid exposure from GERD.
b. Infectious Oesophagitis
Common in immunocompromised individuals.
c. Drug-Induced Oesophagitis
Certain medications irritate the mucosa if taken without enough water.
d. Eosinophilic Oesophagitis
An allergic inflammatory condition seen in younger individuals.
Symptoms
Painful swallowing (odynophagia)
Chest discomfort
Food impaction
Fever (in infections)
Treatment
Treat underlying cause
Acid suppression therapy
Dietary elimination (in allergic cases)
3. Achalasia Cardia
Definition
Achalasia is a motility disorder in which the lower oesophageal sphincter fails to relax, leading to difficulty in food passage.
Pathophysiology
There is degeneration of nerve cells controlling peristalsis, resulting in:
Loss of oesophageal movement
Persistent LES contraction
Symptoms
Progressive dysphagia (for solids and liquids)
Regurgitation of undigested food
Weight loss
Chest pain
Diagnosis
Barium swallow test
Manometry (gold standard)
Treatment
Balloon dilation
Surgical myotomy
Botulinum toxin injection

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