The esophagus is the tube which carries food from the mouth to the stomach, and diseases affecting it generally lead to people having trouble swallowing or experiencing painful swallowing. Esophagus diseases may involve mechanical blockage, as caused by a foreign body, bleeding from a tear or ruptured veins, or injury due to swallowing damaging substances such as acids. Diseases may affect the esophageal muscles, preventing normal swallowing. Tumors, which may sometimes be cancerous, can grow in or around the esophagus. Some esophageal abnormalities are present from birth, while other diseases develop gradually, later in life, such as the esophagus inflammation that arises when acid repeatedly flows back up from the stomach.
Esophagus diseases most often involve a backflow of acid from the stomach into the esophagus, a process known as reflux. Acid reflux can be caused by a hiatus hernia, where the stomach protrudes abnormally up through the diaphragm into the chest, pressure in the abdomen due to conditions such as pregnancy, consuming certain types of food and drink, and smoking. Over time, the effect of acid on the lining of the esophagus leads to inflammation, and symptoms such as heartburn, chest pain, belching and bloating can occur. Changes in the esophageal lining can cause diseases such as ulcerative esophagitis, where ulcers form and bleeding or perforation may follow. The esophagus can become scarred and constricted, or a condition known as Barrett's esophagus may develop.
Barrett's esophagus involves changes in the lining of the esophagus, which make the cells there more likely to become cancerous. For all esophagus diseases where acid reflux is a cause, treatments include simple measures such as stopping smoking, losing weight, and making dietary changes. Drugs to suppress or neutralize stomach acid are often used, and sometimes surgery is carried out to tighten the esophagus where it joins the stomach.
Esophageal cancer is more commonly found in men, and those who smoke and drink alcohol are more at risk. Symptoms such as weight loss, painful and difficult swallowing, vomiting and bleeding, may not be experienced until the disease is quite advanced. If the cancer is discovered early, before it has spread, it may sometimes be cured using surgery, radiotherapy and chemotherapy.
As well as Barrett's esophagus, another of the esophagus diseases which carries a greater risk of developing cancer is the condition called achalasia. In achalasia, the muscles of the esophagus do not function normally, which means that food cannot move along it easily and the lower end does not relax sufficiently to allow passage into the stomach. Symptoms include having difficulty swallowing, coughing and experiencing chest pain. The treatment of achalasia may involve drugs, surgery, and a procedure to stretch the esophagus.