A Simple Guide to Esophagus Disorders, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Esophagus Disorders, Diagnosis and Treatment and Related Diseases

The esophagus is the segment of the digestive tract that travels between the mouth and the stomach.

The esophagus is a tube with its primary function to carry food and liquid, after it has been ingested, from the mouth down into the stomach.

It takes only 10 seconds for food to move down the esophagus.

The esophagus is lined by moist pink tissue called mucosa and about 8 inches long.

The esophagus lies behind the windpipe (trachea) and heart and in front of the spine.

Before entering the stomach, the esophagus passes through a hole in the diaphragm.

The openings at the top of the esophagus at the back of the throat (UES) and at the bottom of the esophagus (LES) at the entrance to the stomach are closed off by muscles termed sphincters (called the upper esophageal sphincter and the lower esophageal sphincter).

The sphincters relax in order to let food and liquid pass through but then tighten again to prevent any materials from going up from the stomach into the esophagus and from the esophagus to the mouth.

The upper esophageal sphincter (UES) is a collection of muscles at the top of the esophagus.

The muscles of the UES are under voluntary control and are utilized when breathing, eating, belching, and vomiting.

They stop food and secretions from going down the windpipe (trachea).

The lower esophageal sphincter (LES) is a collection of muscles at the low end of the esophagus, where it enters the stomach.

When the LES is closed, it stops acid and stomach contents from going backwards from the stomach.

The LES muscles are not under conscious (voluntary) control.

Esophagus Disorders

An incompletely closed LES permits acidic stomach contents to back up (reflux) into the esophagus.

Reflux can produce heartburn, cough or hoarseness, or no symptoms at all.

When reflux happens often or is troublesome, it is called gastroesophageal reflux disease (GERD).

One fairly frequent disorder that can involve the esophagus is gastroesophageal reflux disease.

In GERD, the sphincter between the esophagus and the stomach grows weaker, which permits the food and digestive juices in the stomach to enter back into the esophagus.

Many people have an occasional short period of heartburn or indigestion, but GERD is diagnosed when reflux is happening more than 2 times per week.

Over time, GERD can result in more serious disorders such as an ulcer or strictures.

Inflammation of the esophagus is the reason behind esophagitis.

Esophagitis can be caused by irritation (as from reflux or radiation treatment) or infection.

Regular reflux of stomach acid causes irritation to the esophagus, which may induce the lower part to alter its structure.

Very rarely, Barrett's esophagus goes on to esophageal cancer.

Similar to gastric ulcer, esophageal ulcer is erosion in an area of the lining of the esophagus.

This is often produced by chronic reflux.

Esophageal stricture is a narrowing of the esophagus from a range of causes, which, if narrow enough, may cause difficulty in swallowing.

Chronic irritation from reflux is the normal cause of esophageal strictures.

Achalasia is a rare disorder in which the lower esophageal sphincter does not open properly.

Difficulty in swallowing and regurgitation of food are symptoms of achalasia.

While serious, cancer of the esophagus is not frequent

An esophagogastroduodenoscopy tube is used to diagnose esophageal disorders together with barium X-rays and pH monitoring.

The treatment differs depending on the underlying esophageal disorder.

TABLE OF CONTENT
Introduction
Chapter 1 Esophagus Disorders
Chapter 2 Esophagitis
Chapter 3 Achalasia
Chapter 4 Esophageal Motility Disorders
Chapter 5 GERD
Chapter 6 Hiatus H

• Language: English
• Publisher: Kenneth Kee
• Release date: Mar 29, 2021
• ISBN: 9781005534219

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Esophagus Disorders,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Esophagus Disorders, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Esophagus Disorders)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Esophageal Disorders

The esophagus is the segment of the digestive tract that travels between the mouth and the stomach.

The esophagus is a tube with its primary function to carry food and liquid, after it has been ingested, from the mouth down into the stomach.

It takes only 10 seconds for food to move down the esophagus.

The esophagus is lined by moist pink tissue called mucosa and about 8 inches long.

The esophagus lies behind the windpipe (trachea) and heart and in front of the spine.

Before entering the stomach, the esophagus passes through a hole in the diaphragm.

The openings at the top of the esophagus at the back of the throat (UES) and at the bottom of the esophagus (LES) at the entrance to the stomach are closed off by muscles termed sphincters (called the upper esophageal sphincter and the lower esophageal sphincter).

The sphincters relax in order to let food and liquid pass through but then tighten again to prevent any materials from going up from the stomach into the esophagus and from the esophagus to the mouth.

The upper esophageal sphincter (UES) is a collection of muscles at the top of the esophagus.

The muscles of the UES are under voluntary control and are utilized when breathing, eating, belching, and vomiting.

They stop food and secretions from going down the windpipe (trachea).

The lower esophageal sphincter (LES) is a collection of muscles at the low end of the esophagus, where it enters the stomach.

When the LES is closed, it stops acid and stomach contents from going backwards from the stomach.

The LES muscles are not under conscious (voluntary) control.

Esophagus Disorders

Heartburn:

An incompletely closed LES permits acidic stomach contents to back up (reflux) into the esophagus.

Reflux can produce heartburn, cough or hoarseness, or no symptoms at all.

Gastroesophageal reflux disease (GERD):

When reflux happens often or is troublesome, it is called gastroesophageal reflux disease (GERD).

One fairly frequent disorder that can involve the esophagus is gastroesophageal reflux disease.

In GERD, the sphincter between the esophagus and the stomach grows weaker, which permits the food and digestive juices in the stomach to enter back into the esophagus.

Many people have an occasional short period of heartburn or indigestion, but GERD is diagnosed when reflux is happening more than 2 times per week.

Over time, GERD can result in more serious disorders such as an ulcer or strictures.

Esophagitis:

Inflammation of the esophagus is the reason behind esophagitis.

Esophagitis can be caused by irritation (as from reflux or radiation treatment) or infection.

Barrett's esophagus:

Regular reflux of stomach acid causes irritation to the esophagus, which may induce the lower part to alter its structure.

Very rarely, Barrett's esophagus goes on to esophageal cancer.

Esophageal ulcer:

Similar to gastric ulcer this disorder is erosion in an area of the lining of the esophagus.

This is often produced by chronic reflux.

Esophageal stricture:

This is a narrowing of the esophagus from a range of causes, which, if narrow enough, may cause difficulty in swallowing.

Chronic irritation from reflux is the normal cause of esophageal strictures.

Achalasia:

Achalasia is a rare disorder in which the lower esophageal sphincter does not open properly.

Difficulty in swallowing and regurgitation of food are symptoms of achalasia.

Esophageal cancer:

While serious, cancer of the esophagus is not frequent.

Risk factors for esophageal cancer are smoking, heavy drinking, and chronic reflux.

Mallory-Weiss tear:

Vomiting or retching produces a tear in the lining of the esophagus.

The esophagus may bleed into the stomach, often accompanied by vomiting blood.

Esophageal varices:

In people with liver cirrhosis, veins in the esophagus may become swollen and dilated.

Termed esophageal varices, these veins are susceptible to life-threatening bleeding.

Esophageal ring (Schatzki's ring):

There is a frequent benign accumulation of tissue in a ring around the low end of the esophagus.

Schatzki's rings normally produce no symptoms, but may induce difficulty in swallowing.

Esophageal web:

This is an accumulation of tissue (similar to an esophageal ring) that normally happens in the upper esophagus.

Like rings, esophageal webs normally produce no symptoms.

Plummer-Vinson syndrome:

This is a disorder such as chronic iron-deficiency anemia, esophageal webs, and difficulty swallowing.

Iron replacement and dilation of esophageal webs are the main treatments.

These diseases can involve the esophagus:

Crohn's Disease

The esophagus can be involved by Crohn's disease, while it is very infrequent and estimated to happen in less than 1% of patients.

Symptoms of Crohn's disease in the esophagus can be difficulty in swallowing or painful swallowing and heartburn.

If Crohn's disease in the esophagus is indicated, an upper endoscopy may demonstrate ulcers, fistulas, or strictures in the esophagus.

Treatment for Crohn's disease in the esophagus can be medicines, esophageal dilation, enteral nutrition and surgery.

What are the Symptoms of Esophageal Disorders?

Symptoms

Some of the frequent symptoms that may happen in many esophageal disorders are:

1. Nausea – sensation of wanting to vomit.

2. Vomiting – sometimes bloody vomitus.

3. Dyspepsia (indigestion) – sensation of discomfort especially after a few bites of food.

4. Painful swallowing or discomfort.

Other symptoms are:

1. Onset of difficult or painful swallowing (i.e., dysphagia or odynophagia)

2. Heartburn

3. Retrosternal discomfort or pain

4. Epigastric pain

5. Hematemesis (occasionally)

6. Anorexia and weight loss (depends on chronicity and severity of underlying illness)

7. Cough

8. Fever and sepsis

9. Belching

There may also be linked symptoms with certain stomach disorders, such as heartburn and epigastric abdominal pain.

Without diagnostic investigation, it