barrett's

Esophagus disorders are problems with how your esophagus works. The esophagus is the tube that carries food from your mouth to your stomach. You usually don't notice it unless you swallow something too big, hot, or cold. You might also notice it if something is wrong. When that happens, you might feel pain or have trouble swallowing (dysphagia).

The cause depends on the type of disorder. Some run in families. Others are linked to allergic reactions to food or substances in your environment. Sometimes, the cause is unknown.

You may be more likely to develop an esophagus disorder if you:

• Are overweight or have obesity
• Are pregnant
• Take certain medicines
• Have had radiation treatmentt to your neck or chest
• Smoke or are around secondhand smoke

The most common esophagus problem is gastroesophageal reflux disease (GERD). This happens when the muscle at the bottom of your esophagus doesn't close properly. Stomach acid can move back up and irritate the esophagus.

Other esophagus disorders include:

• Heartburn is a burning feeling in your chest or throat. It is often caused by acid reflux.
• Barrett's Esophagus happens when the lining of your esophagus changes. It is often caused by chronic (long-term) GERD.
• Achalasia is a problem where the lower muscle in your esophagus doesn't relax like it should.
• Esophageal Spasms are muscle contractions that cause chest pain or swallowing problems.
• Eosinophilic Esophagitis (EoE) is a rare condition where certain white blood cells (eosinophils) build up in the esophagus, causing swelling, pain, and trouble swallowing.
• Esophageal Cancer is a type of cancer that starts in the tissues of the esophagus.

Symptoms can be different for each condition but may include:

• Pain in your chest, abdomen (belly), or back
• A cough or sore throat that doesn't go away
• Trouble swallowing or feeling like food is stuck
• A hoarse voice or wheezing
• Heartburn or a burning feeling in your stomach
• Tasting acid or food in the back of your mouth
• Food or liquid coming back up into your mouth (regurgitation)
• Losing weight without trying

Get medical help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These could be signs of a heart problem.

Your health care provider will ask about your symptoms and medical history. They may order one or more tests, such as:

• Upper gastrointestinal (GI) endoscopy. This test uses a tiny camera to look inside your esophagus and stomach.
• Biopsy. This test takes a small tissue sample to check.
• Barium swallow. This test uses imaging to see how you swallow.
• Esophageal manometry. This test checks how well your esophagus moves food to your stomach.
• Esophageal pH test. This test measures how often acid backs up into your esophagus and how long the acid stays there.

Treatment depends on what's causing the problem and your overall health. Some esophagus disorders get better with over-the-counter medicines, diet changes, or lifestyle changes. Others may need prescription medicine or surgery.

Without treatment, some disorders may lead to other problems, such as pneumonia, from food entering the windpipe. GERD, Barrett's esophagus, and achalasia can also raise your risk for esophageal cancer.

You can help prevent or reduce symptoms by:

• Not smoking and limiting alcohol
• Eating smaller meals
• Avoiding eating close to bedtime
• Wearing loose-fitting clothes
• Sleeping on your left side or raising the head of your bed
• Maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may have symptoms such as:

• Painful or difficult swallowing
• Weight loss
• A hoarse voice or cough that doesn't go away

You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid reflux. Your risk also goes up as you age

Your doctor uses imaging tests and a biopsy to diagnose esophageal cancer. Treatments include surgery, radiation, and chemotherapy. You might also need nutritional support, since the cancer or treatment may make it hard to swallow.

NIH: National Cancer Institute

Sometimes, after eating a large meal or lying down too soon after eating, you might feel acid coming up into your throat. This is called gastroesophageal reflux (GER). It happens when the muscle at the end of your esophagus (the tube that carries food from your mouth to your stomach) doesn't close properly. Stomach contents can then move back up and irritate the esophagus.

Having reflux occasionally is common. But if you have symptoms two or more times a week or if they cause damage to the lining of your esophagus, you may have gastroesophageal reflux disease (GERD). GERD is a chronic (long-lasting) condition that can cause discomfort and, over time, lead to other health problems.

Anyone can have GERD, including infants and children.

GERD can happen when the muscle at the bottom of your esophagus becomes weak or relaxes at the wrong time. You are more likely to have GERD if you:

• Are overweight or have obesity
• Are pregnant
• Smoke or are around secondhand smoke
• Have a hiatal hernia (when part of the stomach pushes up into the chest)

Certain foods, drinks, or medicines can also make GERD worse.

The most common symptom of GERD is heartburn. This is a burning feeling in your chest or throat. You can also have GERD without having heartburn. Other symptoms may include:

• Tasting acid or food in the back of your mouth
• A dry cough or hoarse voice
• Asthma-like symptoms
• Trouble swallowing

Get medical help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These can be signs of a heart problem.

Your health care provider will ask about your symptoms and medical history. They may recommend tests such as:

• Upper GI endoscopy to look at the esophagus and stomach lining with a tiny camera.
• Biopsy to check a small tissue sample.
• X-Ray to take pictures of the upper digestive system.
• Esophageal pH test to measure how often acid backs up the esophagus and how long the acid stays there.
• Esophageal manometry to check how well your esophagus moves food when you swallow.
• Transnasal esophagoscopy to look for damage to the esophagus by using a small tube with a camera.

Most people can manage GERD with lifestyle changes and medicine. In rare cases, surgery is needed.

Lifestyle changes can include:

• Eating smaller meals and avoiding lying down for at least 2-3 hours after eating
• Avoiding foods that trigger symptoms, such as spicy foods, chocolate, caffeine, or fatty foods
• Losing weight if needed
• Raising the head of your bed
• Quitting smoking

Medicines can include:

• Over-the-counter medicines, such as antacids
• Prescription medicines

If not treated, GERD can cause problems like inflammation of the esophagus, scarring, or changes in the tissue lining (Barrett's esophagus). It can also worsen asthma or cause chronic (long-term) cough or hoarseness.

You may be able to improve symptoms of GERD by:

• Avoiding alcohol and trigger foods
• Eating smaller meals
• Not eating close to bedtime
• Wearing loose-fitting clothes
• Sleeping on your left side or raising the head of your bed
• Maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Gastroesophageal reflux (GER), often called reflux, occurs when food or stomach acid flows back from your child's stomach into the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. This can sometimes cause irritation or a burning sensation. Occasional reflux is common and usually not a problem.

Gastroesophageal reflux disease (GERD) is a more serious and long-lasting type of reflux. GERD can cause repeated symptoms or damage to the lining of the esophagus. Having reflux two or more times a week may be a sign of GERD. Your child's health care provider may diagnose GERD if the reflux causes pain, feeding problems, or irritation of the esophagus.

A small muscle called the lower esophageal sphincter acts as a valve between the esophagus and stomach. When your child swallows, this muscle relaxes to let food pass from the esophagus to the stomach. This muscle normally stays closed, so the stomach contents and acid don't flow back into the esophagus. This muscle, along with the diaphragm (the large muscle between the chest and abdomen), usually prevents reflux. It's normal for children to have reflux occasionally.

In children who have GERD, the lower esophageal sphincter may be weak or relax when it shouldn't. That allows stomach contents into the esophagus. This can happen because of:

• A hiatal hernia, a condition in which the upper part of the stomach pushes up into the chest
• Increased pressure on the abdomen (belly) from being overweight or having obesity
• Certain medicines, such as some used to treat asthma, allergies, depression, or pain
• Smoking or exposure to secondhand smoke
• Previous surgery on the esophagus or upper abdomen
• Developmental delays or certain neurological conditions, such as cerebral palsy
• Lung conditions, such as cystic fibrosis

Many children have occasional reflux, especially after large meals or physical activity. GERD is less common, and most symptoms improve with time and lifestyle changes.

Symptoms may vary by age. Some children might not even notice reflux, while others may taste food or stomach acid in the back of their mouth.

In children, GERD can cause:

• Heartburn, a burning feeling in the chest or throat (more common in older children and teens)
• Bad breath
• Nausea or vomiting
• Trouble or pain when swallowing
• Cough, hoarseness, or breathing problems
• Wearing away of tooth enamel from stomach acid

Other conditions can cause similar symptoms. Talk to your child's provider if symptoms happen often or make eating, sleeping, or daily activities difficult.

In most cases, your child's provider can tell if it's reflux by learning about your child's symptoms and health history. Tests are usually needed only if symptoms don't get better with lifestyle changes or medicines, or if another health problem is suspected.

Common tests include:

• Upper GI series, which looks at the shape of your child's upper GI (gastrointestinal) tract. Your child will drink or eat a chalky-tasting liquid called barium. For young children, the barium is mixed in with a bottle or other food. Several x-rays are taken to track the barium as it goes through your child's esophagus and stomach.
• Esophageal pH and impedance monitoring, which measures the amount of acid or liquid in your child's esophagus. A thin flexible tube is placed through their nose into the stomach. The end of the tube in the esophagus measures when and how much acid comes up into the esophagus. The other end of the tube attaches to a monitor that records the measurements. Your child will wear the tube for 24 hours. They may need to stay in the hospital during the test.
• Upper gastrointestinal (GI) endoscopy and biopsy, which uses an endoscope, a long, flexible tube with a light and camera at the end of it. An endoscope is inserted down your child's esophagus, stomach, and first part of the small intestine. While looking at the pictures from the endoscope, tissue samples (biopsy) may be taken.

Simple lifestyle changes can often improve symptoms. Examples include:

• Maintaining a healthy weight.
• Eating smaller meals.
• Avoiding high-fat foods or other trigger foods that cause symptoms.
• Wearing loose-fitting clothing around the abdomen (belly).
• Staying upright for 3 hours after meals and avoiding slouching when sitting.
• Sleeping with the head of the bed raised 6 to 8 inches.

If lifestyle changes aren't enough, your provider may recommend medicine to reduce stomach acid. The medicines work by lowering the amount of acid your child's stomach makes. Some are available over-the-counter, while others need a prescription. Do not give your child any medicine unless your provider recommends it.

If symptoms don't get better or are severe, your provider may refer you to a doctor who treats stomach and digestion problems in children. In rare cases, surgery may be considered.

If GERD isn't treated, it can cause problems such as inflammation or scarring in the esophagus, changes in its lining (Barrett's esophagus), or make breathing problems, like asthma, worse.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases