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Diagnosing and Treating Esophageal Disorders

Aug 01, 2022

Affecting more than 15 million adults in the U.S., esophageal disorders can severely affect quality of life. They can cause symptoms such as heartburn, difficulty swallowing, and regurgitation of undigested food.

Affecting more than 15 million adults in the U.S., esophageal disorders can severely affect quality of life. They can cause symptoms such as heartburn, difficulty swallowing, and regurgitation of undigested food. Let's discuss the different types of esophageal disorders, how each is diagnosed, and what your doctor can do to help you treat a diagnosis.

Types of Esophageal Disorders

There are several types of esophageal disorders, but the most common include:

  • Achalasia occurs when the muscles that line the esophagus lose their ability to squeeze food down. The lower esophageal sphincter (LES), the muscular ring that closes off the esophagus from the stomach, fails to relax normally.
  • Gastroesophageal reflux disease (GERD) causes the stomach contents to flow backwards from the stomach into the esophagus.
  • Esophageal spasms occur when the esophagus does not contract or relax properly.

Each of these disorders includes its own treatment path, often dependent on the cause, so it's important that your pain and symptoms are properly diagnosed.

Diagnosing Esophageal Disorders

If your doctor suspects that you have an esophageal disorder, you may need certain diagnostic tests or consultations with other specialists, such as radiologists, speech pathologists, and ENT surgeons. Tests useful in diagnosing esophageal disorders include manometry and impedance monitoring.

Manometry

Manometry measures the pressure in your esophagus. It involves passing a small plastic tube into your esophagus through your nose and measuring the pressure in your esophagus during swallowing. In patients with achalasia, esophageal contractions are weak or absent and the LES is subject to sustained high pressure. Using manometry, a doctor may be able to determine whether achalasia is present.

pH Testing (Bravo clip)

If your doctor suspects GERD, you may require an esophageal pH test. This often involves temporarily attaching a Bravo clip to the lining of your esophagus to monitor the amount of acid that flows back in from your stomach over a 48-hour period. The clip contains a radio transmitter that relays data to a receiver worn on your waistband.

24 Hour Impedance Monitoring Combined with pH Testing for Reflux

Impedance monitoring measures liquid movement from your stomach into your esophagus using a probe, which is inserted into the esophagus with a catheter. Patients with GERD suffer increased backward flow of food and acid from the stomach into the esophagus, and impedance monitoring can detect this issue. The patient wears the probe for a 24 hour period of time.

Treating Esophageal Disorders

Treatment for esophageal disorders depends on the cause. Effective treatments include myotomy, a surgical procedure in which the LES is cut and the upper section of the stomach is wrapped around the esophagus to help prevent reflux; esophageal dilation, during which the LES is widened with a tube-shaped device; and Botox injections, in which Botox is injected to relax the LES.

Early diagnosis and treatment are important to prevent the complications of esophageal disorders. Contact us today to make an appointment to discuss your esophageal concerns.