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The esophagus is the tube that carries food from the mouth to the stomach. Most of the time you do not notice it, unless you swallow something too big, too hot or too cold — or something goes wrong. Then there may be pain or trouble swallowing, called dysphagia.
Causes and risk
The cause depends on the disorder. Some run in families, others are linked to allergic reactions to foods or substances in the environment, and sometimes the cause is unknown. The risk is higher for people who:
- are overweight or have obesity;
- are pregnant;
- take certain medicines;
- have had radiation treatment to the neck or chest; or
- smoke or are around secondhand smoke.
Common disorders
- Gastroesophageal reflux disease (GERD) is the most common. The muscle at the bottom of the esophagus does not close properly, so stomach acid can move back up and irritate it.
- Heartburn is a burning feeling in the chest or throat, often caused by acid reflux.
- Barrett's esophagus is a change in the lining of the esophagus, often caused by long-term GERD.
- Achalasia is when the lower muscle of the esophagus does not relax as it should.
- Esophageal spasms are muscle contractions that cause chest pain or trouble swallowing.
- Eosinophilic esophagitis (EoE) is a rare condition in which white blood cells called eosinophils build up in the esophagus, causing swelling, pain and difficulty swallowing.
- Esophageal cancer starts in the tissues of the esophagus.
Symptoms
Symptoms vary by condition but can include:
- pain in the chest, belly or back;
- a cough or sore throat that will not go away;
- trouble swallowing, or feeling that food is stuck;
- a hoarse voice or wheezing;
- heartburn or a burning feeling in the stomach;
- tasting acid or food at the back of the mouth;
- food or liquid coming back up into the mouth (regurgitation); and
- losing weight without trying.
Chest pain with shortness of breath, or pain in the jaw or arm, needs medical help right away — these can be signs of a heart problem.
Diagnosis
A provider will ask about symptoms and medical history and may order tests:
| Test | What it does |
|---|---|
| Upper gastrointestinal (GI) endoscopy | a tiny camera looks inside the esophagus and stomach |
| Biopsy | a small tissue sample is taken for testing |
| Barium swallow | imaging shows how you swallow |
| Esophageal manometry | checks how well the esophagus moves food to the stomach |
| Esophageal pH test | measures how often acid backs up into the esophagus and how long it stays |
Treatment and complications
Treatment depends on the cause and on overall health. Some disorders improve with over-the-counter medicines or changes in diet and lifestyle; others need prescription medicines or surgery. Left untreated, some can cause other problems, such as pneumonia from food getting into the windpipe. GERD, Barrett's esophagus and achalasia can also raise the risk of esophageal cancer.
Prevention
To help prevent disorders or ease symptoms:
- don't smoke, and limit alcohol;
- eat smaller meals, and avoid eating close to bedtime;
- wear loose-fitting clothes;
- sleep on your left side or raise the head of your bed; and
- keep a healthy weight.
Sources
- MedlinePlus, U.S. National Library of Medicine, "Esophagus Disorders" (summary from the National Institute of Diabetes and Digestive and Kidney Diseases): https://medlineplus.gov/esophagusdisorders.html
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