Oesophagus Health Dictionary

Oesophagitis is in?ammation of the OESOPHAGUS and may be due to swallowing a corrosive chemical (corrosive oesophagitis) or because the muscles of the lower part of the oesophagus do not work properly (ACHALASIA), allowing the stomach’s acidic contents to regurgitate (re?ux oesophagitis). HIATUS HERNIA is sometimes associated with the latter condition. Diagnosis can be made by ENDOSCOPY of the oesophagus and/or an X-ray examination using a barium swallow. Treatment of re?ux oesophagitis is by an appropriate diet and weight loss. Stricture of the oesophagus can result from swallowing a corrosive ?uid and may produce severe narrowing. Such strictures may sometimes be dilated by the use of suitable instruments; otherwise, surgery may be necessary.

A still more serious and frequent cause of oesophageal stricture is that due to cancer, which may occur at any part, but is most common at the lower end, near the entrance into the stomach. The chief symptoms of this condition are increasing di?culty in swallowing, increasing debility, together with enlargement of the glands in the neck. The condition usually occurs in middle age or beyond and around 5,000 people are diagnosed with such cancer every year in the United Kingdom. In many cases treatment can only be palliative, but recent advances in surgery are producing promising results. In some cases treatment with irradiation or anti-cancer drugs produces relief, if not cure. In those in whom neither operation nor radiation can be performed, life may be prolonged and freedom from pain obtained by ?uid food which is either swallowed or passed down a tube. In cases of achalasia (see above), the passage of a special bougie down the oesophagus to dilate the sphincter may be e?ective.

Strictures of the oesophagus may also be produced by the pressure of tumours or aneurysms within the cavity of the chest but external to the gullet.

Finally, di?culty in swallowing sometimes occurs in certain serious nervous diseases from paralysis affecting the nerves supplying the muscular coats of the PHARYNX, which thus loses its propulsive power (bulbar paralysis).

Foreign bodies which lodge in the respiratory part of the throat – i.e. at the entrance to, or in the cavity of, the larynx – set up immediate symptoms of CHOKING. Those which lodge in the gullet, on the contrary, do not usually set up any immediately serious symptoms, although their presence causes considerable discomfort. Medical attention is usually required.... oesophagus, diseases of

A malignant tumour, most common in people over 50, that mainly affects the middle or lower oesophagus and leads to swallowing difficulties. Smoking and heavy alcohol intake are risk factors.

Symptoms progressively worsen to a point where food is immediately regurgitated and there is rapid weight loss. Regurgitated fluid spilling into the trachea often causes respiratory infections.

Diagnosis is with a barium swallow (see barium X-ray examinations) and a biopsy taken during endoscopy. Removal of the oesophagus may be possible in some cases. Radiotherapy may cause regression of the cancer, relieve symptoms, and occasionally cure older patients who might not survive major surgery. Insertion of a rigid tube through the tumour, or laser treatment to burn through it, can help to relieve symptoms and improve nutrition. The overall outlook is poor, but is improved with early diagnosis.... oesophagus, cancer of

Several disorders, most of which cause swallowing difficulties and/or chest pain.

Infections of the oesophagus are rare but may occur in immunosuppressed patients. The most common are herpes simplex and candidiasis (thrush). Oesophagitis is usually due to reflux of stomach contents, causing heartburn. Corrosive oesophagitis can occur as a result of swallowing caustic chemicals. Both may cause an oesophageal stricture.

Congenital defects include oesophageal atresia, which requires surgery soon after birth. Tumours of the oesophagus are quite common; about 90 per cent are cancerous (see oesophagus, cancer of). Injury to the oesophagus is most commonly caused by a tear or rupture due to severe vomiting and retching. (See also swallowing difficulty.)... oesophagus, disorders of

(columnar-lined oesophagus) a condition in which the squamous *epithelium lining the oesophagus is replaced by columnar epithelium of the type normally lining the intestine (‘intestinal metaplasia’). Barrett’s oesophagus is caused by chronic inflammation and damage resulting from *gastro-oesophageal reflux or (less frequently) corrosive *oesophagitis. The appearance of Barrett’s epithelium seen at endoscopy must be confirmed by biopsy. Patients with confirmed Barrett’s oesophagus are at a higher risk of developing oesophageal adenocarcinoma and may be kept under surveillance with regular endoscopies. [N. R. Barrett (1903–79), British thoracic surgeon]... barrett’s oesophagus

Usually epithelial in character, similar to that of the lips. Mostly in males.

Seldom before 45 years. Frequently in lower one-third of gullet. Dysphagia, with sense of obstruction on swallowing food. May perforate wall of trachea. Pain, worse at night, radiates from an exact spot. Eating hot food and drinking piping hot tea are heavily suspect.

At risk. Heavy smokers and alcoholics with depleted reserves of Vitamin A and zinc. These two factors play an important role in modern treatment.

Occurs in areas where the soil is low in molybdenum which causes plants to have a high level of nitrates. When such plants are stored they form nitrites which in turn form nitrosamines – which are carcinogens. Experimental rats given nitrous amines have a strong tendency to form cancer of the oesophagus. Eating pickled vegetables carries a high risk.

There are a few areas of the world where these adverse soil conditions pertain – one in Iran, another in Calvados, but the worst was in Lin Xian of the province of Honan, China. In Lin Xian, in the 1970s, it was found that villagers ate mainly persimmon and corn cakes and pickled vegetables. These, and their water, were high in nitrates. It was also their habit to eat mouldy bread which is high in amines – even nitrosamines. Their food was deficient in Vitamin C, which is likely to produce nitrous amines in the stomach.

The molybdenum problem was solved by sowing seeds with a fertiliser containing molybdenum. Piped water replaced old cistern wells and food was carefully stored. Even the chickens oesophageal cancers were cured. As a result of modern scientific investigation and treatment in which medicinal herbs made an important contribution, what was once a high gullet cancer area was resolved into one of the success stories of modern medicine.

Tannin has long been identified as a cancer-causing chemical, supported by findings of a high incidence of the disease among those who consume large quantities of tannin-containing beverages such as tea. Milk binds with tannin and is advised in tea-drinking where lemon is not taken.

Solid drugs and tablets should not be swallowed in the recumbent position without chewing a piece of banana.

Symptoms. (1) Sensation of obstruction when swallowing food. (2) Sharp pain behind breastbone. (3) “Something stuck in the gullet.” (4) Stomach ache, dry throat. (5) Belching when taking food. (6) Soreness of the upper back. (Dr Ge-ming, Lin Xian, Province of Honan, Chinese People’s Republic)

Of possible value. Alternatives:– Tea. Equal parts: Chaparral, Gotu Kola, Red Clover. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. Drink freely.

Powders. Combination. Goldenseal 1; Echinacea 2; Slippery Elm 3. Dose: 750mg (three 00 capsules or half a teaspoon). 3 or more times daily.

Tinctures. Combination. Goldenseal 1; Bayberry 1; Thuja 1; Condurango 1; Rosebay Willowherb 2. One teaspoon 3 or more times daily.

Chinese Herbalism. Powdered Huang yao-tzu 3 ch’ien, 3 times daily. Remedy is prepared by taking 12 liang of huang yao-tzu and steeping in 3 chin of white wine 24 hours. Then place huang yao-tzu in cold water and soak for another 7 days and 7 nights. Take out, dry and crush into powder. (A Barefoot Doctor’s Manual)

Diet. Leafy vegetables, carrots, tomatoes and fruit help to protect against the disease. Supplements. Especially Vitamin A, zinc and molybdenum.

Treatment by a general medical practitioner or hospital oncologist. ... cancer – oesophagus