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Oesophagus



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Oeophagus

Reflux Oesophagitis

Reflux Oesophagitis refers to the inflammation and damage to the distal oesophagus at the junction where it meets the stomach. This inflammation and damage are due to the backwards reflux of stomach contents into the oesophagus. Contrary to popular belief, reflux oesophagitis is not only caused by the acidic gastric contents, but can also be caused by alkaline biliary contents that are in turn refluxed into the stomach from the duodenum.

Common symptoms include pain over the upper central region of the abdomen with associated heartburn sensation (burning sensation behind the sternum) and a sourish (acidic regurgitation) or bitter (biliary regurgitation) taste in the mouth. Reflux oesophagitis can lead to linear ulcers with a risk of bleeding or narrowing/strictures.

Long term reflux esophagitis can lead to changes in the lining known as Barrett’s Oesophagus which is a risk factor for cancer development.

Oesophageal Tumour

Most instances of Oesophageal Tumours tend to be malignant/cancerous tumours. There are two types of Oesophageal Cancers, namely a squamous cell type or an adenomatous cell type.

Risk factors for oesophageal cancers include smoking and the presence of reflux oesophagitis. Oesophageal cancers are relatively symptomless in their early stages. Late-stage symptoms include difficulty swallowing, rapid weight loss, vomiting of fresh blood, upper central region abdominal pain and central retro-sternal chest pain.

Oesophageal Web

Oesophageal Webs are congenital thin membranous outgrowths of the oesophageal lining. Due to the nature of the web, difficulty in swallowing is a common symptom. Webs are otherwise asymptomatic if they are not causing any obstruction.

 

Achalasia

Achalasia is a degenerative motility (movement) disorder of the lower oesophagus with two key characteristics. The first characteristic is the relative absence of propulsive contractions (peristalsis) of the lower oesophagus that moves the food along to the stomach. The second characteristic is the inability of the lower oesophageal sphincter (‘valve’) to relax to allow food to enter the stomach.

The conmon symptoms include difficulty with swallowing, heartburn sensation (burning sensation behind the sternum) and food regurgitation back to the mouth.


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