Clinical symptoms of Esophageal Disease

Dysphagia is the sensation that food is hindered sticking in its normal passage from the mouth to the stomach.

Dysphagia is divided into two distinct syndromes: that resulting from abnormalities affecting the pharynx and UES(oropharyngeal dysphagia) and that caused by any of a variety of disorders affecting the esophagus itself(esophageal dysphagia). Oropharyngeal dysphagia is usually described as the inability to initiate the act of swallowing.

It is a”transfer” problem of impaired ability to move food from the mouth into the upper esophagus. Esophageal dysphagia results from difficulty in transporting food down the esophagus and may be caused by motility disorders or mechanical obstructing lesions. Patients most often report that their food hangs up somewhere behind the sternum. If this symptom is localized to the lower part of the sternum then the lesion is most likely in the distal esophagus although the patient may also refer the feeling of blockage to the lower part of the neck. To classify the symptom of esophageal dysphagia, three questions are crucial: (1) What type of food causes symptoms? (2) Is the dysphagia intermittent or progressive? and(3) Does the patient have heartburn? An algorithm for approaching patients with dysphagia is shown in object. Heartburn(pyrosis), the most common of all esophageal symptoms, results from the reflux of gastric contents into the stomach. It is usually described as a burning pain that radiates up behind the sternum. It has many including”indigestion acid regurgition,” “sour stomach,” and”bitter belching.” Heartburn is predictably aggravated by several factors, including certain foods(fatty foods, chocolate, or spicy products) the act of bending over or lying down, alcohol(especially red wines), caffeine smoking, and emotions. Heartburn is usually relieved, albeit only transiently, by ingesting antacids, baking soda, or milk. Heartburn may be accompanied by regurgitation or water brash. Regurgitation is the flow into the mouth of a sour or bitter fluid that comes from the stomach and often occurs at night or when bending over.

Water brash describes the fluid. This fluid is not regurgitated material, but rather it consists of secretions from the salivary glands as part of a protective, vagally mediated reflex from the distal esophagus swallowing, is usually associated with caustic ingestion, pill-induced esophagitis infectious esophagitis caused by viral or fungal agents rarely, severe GERD .

Severe substernal chest pain that is indistinguishable from angina pectoris may be esophageal in origin. Although this pain was once commonly thought to be secondary to spasms of the esophagus, later studies have suggested that gastroesophageal reflux is more a likely the cause.