Esophageal Obstruction - Causes, Diagnosis, and Treatment

What Is Esophagus?

It is a muscular tube for swallowing food that extends to the stomach, starting from the pharynx. It is a passage for food and is called a food pipe. In an adult, it is 28 to 33 centimeters long, 11 to 13 inches long, with an internal diameter of two centimeters. The inner layer of the food pipe has a mucosal lining, which allows the food to pass through from the oral cavity into the stomach easily.

How Does It Function?

An upper esophageal sphincter is a group of muscles at the top of the esophagus. It functions when we breathe, eat, and vomit. They prevent the food from going down the windpipe, which is present adjacent to it. Another group of muscles present at the lower end of the esophagus called the lower esophageal sphincter prevents the acids in the stomach from moving back to the esophagus.

What Could Be the Possible Causes of Esophageal Obstruction?

The causes of esophageal obstruction are as follows:

• The obstruction happens when a large bolus of food is swallowed at a time. It is also termed ‘Steakhouse syndrome.’

• Not chewing properly can also lead to obstruction.

• Wearing dentures may lead to improper chewing of food, making it difficult to swallow.

• Achalasia is a condition where it is difficult to move food through the esophagus due to the breakdown of nerve cells in the esophagus.

• Gastroesophageal reflux disease where acids in the stomach along with the food rise back to the esophagus, irritating the lining of the esophagus

• A muscular ring called the esophageal sphincter controls the opening between the esophagus and the stomach. The food passes into the stomach when the sphincter relaxes and closes shut to keep the contents in the stomach from coming back. If the ring does not close completely, the acid from the stomach can come back to the esophagus, which causes irritation. The walls of the esophagus can get obstructed if this process repeats itself for a longer period.

• Excessive vomiting due to anorexia or other eating disorders.

• Esophageal cancer can also cause the narrowing of the esophagus.

• Injury to the esophagus by taking medications like Ibuprofen and Aspirin.

• Prolonged exposure to the endotracheal tube or nasal tube causes the narrowing of the esophagus.

• Esophageal atresia is a defect at birth where the esophagus does not develop properly.

• Esophageal webs are thin layers of extra tissues that grow internally on the upper part.

What Are the Symptoms That a Patient With Esophageal Obstruction May Experience?

Patients would have the following symptoms if something got stuck in their throat, which is where the esophagus is present:

• Pain while swallowing.

• Pain in the upper chest.

• A problem with swallowing.

• Drooling.

• Coughing.

• Choking.

• Gagging.

• Hoarseness.

• Uneasy feeling like there is something struck in the throat.

• Hiccups.

• Shortness of breath.

• Fever.

• Weight loss.

What Are the Risk Factors Leading To Esophageal Obstruction?

• Obesity.

• Smoking.

• Consumption of alcoholic beverages.

• Gastroesophageal reflux disease.

How To Diagnose This Condition?

• Endoscopy of the Upper Part of the Esophagus: In the procedure, doctors insert a flexible tube inside the esophagus to visualize an obstruction.

• Biopsy: Doctors take samples from the walls of the esophagus to diagnose the condition and cause of the irritation or obstruction.

• X-Ray: To visualize the internal structure of the esophagus.

• Use of Barium: Sometimes, doctors may use barium which is a chemical compound, mix it in a liquid such as water and ask the patient to swallow it so that it lines the esophagus, after which an X-ray is taken to see the abnormalities more clearly.

• Ultrasound: It is an imaging technique that uses sound waves to produce images of the structures within the body. This technique will help show detailed images of the walls of the esophagus and can be useful in finding the obstruction. It is a safe procedure that uses sound waves of low power.

• Esophageal Manometry: In this procedure, a slender, flexible tube known as the catheter contains pressure sensors that will be passed through the nose, down through the esophagus, and into the stomach. It measures the functioning of the valves and the muscles of the esophagus while swallowing.

How To Treat this Condition?

The condition can be treated by the following measures:

• Doctors may use an endoscope to pass it into the throat and small instruments at the tip to push or remove the object struck in the esophagus.

• Intake of carbonated beverages can help make the food flow down the esophagus easily.

• Esophageal dilation is the most common treatment for esophageal obstruction wherein the patient is given sedatives not to feel any pain, puts an endoscope in the throat to see it visually, and then uses a balloon or a catheter, like a long cylinder made of plastic or rubber to widen the esophagus.

• Suppose the obstruction is because of gastroesophageal reflux. In that case, antacids can be given to neutralize the acid level in the stomach and esophagus, and proton pump inhibitors like Omeprazole and Pantoprazole can be recommended. It acts by blocking a protein essential for acid secretion in the stomach.

How To Prevent This Condition?

The preventive measures include:

• Eating slowly.

• Chewing properly.

• Avoiding smoking and alcohol.

• Raising the head six inches lets gravity reduce the acid reflux that can go from the stomach to the esophagus.

• Eating two hours before bedtime can help in reducing the level of acid.

Conclusion:

Thus, esophageal obstruction is not dangerous if we give the right treatment at the right time. If food gets obstructed in the esophagus, one should not panic and contact the doctor immediately to get the necessary help. With technological advancements and advanced medical equipment, it is easy to diagnose and treat this condition if one seeks help at the right time.