Pathophysiology, Diagnosis, and Treatment of Esophageal Diseases

Abstract

Introduction Although the esophagus constitutes the beginning of the gastrointestinal tract, its study has been more neglected than that of any other component part. This neglect has resulted primarily from the difficulty in investigating symptoms referable to this organ. Recent advances in diagnostic equipment and procedures, however, have made possible a better understanding of the pathophysiology of the esophagus. Flexible esophagoscopes, cinefluorography, the use of transistors in recording esophageal pressures, biopsy, and cytology have made exact study of this structure possible. Decision to utilize any of these procedures must be based upon an awareness of the characteristic symptoms of esophageal disease. Attention is directed to the esophagus by such symptoms as dysphagia, substernal pain during deglutition, heartburn (pyrosis), regurgitation, and hematemesis. Esophageal symptoms usually originate at the site of a lesion; however, pain may extend into the neck, the back, and, if a lesion is near the diaphragmatic portion of