Benign Esophageal Disease

Benign esophageal diseases encompass a range of conditions that affect the esophagus but are non-cancerous.

These conditions can significantly impact quality of life by obstructing normal swallowing or causing discomfort.

Without appropriate treatment, benign esophageal diseases can lead to complications such as severe malnutrition, chronic discomfort, and aspiration pneumonia.

Our team of surgeons at WashU Medicine use state-of-the-art techniques to ensure the best outcomes.

What is the esophagus?

The esophagus is a muscular tube that transports food from the throat to the stomach.

When functioning properly, the esophagus works seamlessly. However, conditions can disrupt this process, causing symptoms such as difficulty swallowing (dysphagia), heartburn, chest pain, and regurgitation.

Risk factors

Awareness of risk factors is crucial for early detection and effective management of benign esophageal diseases, potentially preventing the progression to more severe complications.

Some major factors include:

• Genetic predisposition: Family history can increase susceptibility.
• Age: Older adults are more at risk for certain conditions like achalasia and Zenker’s diverticulum.
• Lifestyle: Smoking, diet, and obesity can contribute to gastroesophageal reflux disese (GERD) and hiatal hernias.
• Medical history: Previous esophageal injuries or surgeries can lead to strictures.

Screenings and diagnosis

Initial evaluations often include a detailed medical history and physical examination. Diagnostic tests may include:

• Endoscopy: Visual inspection of the esophagus.
• Barium swallow: X-ray examination using a contrast material.
• Esophageal manometry: Measuring the pressure inside the esophagus.

Benign esophageal diseases

There are several different types of esophageal diseases. Each may have different causes, symptoms, and treatments.

• Hiatal hernia: A portion of the stomach pushes through the diaphragm into the chest cavity, causing acid reflux and heartburn.
• Achalasia: A rare disorder where the esophagus loses the ability to move food toward the stomach, causing severe swallowing difficulties.
• Zenker’s diverticulum: A pouch forms at the junction of the throat and esophagus, trapping food and leading to bad breath, coughing, and difficulty swallowing.
• GERD (gastroesophageal reflux disease): Frequent acid reflux irritates the esophagus, causing heartburn and potential damage over time.
• Benign esophageal strictures: Narrowing of the esophagus, often due to chronic GERD, can cause difficulty swallowing solid foods.

Treatment options

Medication

• Proton pump inhibitors (PPIs): Reduce stomach acid to provide relief from GERD.
• Prokinetics: Help strengthen the lower esophageal sphincter and improve motility.

Surgical procedures

• Fundoplication: Surgery to wrap the top of the stomach around the lower esophagus to prevent reflux.
• Esophageal dilation: Stretching the narrowed esophagus to improve swallowing.
• Heller myotomy: Cutting the muscle at the lower esophagus to treat achalasia.

Recovery and rehabilitation

Post-treatment care often includes dietary modifications, medications, and follow-up endoscopies to monitor healing and prevent recurrence.

Physiotherapy may be recommended for swallowing rehabilitation.

WashU Medicine offers world-class expertise in diagnosing and treating benign esophageal diseases.