Many conditions affect the Gastroesophageal Tract. They include:
Gastroesophageal Reflux Disease (GERD): When stomach acid back flows into the throat, it irritates the lining of the esophagus and raises your risk for abnormal (cancerous) cell growth. Usually GERD can be treated with lifestyle modifications and oral medications, but occasionally surgery is needed.
Barrett’s esophagus: People with chronic GERD are at a higher risk of developing this condition. The acidic environment can lead to an abnormal growth of cells, which in turn raises a patient’s risk for develop esophageal cancer.
Cancer: Esophageal cancer is rare, but it is important to address because it can narrow or block the passage of food and liquids. Types of cancerous tumors include adenocarcinoma or squamous cell carcinoma.
Achalasia: The sphincter that separates the esophagus from the stomach doesn’t fully open, making it difficult for food to pass into the stomach.
Esophageal diverticula: These outpouchings of the esophagus can lead to difficultly swallowing, regurgitation, chronic coughing and other issues.
Hiatal hernia: The diaphragm is a large muscle that separates the abdomen from the chest. A hiatal hernia occurs when part of the stomach moves into the chest through a small opening in this muscle.
A Patient’s Perspective
Learn what one patient has to say about the Lourdes Cardiovascular Institute.
What is the Gastroesophageal Tract?
Your stomach (the “gastro” part of “gastroesophageal”) is connected to your mouth by the esophagus (the “esophageal” part of the phrase).
The lower esophageal sphincter is a muscular valve that separates your esophagus from your stomach.
This valve opens to allow food into the stomach and then closes to keep food and stomach acid from rising into the esophagus.
Problems that Can Develop
When this esophageal sphincter doesn’t function properly, the stomach’s contents can back flow into the esophagus. This is called acid reflux.
An acidic environment in the esophagus can raise risk for abnormal cell growth and cancer of the esophagus.
Other problems include a sphincter that doesn’t open fully (called achalasia) and outpouchings in the esophageal lining (called diverticula).
To control acid reflux, your physician may recommend a number of lifestyle changes, such as raising the head of your bed by six inches or avoiding certain foods.
Medications may help to control symptoms of acid reflux and other conditions.
Surgery can be used to remove tumors and diverticula, tighten or expand the esophageal sphincter (depending on the condition) and/or repair hiatal hernias.
When lifestyle changes and medications do not bring esophageal problems under control, surgery can restore quality of life as well as help to reduce risk for future problems. Types of esophageal surgeries include:
For patients with cancer, surgeons can remove cancerous tumors and (if needed) additional tissues (such as a part of the esophagus, stomach and lymph nodes). If a substantial portion of the esophagus must be removed, surgeons can create new esophageal tissue from the stomach or the intestine.
For patients with GERD, surgeons can tighten the juncture where the esophagus opens into the stomach (called the esophageal sphincter). To reinforce the area where the esophagus and stomach meet, a surgeon performs a fundoplication, in which the upper portion of the stomach is wrapped around the base of the esophagus, stopping acid from backing up so easily. The operation may also involve repair of a hiatal hernia, if present, or the removal of scarred or ulcerated tissue.
For patients with achalasia, a balloon is inserted endoscopically to expand and stretch the valve at the base of the esophagus. Another option: a surgeon makes a cut through the esophageal sphincter to relax it.
For people with diverticula, a surgeon may use endoscopy through the mouth or minimally invasive laparoscopic access through the side of the patient’s neck to reach, remove and close the diverticula.