A report on Esophagus and Esophageal achalasia

Esophageal cancer is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach.

Achalasia (i.e. lack of the involuntary reflex in the esophagus after swallowing) appears to be a risk factor for both main types of esophageal cancer, at least in men, due to stagnation of trapped food and drink.

Achalasia is a major exception to usual pattern of dysphagia in that swallowing of fluid tends to cause more difficulty than swallowing solids.

In achalasia, there is idiopathic destruction of parasympathetic ganglia of the Auerbach's (Myenteric) plexus of the entire esophagus, which results in functional narrowing of the lower esophagus, and peristaltic failure throughout its length.

Achalasia, nutcracker esophagus, and other motility disorders of the esophagus

Esophagectomy or oesophagectomy is the surgical removal of all or parts of the esophagus.

Esophagectomy is also occasionally performed for benign disease such as esophageal atresia in children, achalasia, or caustic injury.

Nutcracker esophagus, Jackhammer esophagus, or hypercontractile peristalsis, is a disorder of the movement of the esophagus characterized by contractions in the smooth muscle of the esophagus in a normal sequence but at an excessive amplitude or duration.

Nutcracker esophagus is one of several motility disorders of the esophagus, including achalasia and diffuse esophageal spasm.

This in combination with other plain radiographs allows for the imaging of parts of the upper gastrointestinal tract such as the pharynx, larynx, esophagus, stomach, and small intestine such that the inside wall lining, size, shape, contour, and patency are visible to the examiner.

Amongst the uses of barium swallow are: persistent dysphagia and odynophagia despite negative esophagogastroduodenoscopy (OGDS) findings, failed OGDS, esophageal motility disorder, globus pharyngis, assessment of tracheoesophageal fistula, and timed barium swallow to monitor the progress of esophageal achalasia therapy.

Megaesophagus, also known as esophageal dilatation, is a disorder of the esophagus in humans and other mammals, whereby the esophagus becomes abnormally enlarged.

Megaesophagus may occur secondary to diseases such as achalasia or Chagas disease.

When a peristaltic wave reaches at the end of the esophagus, the cardiac sphincter (gastroesophageal sphincter) opens allowing the passage of bolus into the stomach.

Aperistalsis refers to a lack of propulsion. It can result from achalasia of the smooth muscle involved.

In a fundoplication, the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the lower end of the esophagus and stitched in place, reinforcing the closing function of the lower esophageal sphincter (LES).

In contrast, surgery for achalasia is generally accompanied by either a Dor or Toupet partial fundoplication, which is less likely than a Nissen wrap to aggravate the dysphagia that characterizes achalasia.