Esophageal rupture is a rupture of the esophageal wall. Amylase may be elevated in pleural effusions related to gastric/esophageal perforations, pancreatitis or malignancy. Peristaltic contractions of the esophageal muscle push the food down the esophagus. Patients typically aspirate food because they have esophageal, gastric or neurologic problems. Complications may include cirrhosis, liver cancer, and esophageal varices. Respiratory, gastrointestinal, and esophageal candidiasis require an endoscopy to diagnose. Leukoplakia may rarely be associated with esophageal carcinoma. TIPS is a life-saving procedure in bleeding from esophageal or gastric varices. Carbenoxolone is used for the treatment of peptic, esophageal and oral ulceration and inflammation. Metoclopramide also increases the tone of the lower esophageal sphincter. Opening of the upper esophageal sphincter is triggered by the swallowing reflex. Most patients with esophageal carcinoma survive less than one year. Endoscopy has no role in the diagnosis of spontaneous esophageal perforation. It also suggests the probability of esophageal varices. A TEE may be technically difficult to perform in individuals with esophageal strictures or varices.