gastrointestinal disorders
Overview of Esophageal and Swallowing Disorders
Introduction
The swallowing apparatus consists of the pharynx, upper esophageal (cricopharyngeal) sphincter, the body of the esophagus, and the lower esophageal sphincter (LES). The upper third of the esophagus and the structures proximal to it are composed of skeletal muscle; the distal esophagus and LES are composed of smooth muscle. These components work as an integrated system that transports material from the mouth to the stomach and prevents its reflux into the esophagus. Physical obstruction or disorders that interfere with motor function ( Esophageal Motility Disorders ) can affect the system. The patient’s history suggests the diagnosis most of the time. The only physical findings in esophageal disorders are cervical and supraclavicular lymphadenopathy caused by metastasis, swellings in the neck caused by large pharyngeal diverticula or thyromegaly, white plaques in the posterior oropharynx caused byCandidainfection, and prolonged swallowing time (the time from the act of swallowing to the sound of the bolus of fluid and air entering the stomach—normally≤12 seconds—heard by auscultation with the stethoscope over the epigastrium). Watching the patient swallow may help diagnose aspiration or nasal regurgitation. Most esophageal disorders require specific tests for diagnosis. Esophageal and swallowing disorders include the following: Achalasia None Cricopharyngeal incoordination Diffuse Esophageal Spasm None Dysphagia None Dysphagia Lusoria None Eosinophilic Esophagitis None Esophageal Diverticula None Esophageal Motility Disorders None Esophageal Rupture None Esophageal Web None Gastroesophageal Reflux Disease (GERD) None Hiatus Hernia None Infectious Esophageal Disorders None Lower Esophageal Ring None Mallory-Weiss Syndrome None Obstructive Disorders of the Esophagus None ( See also Esophageal Cancer and see 