Dr. Neil Julie

Hi, this is Dr. Julie and these are informal Blogs to help you learn about your G.I. problems. Every two months I will refresh the Blog and move to another aspect of the same original topics. This first one looks at disorders that give rise to symptoms from the top of your stomach into the chest and throat. Specifically, this primarily consists of problems of the esophagus and the very top of your stomach.

  1. GERD (and it’s cousin Nerd), hiatal hernias, acid-related esophagitis and Barrett’s esophagus. Symptoms most commonly are a burning behind the breast bone sometimes called pyrosis and sometimes sore throat or pain at the end of the breast bone. (Occasionally patients just have a sore throat or hoarseness and nothing else.)This pain can sometimes travel straight through to the back. But Barrett’s esophagus can be present in people who have little or no symptoms but may have had a remote history of reflux in earlier years. Once you get to Barrett’s esophagus the pain symptom surprisingly goes away!(By the way Nerd is real and stands for Normal endoscopic reflux disease. It’s a common condition where the patient has symptoms but the endoscopy shows a normal esophagus)
  2. Swallowing problems for which the medical term is dysphagia. The symptom is that foods- usually solids but sometimes liquids- are getting stuck partway down and don’t make it into your stomach. This can happen in the upper or lower esophagus and is generally caused by either structural problems, motility/motor problems and occasionally malignancy. The structural problems are esophageal strictures or rings or a condition called eosinophilic esophagitis. If you are over 25 this is a problem you should discuss with your doctor. Especially if you’ve only had it for a year or less (or you are a smoker/drinker) since this can be a sign of a serious condition that requires medical treatment. We can also dilate the esophagus at the same time we do endoscopy which will make you feel a whole lot better. Motor disorders basically mean that your esophagus just is not contracting normally and not pushing the food through. This can arise from systemic diseases such as Parkinson’s or localized esophageal problems.
  3. Non-cardiac chest pain which we doctors call “atypical chest pain” is often from the esophagus. Of course, you need to always think about your heart first and make sure that your chest pain is non-cardiac before dismissing it as G.I. related. If you have NO cardiac risk factors and the pain appears to be occurring during or immediately after eating then it may be a reasonable conclusion that it is related to your esophagus and you can come to see us for further workup.
  4. Rarer conditions include esophageal cancer, Pill induced esophagitis candida esophagitis, CMV, esophageal diverticulum, polyps or esophageal ulcer.

So that’s the brief introduction of things that can be up with your esophagus. Many of them are easy to treat and a few of them are risky to ignore. In our next blog in February we will explore more about the underlying defect behind these disorders and say more about the workup.

Disclaimer: This blog is meant to be informative but not comprehensive, generally accurate but not authoritative!