What is Megaesophagus?

Geisha A. Legazpi

Megaesophagus is an esophagus disease wherein the organ enlarges due to failure of peristalsis. It occurs not just in humans, but also in cats and dogs. In a normal esophagus, peristalsis occurs through the synchronized movement of the esophageal muscle. When peristalsis is abnormal or absent, food fails to go down to the stomach, leading to an enlargement of the esophagus. Treatment of this condition involves targeting the underlying cause, modifying the diet, and administering drugs that can facilitate the motility of the esophagus and stomach.

Megaesophagus is a condition that hinders food from going down to the stomach and leads to an enlargement of the esophagus.
Megaesophagus is a condition that hinders food from going down to the stomach and leads to an enlargement of the esophagus.

This condition has different underlying causes. In humans, it may occur due to achalasia. Achalasia is a condition mostly occurring in middle-aged adults wherein there is absence of ganglion cells in the myenteric plexus. This leads to decreased peristalsis and increased pressure of the lower esophageal sphincter. The result is dilatation or enlargement of the esophagus. Achalasia is known to predispose affected patients to esophageal carcinoma.

Megaesophagus can occur in cats and dogs.
Megaesophagus can occur in cats and dogs.

In dogs, megaesophagus may be a manifestation of a disease called myasthenia gravis (MG). MG is a neuromuscular disease in which weakness is a primary symptom. In MG, the receptors of the neurotransmitter acetylcholine do not function properly, leading to impairment of the conduction of signals from the nerves to the muscles. With weakness of the esophageal muscle, megaesophagus occurs.

An endoscopy may be done to help diagnose megaesophagus.
An endoscopy may be done to help diagnose megaesophagus.

Megaesophagus may also occur due to esophageal scarring or strictures. These strictures may be a results of swallowing of foreign bodies. The presence of tumors in the esophagus can lead to the same condition. Other diseases associated with megaesophagus include hypothyroidism and Addison’s disease.

Feeding tubes may be required in cases of megaesophagus where voluntary feeding is not possible.
Feeding tubes may be required in cases of megaesophagus where voluntary feeding is not possible.

Diagnosis of megaesophagus usually involves radiographic examinations. A plain X-ray is usually done, but a barium study may be needed in special cases. Endoscopy may be performed to visualize narrowing and tumors. When this condition is confirmed radiologically, and symptoms of cough, nasal discharge, and fever are present, a diagnosis of aspiration pneumonia may be given. Aspiration pneumonia is a serious condition that needs treatment with antibiotics and removal of the aspirated material.

Megaesophagus may occur as a result of hypothyroidism.
Megaesophagus may occur as a result of hypothyroidism.

Treatment of this condition, whether it occurs in humans or in pets, involves modification of diet, and sometimes patients do better with liquid diets. It is best to eat meals in an upright position. Feeding tubes may be required in cases wherein voluntary feeding is not possible. To address the nausea and regurgitation associated with megaesophagus, a motility-modifying drug called cisapride may be given. If aspiration pneumonia is present, hospitalization may be required, and fluids and antibiotics are usually given.

Symptoms of aspiration pneumonia may include fever.
Symptoms of aspiration pneumonia may include fever.
Nasal discharge will be present with megaesophagus.
Nasal discharge will be present with megaesophagus.
Coughing may be a symptom of aspiration pneumonia.
Coughing may be a symptom of aspiration pneumonia.
Megaesophagus is an esophagus disease where the organ enlarges due to failure of peristalsis.
Megaesophagus is an esophagus disease where the organ enlarges due to failure of peristalsis.

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