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What is the Esophagus?

A. Pasbjerg
A. Pasbjerg

The esophagus is the portion of the digestive system that leads from the mouth to the stomach. Sometimes called the gullet, it is a muscular passageway that begins at the throat, or pharynx. Located between the trachea and the spine, it passes down through the diaphragm and ends at the lower esophageal sphincter, a muscular ring opening into the upper end of the stomach.

The primary function of the esophagus is to carry ingested food and liquids to the stomach. When a person eats or drinks and swallows, the sphincter at the top of the structure, which is normally closed, opens and allows the material to pass through. The muscles in the walls of the passage then contract, pushing it downward; this process is facilitated by the mucus produced by glands along the esophagus to keep it moist. It then passes through the lower sphincter, which also relaxes and opens, and enters into the stomach.

The esophagus carries ingested food and liquids to the stomach.
The esophagus carries ingested food and liquids to the stomach.

Sometimes the lower esophageal sphincter opens at times other than when food is being swallowed, and allows acid from the stomach to splash up into the esophagus. This is known as acid reflux and typically causes heartburn, a burning sensation in the lower chest that is uncomfortable but not dangerous. When acid reflux becomes chronic, it is called gastroesophageal reflux disease, or GERD. GERD is a fairly common disorder and should be treated, as over time it can cause damage. Treatment typically includes medications such as antacids, H2 blockers, and proton pump inhibitors.

Smoking may cause esophageal cancer.
Smoking may cause esophageal cancer.

People with GERD may develop a condition called Barrett’s esophagus. In these cases, cells in the lower esophagus change and are replaced with cells like those in the stomach and intestines. These cells are tolerant of the acid from the stomach, which helps them resist the damage from the reflux. While this may reduce the person’s discomfort from heartburn, the condition is a cause for concern, as the Barrett’s cells can sometimes lead to a form of cancer known as adenocarcinoma.

The hollow tube known as the esophagus runs from the stomach to the throat.
The hollow tube known as the esophagus runs from the stomach to the throat.

In addition to adenocarcinoma, the other main type of esophageal cancer is squamous cell carcinoma. This type of cancer is often associated with use of tobacco or alcohol, though it can have other causes. Both types of cancer usually cause pain and difficulty swallowing, which may lead to weight loss in patients. Treatments can include endoscopic therapy to remove localized lesions or laser therapy and chemotherapy to destroy tumor cells.

Discussion Comments

anon985591

GERD / reflux could be mistaken for eosinophilic oesophagitis, a condition with similar symptoms of discomfort/pain, often with dysphagia. Thought to be caused by immune response to allergens either ingested or inhaled - food, pollen or mold spores.

anon329932

I had acid reflux in which I was on prescription medicine. When I was diagnosed with sleep apnea and started using a CPAP machine at night, my reflux went totally away.

anon266257

I just learned about the digestive system in science.

Clairdelune

@B707 - My mother takes an anti-acid medication for her GERD condition. Unfortunately, the medication is expensive and she has trouble affording it. I'm going to suggest to her that she take a good look at the food she eats and figure out which ones cause problems with her esophagus.

Of course, I think that she should talk to her doctor, before she makes any permanent changes in her treatment.

B707

@VivAnne - You're right on! GERD is a condition that lasts your whole life. I was diagnosed with it about a year ago. I have medication, but I often forget to take it because you're supposed to take it about a half hour before meals.

I'm trying to figure out which foods and spices cause acid reflux, so I can change my diet and avoid foods that irritate my esophagus.

I wonder why the ring opening from the esophagus to the stomach opens when you aren't swallowing food and lets stomach acid into the esophagus. I guess I'll have to ask my doctor that one.

malmal

Wow, I've never heard of anything like Barrets esophagus. That sounds like a case of the body adapting to meet a challenge or condition that it's dealing with for a long time. The fact that it can cause cancer eventually means it's a bad thing, of course, but I wonder if whatever makes the body react to acid reflux by converting the lower cells of the esophagus to the same types as those of the stomach could be used for good in health treatments? Very interesting.

VivAnne

@Malka - It sounds like you're talking about GERD -- Gastroesophageal Reflux Disease -- rather than just the occasional case of heartburn. GERD is a life-long kind of condition in which you get acid reflux a lot -- daily, multiple times a day in fact.

Because reflux happens so often, the answer to your question is yes. Yes, GERD can cause permanent damage to the esophagus.

You can start medication to help treat the acid reflux so that your throat can heal up, but as soon as you quit doing the treatment that stopped the acid reflux and let it heal it will just get injured again. GERD is an incurable and lifelong condition, and usually the best way to treat the acid reflux and accompanying problems is to make lifestyle changes to avoid eating foods that cause flare ups.

If you were just talking about heartburn, on the other hand, don't worry -- one or two encounters with a bit of refluxed stomach acid isn't going to hurt your esophagus. Your saliva has something in it called bicarbonate that neutralizes the stomach acids to some degree.

Malka

I read somewhere that acid reflux burns the esophagus with stomach acid. Is that true? If so, is it doing any permanent damage? Burning your insides sounds like serious business!

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    • The esophagus carries ingested food and liquids to the stomach.
      By: laszlolorik
      The esophagus carries ingested food and liquids to the stomach.
    • Smoking may cause esophageal cancer.
      By: ehabeljean
      Smoking may cause esophageal cancer.
    • The hollow tube known as the esophagus runs from the stomach to the throat.
      By: snapgalleria
      The hollow tube known as the esophagus runs from the stomach to the throat.
    • When the lower esophageal sphincter is not working properly, GERD may occur.
      By: bilderzwerg
      When the lower esophageal sphincter is not working properly, GERD may occur.
    • Chronic alcohol abuse may cause esophageal ulcers.
      By: BlueSkyImages
      Chronic alcohol abuse may cause esophageal ulcers.