Disorders at the cricopharyngeal level lead to oropharyngeal dysphagia , or transfer dysphagia . With this term, we usually refer to the difficulty in making the food progress from the oropharynx to the esophagus, through the upper esophageal sphincter (UES),…
Endoscopy remains the fundamental diagnostic technique for the evaluation of a wide spectrum of esophageal disease. Its cardinal purposes are to perform a comprehensive visual assessment of the esophagus, and to obtain tissue for histologic evaluation. The current standard for…
Gastroesophageal reflux disease (GERD) is a very common global disorder that poses a significant public health burden. GERD affects approximately 20% of the population of the Western world and has been ranked as the fourth most prevalent gastrointestinal disease and…
Esophageal motility disorders may be implicated as an explanation for dysphagia and noncardiac chest pain after exclusion of esophageal structural lesions by endoscopy, with the caveat that eosinophilic esophagitis has been ruled out with histology. Gastroesophageal reflux disease (GERD) must…
The endoscopist who examines the esophagus evaluates a muscular tube whose primary function is to convey swallowed material from the mouth to the stomach. The esophagus is approximately 25 cm in length measured from its origin in the neck just below…
Radiologic evaluation of esophageal diseases can be performed by fluoroscopic barium examination (esophagram), computed tomography (CT) scan, positron emission tomography (PET) scan, fused CT and PET images (PET/CT), and magnetic resonance imaging (MRI). These five imaging modalities constitute the radiologic…
A surgeon evaluating a patient prior to a possible esophageal operation must spend enough time in conversation with that patient to ensure a clear understanding of their symptoms. Such dialogue not only illuminates potential causes of those symptoms, but more…
The primary purpose of the esophagus is to transport food from the mouth to the stomach, and the esophagus has no digestive or absorptive function. The esophagus is a muscular tube that starts at the inferior border of the cricoid…
Pathology has no clinical value at the present time in the diagnosis and management of gastroesophageal reflux disease (GERD) before the occurrence of visible columnar lined esophagus (vCLE). Its only value is in the diagnosis of intestinal metaplasia, increasing dysplasia…
High-resolution manometry (HRM) is a well-established diagnostic tool that evaluates esophageal motility. It dynamically measures intraluminal pressure changes in the esophagus by using closely spaced pressure sensors. Data are acquired, displayed, and interpreted by esophageal pressure topography plots. The Chicago…