Disorders of the Oesophagus

In this section we look at some of the common disorders of the oesophagus, namely Gastro-oesophageal reflux disease (GORD), Achalasia, Oesophagitis and Barrett's oesophagus. We also look at Heartburn in Pregnancy and Possetting in Infants.

Disorders of the oesophagus are in the main caused by a faulty lower oesophageal sphincter (LOS). The LOS represents the primary barrier to the reflux of food and stomach contents back into the oesophagus when pressure increases in the abdomen. If pressure in the LOS is too low, it may allow reflux of stomach (gastric) contents into the oesophagus. The oesophagus does not have the same thick layer of alkaline mucus that protects the stomach. Thus, if gastric juice refluxes into the oesophagus, the acid, bile, and pepsin, and other digestive enzymes in the gastric juice can cause erosion and inflammation of the lower oesophagus. Because the oesophagus has many sensory nerve endings, this may cause severe pain known as heartburn, which is felt in the epigastric region of the abdomen, behind the breastbone. If reflux occurs frequently, the lining of the oesophagus may become permanently damaged. Erosion of the epithelium by gastric juice can also cause bleeding, which may be severe.

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