esophageal conditions

At the MedStar Health Department of Gastroenterology, we offer expert care for a wide range of esophageal conditions.

The esophagus is a muscular tube made of several layers of tissue, muscle, and membranes. It connects the throat to the stomach, serving as a passageway for food, drink, and saliva. Despite its simple purpose, the esophagus can be affected by many types of conditions.

Esophageal cancer

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus.

The esophagus is the hollow, muscular tube that moves food and liquid from the throat to the stomach. The wall of the esophagus is made up of several layers of tissue, including mucous membrane, muscle, and connective tissue. Esophageal cancer starts at the inside lining of the esophagus and spreads outward through the other layers as it grows.

Esophageal motility disorders (difficulty swallowing or dysphagia) are a group of conditions that affect the ability to swallow normally.

Esophageal causes of dysphagia include GERD esophageal strictures, eosinophilic esophagitis, and issues with the esophageal muscles or nerves (esophageal motility disorders). Dysphagia may also be caused by hardened esophageal tissues, tumors, or scarring caused by radiation. Dysphagia is particularly common in older patients.

Symptoms of swallowing disorders include:

  • Feeling like something is stuck in the throat

  • Hoarseness or changes to the sound of your voice

  • Drooling

  • Weight loss or dehydration

  • Pain, coughing, gagging, or choking when trying to swallow

Treatments options for swallowing disorders  include esophageal dilation with endoscopy to stretch the size of the esophagus, surgery to remove tumors or blockages, and medication to treat underlying causes.

Barrett's esophagus is a change in the tissue of the esophagus that is related to long-term acid reflux.

Patients are at heightened risk if they are male, obese, over 50 years of age, Caucasian, a current or former smoker, and/or have a diagnosis of gastroesophageal reflux disease (GERD).Patients with Barrett’s esophagus are at increased risk for a type of cancer called esophageal adenocarcinoma.

Treatment options include endoscopic eradication therapy (EET), cryoablation, radiofrequency ablation, endoscopic mucosal resection, or surgery.

Your doctor can examine the esophagus by using a thin, camera-equipped tube called an endoscope. Patients at high risk may require periodic preventative screening.

Patients who have been previously treated for Barrett’s esophagus also require periodic follow-up exams, the frequency of which depends on the severity of the initial condition and the amount of time that has elapsed since treatment. 

A diverticulum is a small pouch that can form in a weakened area of an organ. A Zenker’s diverticulum is a pouch that develops on the upper esophagus, near the lower neck. The pouch becomes infected or inflamed. It can also grow over time, increasing the risk of pneumonia or liquid or food getting forced into the airways (aspiration).

Symptoms of Zenker's diverticulum include:

  • Difficulty swallowing (dysphagia)

  • Heartburn

  • Regurgitation of food

  • Hoarseness

  • Repeated pneumonia

  • Bad breath (halitosis)

A Zenker’s diverticulum can be treated endoscopically or surgically using procedures called diverticulectomy and myotomy 

Esophageal stricture is a term for the tightening or narrowing of the esophagus. This problem is associated with gastroesophageal reflux disease (GERD), eosinophilic esophagitis, and hernias. It can also be a side effect of scar tissue forming after esophageal surgeries.

Symptoms of esophageal stricture include:

  • Difficulty swallowing (dysphagia)

  • Heartburn

  • Choking, coughing, hiccups, or burping

  • A bitter taste in your mouth

  • Vomiting food or blood

  • Weight loss

There are several options available for esophageal stricture treatment 

Eosinophilic esophagitis is a condition in which the esophagus chronically swells due to a build-up of white blood cells. Eosinophilic esophagitis can be brought on by food or environmental allergies or overuse of certain medications used to treat gastroesophageal reflux disease GERD. For some patients, the cause is not clear.

Symptoms of eosinophilic esophagitis include:

  • Food getting stuck in the esophagus

  • Difficulty swallowing (dysphagia)

  • Heartburn that does not respond to medication

  • Chest pain

  • Weight loss

  • Regurgitation of food

Eosinophilic esophagitis can sometimes be treated with medication or dietary changes to eliminate allergens. In other cases, eosinophilic esophagitis treatment may require endoscopy to dilate (stretch) the esophagus. 

The Lung and Esophageal Center

The team at the Lung and Esophageal Center at MedStar Washington Hospital uses a breadth of novel and traditional diagnostic and surgical tools to care for patients.

Esophageal achalasia

Esophageal achalasia prevents a patient's lower esophagus muscles from relaxing and allowing food to enter the stomach. Symptoms include:

  • Painful or difficulty swallowing
  • Coughing or gagging while swallowing
  • Heartburn
  • Regurgitation of food
  • Feeling of food being stuck in the throat, chest, or behind the breastbone

options include:

  • Esophageal dilation: This minimally invasive treatment employs a balloon or flexible tube attached to an endoscope to gently stretch your esophagus.
  • Heller myotomy: A minimally-invasive surgical approach in which a surgeon makes multiple tiny incisions in the abdomen to open the area that is too tight between the border of the stomach and esophagus.

Benign esophageal tumors

These growths on the wall of the esophagus are often benign and not life-threatening. Most, however, go undetected until they grow large enough to cause dysphagia, a condition that makes swallowing difficult. When this happens, surgeons typically use a small excision in the chest to insert a specially designed lighted microscope and video camera, VATS (video-assisted thoracic surgery). The tumor is then isolated and removed through the small incision.

Esophageal cysts

These growths in the lining of the esophagus can cause difficulty swallowing and problems with breathing. Depending on the location of the cyst, a surgeon may use VATS or another minimally invasive surgical approach to remove them.

Our providers

Gastroenterologist examines the stomach of the patient on the table

Expert gastroenterology care

Getting the care you need starts with seeing one of our gastroenterologists.