Dysphagia, the difficulty or discomfort while swallowing, is a complex issue that gastroenterologists frequently address. This symptom can arise from various underlying conditions affecting the esophagus, each requiring specific evaluation and management.
- Achalasia: Achalasia is a rare disorder characterized by impaired esophageal motility and failure of the lower esophageal sphincter (LES) to relax properly. Gastroenterologists diagnose achalasia through tests like esophageal manometry and upper endoscopy. Endoscopic treatment of achalasia involves methods like pneumatic dilation, where a balloon is inflated in the esophagus to stretch the tight lower esophageal sphincter. Peroral endoscopic myotomy (POEM) is another technique, where the muscle fibers of the sphincter are cut to improve swallowing.
- Peptic Stricture: Peptic strictures are caused by chronic acid reflux damaging the esophagus and leading to scar tissue formation. Gastroenterologists often perform upper endoscopy to visualize strictures and can dilate them using special balloons or bougies during the procedure. Long-term management involves addressing acid reflux to prevent stricture recurrence.
iii. Esophageal Rings: Esophageal rings are narrowing in the esophagus, often related to eosinophilic esophagitis or gastroesophageal reflux. Gastroenterologists diagnose rings using endoscopy and can dilate them if necessary. Addressing underlying causes and managing inflammation are crucial for long-term management.
- Esophageal Dysmotility: Esophageal dysmotility refers to irregular muscle contractions affecting swallowing. Gastroenterologists diagnose dysmotility using esophageal manometry. Depending on the specific type of dysmotility, treatment options may include lifestyle modifications, medications, or interventions to improve esophageal motility.
- Zenker’s Diverticulum: Zenker’s diverticulum is a pouch that forms at the junction of the esophagus and the throat. Gastroenterologists diagnose it through endoscopy and perform endoscopic or surgical procedures to alleviate symptoms. Dr. Fasullo has the specialized skill to be able to treat the majority of Zenker’s endoscopically.
Conclusion: Dysphagia is a multifaceted symptom arising from various esophageal conditions. Gastroenterologists play a pivotal role in diagnosing and managing these disorders, tailoring approaches based on the specific underlying cause. Through specialized diagnostic tools and innovative interventions, gastroenterologists strive to improve patients’ swallowing function and overall quality of life. Individuals experiencing difficulty swallowing should seek expert evaluation to determine the cause and receive appropriate care.