Oesophageal disorders are extremely common. Many people seek medical advice for typical symptoms of gastro-oesophageal reflux such as heartburn, epigastric or retrosternal discomfort and regurgitation. Symptoms of acid reflux may include persistent sore throat, hoarseness, chronic cough, asthma, heart-like chest pain and a feeling of a lump in the throat.
What is gastro-oesophageal reflux ?
Gastro-oesophageal reflux disease (GORD) occurs when stomach acid leaks back up into the oesophagus. This is known as acid reflux. The oesophagus is the tube that runs from your throat to your stomach. GORD is often a chronic condition, which means that if you have it, you may experience recurring episodes for the rest of your life.
The symptoms of GORD may be improved by making lifestyle changes that affect acid reflux, such as eating smaller meals and, if you smoke, giving up.
There are also a number of medicines that can be used to relieve the symptoms of GORD. More severe cases of the condition may require surgical treatment.
Repeated episodes of GORD can make the lining of your oesophagus inflamed (known as oesophagitis). GORD is a common condition, and it's one of the most frequent causes of indigestion and heartburn. It is estimated that 10 to 20% of people will have acid reflux at least once a week
What are the symptoms of cancer of the oesophagus?
The first symptom of the disease is almost always difficulty in swallowing. There is the feeling that food is getting stuck, often behind the lower end of the breastbone. At first the problem is only with solid food but later even semi-solids and liquids can cause problems.
Pain felt between the shoulder blades can also be troublesome. This discomfort is sometimes triggered by eating.
Another characteristic symptom is regurgitating unaltered food a few minutes after having difficulty swallowing the food. The patient often tries to handle these problems by eating less and avoiding solid food. This causes weight loss and fatigue.
Later on, heartburn, vomiting and vomiting of blood may become the dominant symptoms. The early symptoms are relatively minor and tend to creep up on patients. This means it is often several months before they consult their doctors.
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How is cancer of the oesophagus treated?
Treatment may consist of surgery, radiotherapy, chemotherapy or a combination of these.
The best chance of cure is with surgery. Patients who are in good general condition and who have small tumours have more than a 25 per cent chance of cure with surgery.
In fit patients with more advanced disease, the combination of chemotherapy and radiotherapy may be used - this can produce cure rates of around 20 per cent. The combination is sometimes used to shrink tumours in order to make subsequent surgery easier and more effective.
Unfortunately the majority of patients are not fit for intensive treatment of this type. In their case treatment will be aimed simply at relieving symptoms.
This can sometimes be done most easily using a stent. A stent is simply a kind of tube that is inserted inside the gullet to help keep it open and allow the passage of fluid and food. There are various kinds available, ranging from a simple plastic tube to a device made of metal mesh that expands once it has been put in place.
Stents can be put in place as a simple procedure at the same time as an endoscopy is carried out.
Radiotherapy can also be used to try and shrink the tumour and keep the gullet open for longer.
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