Symptoms of disease - pain in the esophagus
The esophagus (Latin œsophagus) - part of the alimentary canal. Is a flattened in anteroposterior direction of a hollow muscular tube through which food from the throat enters the stomach.
The esophagus of the adult person has a length of 25-30 cm. Is a continuation of the pharynx, begins in the neck at the level of the VI-VII cervical vertebra, then passes through the chest cavity in mediastinum and ends in the abdomen at the level of X-XI of thoracic vertebrae, into the stomach.
Accordingly areas of the esophagus are distinguished: neck, chest and abdominal parts.
Lumen of the esophagus is uneven, on its course to distinguish three narrowing. The first of them is located at the crossing location of the throat into the esophagus, the second - in a place of crossing of the esophagus with the left main bronchus, and the third is when passing through the aperture. In the upper part of the esophagus has an upper esophageal sphincter, in the lower, respectively, lower esophageal sphincter, which play a role of valves to ensure the passage of food through the digestive tract in only one direction and prevent the diversion of aggressive contents of the stomach into the esophagus, throat, mouth cavity.
The wall of the esophagus is built of mucous, mucous basis, muscle and adventitia shells. Muscular layer of the esophagus is composed of two layers: the outer longitudinal and internal circular. In the upper part of the esophagus muscular layer is formed by the cross-striped muscle fibers. Approximately at the level of one-third of the esophagus (from the top) cross-striped muscle fibers are gradually being replaced by smooth muscle. At the bottom of the muscular layer consists only of smooth muscle tissue.
The membrane is covered with multi-layer flat epithelium, in its column are mucous glands, operable in the lumen of the body
Pain in the esophagus is perceived as a feeling of discomfort in the chest, and may be accompanied by dysphagia and migraine.
Characteristics of pain in the esophagus.
In diseases of the esophagus pain is usually behind the breastbone, changes in the back, right and left of the sternum, linked to the reception of food and accompanied by a violation of swallowing. Often the pain is caused by damage to the esophagus (perforation, burns concentrated solutions of caustic alkalis or strong acids), neuromuscular diseases (achalasia cardia, esophagism, diverticulum), tumors, inflammatory-peptic changes (esophagitis, the treatment of peptic ulcer of esophagus, hiatal hernia, peptic strictures, etc.).
Which diseases there is pain in the esophagus
Causes of pain in esophagus:
1. Pain in the esophagus may be the result of reflux-esophagitis is an inflammatory process in the distal portion of the esophagus caused by the action of the mucous membranes of the body of gastric juice, bile and intestinal contents during gastroesophageal reflux and accompanied by the appearance of characteristic symptoms (heartburn, retrosternal pain, dysphagia).
2. Pain in the esophagus is observed when his injuries, which are divided into internal (private) from the side of the mucous membranes and external (open), when penetrating injury to the neck and chest.
"There are injury of the esophagus from the inside in case of his foreign bodies. Bedsores wall of the esophagus arise in the long-term presence in it probes, the pressure of mangetki breathing or tracheostomy tube.
- Perforation of the wall of the esophagus may occur in a variety of diseases him, tumors, peptic ulcers, chemical burns. In the irradiation of malignant tumors of damage to the esophagus arise as a consequence of the collapse of the tumor.
The first symptom of perforation of the esophagus is a sharp pain behind the breastbone, which has a tendency to increase, growing by coughing, swallowing, deep breath. In spontaneous rupture of the esophagus unbearable pain occurs most often during vomiting, is localized in xiphoid process, changes in epigastric area, back, left shoulder. Quickly arise subcutaneous emphysema (above the collarbone and neck), sometimes bloody vomiting.
"The dull trauma of the neck, chest and abdomen may lead to a disruption of power and necrosis of the wall of the esophagus as a result of squeezing it between the breastbone and the bodies of the vertebrae. It is often noted damage to neighboring organs. Direct injury of the esophagus may occur during the operations on the organs of the mediastinum and the lungs.
- Observe cases of spontaneous rupture of the esophagus.
Factors predisposing to spontaneous breaking of the esophagus, are alcoholic intoxication, overeating, vomiting during vomiting movements there is a simultaneous disclosure of esophago cardia sphincter, the voltage of the abdominal muscles, reducing the aperture and muscular membrane of stomach, pharynx-esophageal sphincter remains closed. As a result of a significant increase of pressure in the esophagus occurs longitudinal or transverse rupture of its walls, often directly above the diaphragm (back left in 95%, right in 5% of cases). Rupture of the esophagus occurs when you try to hold back the vomit or in violation of coordination in the work of the above sphincters as a result of strong alcoholic intoxication, diseases of the Central nervous system.
The gap often has the form of a linear wounds, may apply to the stomach.
When spontaneous tears in the esophagus pain occurs suddenly (often during vomiting) in the field of xiphoid process, can irradiate in the epigastric region, back, left shoulder. It is noted bloody vomiting, mediastinal and subcutaneous emphysema develops shock, increased body temperature. When damaged, mediastinal pleura arise symptoms hydro pneumothorax).
3. Foreign bodies of the esophagus.
Most often in the esophagus detained meat, fish and bird bones, pins, coins, buttons, needles, clips, fewer pieces of wood, glass, dentures, nails, icons, and other items. The reasons for ingress of foreign bodies into the esophagus different: negligent in the preparation of food, when in food products can be anything; a hasty meal, inattention during the meal, insufficient chewing of food; the habit of employees of certain occupations (shoemakers, tailors, carpenters) during the works kept in the mouth needles, nails. Meet and deliberate ingestion of foreign objects mentally ill persons.
If swallowed a foreign body in the esophagus pain is localized behind the breastbone, increases in swallowing, appears excessive salivation. In the future join dysphagia, fever, General condition worsens, there are symptoms peri esophagitis, in the future may develop purulent mediastinitis.
The delay of a foreign body in the esophagus threatening complication even after a long period of time - from several months to several years.
4. Burns of the esophagus arise either random reception of the corrosive substances, or when a suicide attempt. Often there is a burn of the esophagus concentrated solutions of alkalis and acids, less phenol, iodine, sublimate and other chemical substances.
In the case of burns of the esophagus patients experience severe pain in the esophagus, in the area epigastralna, in the oral cavity and pharynx.
5. Peptic esophagitis.
When peptic esophagitis pain in the esophagus can also occur during swallowing saliva, and in the period of passage of food through the oesophagus. The pain is usually behind the breastbone or under the xiphoid process, can irradiate in the back, interscapular space, up the oesophagus, in the neck, jaw, left side of the chest, often reminiscent of coronary pain, differing from it the lack of connection with physical activity, often dependence from the reception and the nature of the food, the provisions of the patient's body, as well as the lack of effect of nitroglycerin.
6. Hiatal hernia.
For hernia ulcers holes diaphragm, especially when expressed gastro-esophageal reflux, pain in the esophagus can mimic angina pectoris. Patients often without the physical and nervous tension, often after a heavy meal, in a horizontal position the pain behind the breastbone, sometimes intensive, often with a typical radiating to the left arm. In large hernia pain can irradiate in the spine. The pain is not eased by the nitroglycerine, but it is less intense in the vertical position of the patient. Bouts of pain may be accompanied by shortness of breath.
7. Neuro-muscular (achalasia cardia) and malignant (cancer) diseases of the esophagus.
In these diseases of the esophagus is often a spontaneous pain in the esophagus in the form of "pain hypertensic crisis". When achalasia cardia pain crisis occurs in the early period of the disease, often at night, without a direct cause. The pain is intense, changes in the back, up the oesophagus, in the neck, jaw, its duration from several minutes to several hours. Crisis occurs 1-3 times a month. In some patients achalasia cardia pain notes while trying to swallow food. In these cases, the passage of food through the cardia leads to short-term, sometimes quite strong, usually the cutting pain in the xiphoid process with spread up behind the breastbone, the feeling of overflow of the esophagus, then the pain disappears, and the patient continues to receive food.
The cancer of the esophagus pain crisis occurs in the advanced upon germination of the tumor to the surrounding tissue. The pain is usually not associated with swallowing, more expressed in the night time, is located behind the breastbone or in xiphoid process, can irradiate in the back, the neck, the left half of the breast.
The attacks of severe pain in the lower retrosternal department can be caused by retrograde prolapse the mucous membrane of the stomach into the esophagus. If the pain is not related to food and is not accompanied by dysphagia, it is difficult to distinguish from angina at rest. The often-repeated pain behind the breastbone, reminiscent of the localization and irradiation the pain of angina, can be caused by esophagism (dyskinesia of the esophagus). Many patients can determine the relationship of pain with dysphagia. In some cases esophagism arises outside eating, on the background of an emotional or physical stress. Distinguish diskineziu the esophagus from the attack of angina difficult, especially because nitroglycerine due to its relaxing effect on smooth muscles gives a positive effect in both cases.
Which doctor should I contact if there is a pain in the esophagus
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Do you feel esophagus hurts? You should be very careful approach to your health in general. People pay not enough attention to the symptoms of the disease and don't realize that these diseases can be critically dangerous. There are many diseases that in the beginning didn't manifest in our body, but in the end it turns out, unfortunately, it have already been treated too late. Every disease has its own specific features typical symptoms - called symptoms of the disease. Definition of symptoms is the first step in the diagnosis of diseases in general. You just need a few times a year to be screened by a doctor, not only to prevent a terrible disease, but also to maintain a healthy spirit in a body and the organism in general.
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Map of the symptoms and the types of pain is intended solely for educational purposes. We strongly recommend do NOT self-medicate; on all matters relating to the definition of the disease and ways of its treatment, contact your doctor. Md-tips is not responsible for the consequences of use information posted on the site.