Esophageal Ulcers
Esophageal ulcers are painful lesions or sores that occur in the lining of the esophagus, which is the tube that transports food from the throat to the stomach. The ulcers are located at the lower end of the esophagus and are usually accompanied by severe acid reflux or GERD.
Esophageal ulcers cause pain in the area below the breastbone. Most individuals suffering from these ulcers experience pain in the same location as heartburn.
Many cases of esophageal ulcers are chronic, meaning they reoccur frequently and have difficulty healing. The esophagus may become tighter or narrower after many reoccurring cases of ulcers.
The key to avoiding chronic esophageal ulcers is the early treatment of acid reflux. The earlier the treatment, the less complications that develop later in life.
Causes of Esophageal Ulcers
The most common cause of esophageal ulcers are chronic gastro esophageal reflux disease or GERD, which is a condition characterized by chronic acid reflux.
The stomach has a protective mucous lining that guards it against damage from digestive acid. The esophagus does not have this protective lining and can be damaged by the stomach’s acid. Excessive acid in the stomach can reflux from the stomach into the esophagus. This is what is commonly referred to as acid reflux.
Stomach acid can corrode the lining of the esophagus, which can lead to inflammation. Eventually this inflammation can cause the formation of ulcers.
While acid reflux is the most common cause of esophageal ulcers, there are other factors that may contribute to their formation. Excessive or prolonged use of NSAID’s, commonly referred to as anti-inflammatory medications, can weaken the lining of the esophagus and increase the risk of developing ulcers. Smoking can also weaken the lining of the esophagus.
Sometimes ulcers are caused by individuals who are bulimic. Bulimia is an eating disorder that causes individuals to binge on food and then vomit to control their weight. Frequent vomiting can damage the esophagus and expose it to large amounts of stomach acid. This acid can eventually corrode the lining of the esophagus and cause ulcers.
Treatment of Esophageal Ulcers
Those who believe they may be suffering from esophageal ulcers should contact their doctor. Esophageal ulcers are diagnosed using a barium x-ray or an endoscopy, which is a small camera inserted down the throat.
Esophageal ulcers are caused by stomach acid. When treating these ulcers, doctors will often proscribe a proton-pump inhibitor that will suppress the stomach acid. This will prevent the ulcers from being exposed to acid, which may inhibit healing.
In most cases, an infection of the H. pylori is the underlying cause of the esophageal ulcers. It is recommended that the cause of the ulcers be treated rather than the symptoms. It is best to avoid antacids, which have been proven to be harmful to ulcers. Smoking and anti-inflammatory medications should also be avoided as they can cause a weakening of the lining of the esophagus and may inhibit proper healing.
Many individuals suffering from esophageal ulcers will experience a narrowing of the esophagus during or after the healing process. This narrowing is usually treated through drug therapy and the repeated use of a dilator. Dilators are either small balloons or progressively larger cone-shaped tubes that are inserted down the throat of the patient to expand the esophagus.
Complications Associated with Esophageal Ulcers
The most common complication associated with esophageal ulcers is bleeding or perforation caused by the inflammation’s eroding effect on the blood vessels in the esophagus.
Chronic acid reflux can also effect the cells in the esophageal lining. These cells may become cancerous over time. About 10% of individuals suffering from acid reflux will eventually develop esophageal cancer, which is the fastest growing cancer in the western world. Acid reflux or GERD and Barrett’s esophagus are the biggest risk factors for the development of esophageal cancer.
Barrett’s esophagus is caused by the inflammation of the esophagus and is characterized by an abnormal lining at the bottom of the esophagus. Barrett’s esophagus usually proceeds the development of esophageal cancer.
According to a 1998 survey, esophageal cancer is among the 10 cancers most likely to lead to the death of men in the United States.