Understanding the Esophageal Sphincter - Key Facts
The esophagus, a tube-like organ connecting the throat to the stomach, plays a crucial role in moving food from the mouth to the stomach. This process is facilitated by two sphincters - the upper esophageal sphincter (UES) and the lower esophageal sphincter (LES).
The UES, located at the top of the esophagus, prevents air from entering the esophagus and prevents contents from flowing back up into the throat. It opens only when a person is swallowing food, allowing the food to move down the esophagus. The LES, situated at the base of the esophagus, helps initiate contractions to move food downward into the stomach.
Dysfunction of these sphincters, particularly the LES, can lead to various issues. Dysphagia, or difficulty swallowing, can occur due to physical or neurological injuries or in older adults due to dementia. Dysfunction of the LES can cause reflux, allowing acidic stomach contents to flow back up the esophagus, damaging its lining and interfering with normal digestion and swallowing.
This disruption can lead to symptoms such as a burning sensation in the chest and upper abdomen, sensation of food sticking in the throat, chronic cough, and increased salivation. In severe cases, it can contribute to esophageal motility disorders or complications like esophageal strictures or Barrett’s esophagus.
Malnourishment can also be a result of problems with the LES. Treatment for these conditions often begins with lifestyle modifications such as avoiding trigger foods and positional changes, but the mainstay of medical treatment is acid suppression using proton pump inhibitors (PPIs) to reduce acid production and allow esophageal healing.
When reflux is associated with anatomical abnormalities (e.g., hiatal hernia) or if medical management fails, surgical interventions like Nissen fundoplication or other esophageal surgeries can be performed with varying success. In rare cases associated with esophageal motility disorders causing syncope, procedures like esophageal dilation or peroral endoscopic myotomy may be used.
The esophagus creates rhythmic contractions, a process called peristalsis, from the UES to the LES to move food downward and out of the esophagus. Food most typically becomes trapped in three areas of the esophagus: at the cricopharyngeus muscle near the UES, as it travels downward next to the aortic arch in the chest, and near the diaphragm. People with esophageal sphincter dysfunction are especially vulnerable to trapped food in these areas.
Achalasia, a disorder that causes the LES to fail to relax, can cause food to remain in the esophagus. In severe and untreated cases, esophageal cancer can be a possible outcome.
In summary, dysfunction of the esophageal sphincters, particularly the LES, impairs the prevention of stomach acid reflux, disrupting swallowing and digestion. Treatment primarily involves acid-suppressing medications and, if needed, surgical repair of the sphincter or associated anatomical defects.
- Science has revealed that chronic diseases like gastroesophageal reflux disease (GERD) are often linked to the malfunction of the lower esophageal sphincter (LES), affecting digestive health, medical-conditions, and overall health-and-wellness.
- Ensuring proper nutrition becomes crucial in managing GERD, as malnourishment can result from problems with the LES, making it essential to avoid trigger foods and focus on foodandfoodbenefits suitable for individuals with digestive-health issues.
- Fitness-and-exercise and maintaining a healthy lifestyle can aid in preventing and managing conditions like GERD, as they help improve overall digestive-health and reduce the risk of developing digestive-health problems.
- Medical-conditions such as esophageal motility disorders and esophageal strictures may require surgical interventions to restore normal esophageal function, addressing anatomical abnormalities, and alleviating symptoms associated with the LES dysfunction.
