Oesophageal Surgery

Various conditions require oesophageal surgery. Surgery is done when the non-invasive methods of treatment fail to provide adequate relief to the patient or in cases where surgery is the only option left to save the patient's life or provide relief from symptoms. Various conditions that require oesophageal surgery include Achalasia, Gastroesophageal reflux disease (GERD), Corrossive esophageal stricture, Hiatal Hernia, Barrett’s esophagus with dysplasia, oesophageal cancer, and in advanced stage achalasia.

What Is Achalasia?

Achalasia is the condition characterized by difficulty in passing the food or fluid from the mouth to stomach. Nerves are present in the esophagus that regulates the flow of fluid and food from the mouth to stomach by contracting and relaxing the muscles. Further, the lower oesophageal sphincter also relaxes to allow the food to move into the stomach. In achalasia, the nerves of the esophagus get damaged leading to improper transit of food and fluid in the stomach. 

How The Diagnosis And Treatment Of Achalasia Are Done?

Most of the symptoms of achalasia are like digestive disorder thus increases the risk of its misdiagnosis. Various diagnostic methods such as oesophageal manometry, upper endoscopy, and X-ray of the digestive system is done to diagnose achalasia. 

There is no treatment for this disease and the treatment is directed to provide relief from symptoms. Non-invasive treatment includes medication and pneumatic dilation. Surgery is also done in cases when non-invasive treatment is ineffective.  Various surgical options for achalasia include Peroral endoscopic myotomy, Heller myotomy, and Fundoplication.

What Is Hiatus Hernia?

A large muscle separates the abdomen and diaphragm. Through the diaphragm, at a point called hiatus, the esophagus passes and connects to the stomach. A hiatus hernia occurs when the stomach is pushed up. This causes a bulging of the stomach. Mild hiatus hernia is not a cause of concern and is diagnosed when the abdomen is evaluated for any other reason. However, the large hiatal hernia poses a problem and may lead to heartburn as the food and other substances move upward into the esophagus.

What Are The Treatment Options For Hiatus Hernia?

Non-invasive treatment options for hiatus hernia are aimed to provide relief from the symptoms such as heartburn or acidity. Medications may include antacids, proton pump inhibitors, and H2 receptor blocker. Surgery is required in severe cases of hiatus hernia. Surgery includes removing the hernia sac, reforming the sphincter, and pulling the stomach back into the abdominal cavity.

What Are The Causes For Oesophageal Cancer?

Oesophageal cancer is the cancer of esophagus which usually initiates in the inner lining of the esophagus. Men are more prone to develop oesophageal cancer as compared to women. The exact cause of oesophageal cancer remains unknown. Various factors increase the risk of oesophageal cancer. These include smoking, obesity, drinking alcohol, achalasia, gastroesophageal reflux disease, making habit of drinking the hot liquid, lack of fruits and vegetables in the diet, and presence of Barrett's esophagus.

What Are The Various Treatment Options For Oesophageal Cancer?

Surgery is one of the options for treating oesophageal cancer. Surgery of esophagus is done either to remove small tumors, to remove part of the esophagus or to remove complete esophagus and upper part of the stomach depending upon the severity of the disease. Other options for treating oesophageal cancer include chemotherapy and radiation therapy. Different options may be used simultaneously for treating oesophageal cancer.