6 ways to diagnose esophageal disease

Esophageal X-ray with contrast agent, CT scan, endoscopic ultrasound, esophagogastroduodenoscopy help diagnose common esophageal diseases.

The esophagus is an important part of the digestive system, performing the function of swallowing, transporting food to the stomach and preventing gastric reflux. Some common diseases that occur in the esophagus are gastroesophageal reflux, achalasia, esophagitis, barrett's esophagus, and esophageal cancer.

Dr. Pham Huu Tung, Deputy Director of the Center for Endoscopy and Endoscopic Surgery of the Digestive System, Tam Anh General Hospital, Ho Chi Minh City, said that there are currently many tools to help accurately diagnose esophageal diseases, divided into two groups: the paraclinical imaging group and the functional assessment group.

The paraclinical imaging team includes:

Esophagograms are X-rays of the esophagus with contrast material. The patient swallows a liquid containing a contrast material (usually barium). The bright contrast material on the film highlights the esophagus, including the inner lining and changes in shape of the esophagus during swallowing.

Chest and abdominal CT scans help detect changes in the esophageal wall, local lesions, correlations with neighboring structures, and assess distant metastases - which other methods cannot demonstrate, according to Dr. Tung.

Esophageal-gastric-duodenal endoscopy is a procedure in which a flexible endoscope with a camera is inserted to examine the esophagus, stomach and duodenum. According to Dr. Tung, this method is highly appreciated for its safety and at the same time brings optimal efficiency in detecting and assessing lesions of the upper digestive tract.

During the endoscopy, the doctor can also biopsy suspected lesions to determine the nature of the disease or use some special tools to cut polyps, stop bleeding, remove foreign objects in the digestive tract, dilate the narrowed part, ligate esophageal varices... This is a method that both supports endoscopy and contributes to the intervention and treatment of digestive diseases.

Doctor Tung during an endoscopic surgery on a patient in December 2023. Photo: Tam Anh Hospital

Endoscopic ultrasound is performed with a digestive endoscope with an integrated ultrasound probe, helping to access the lesion from inside the esophagus. Thanks to endoscopic ultrasound, the doctor identifies and distinguishes blood vessels, the origin of the lesion, evaluates the structure, size, level of invasion, and stage of tumor development... of the patient.

For the paraclinical group assessing function, specific methods include:

24-hour esophageal pH impedance measurement is commonly used in the diagnosis and detection of gastroesophageal reflux disease. Based on the data from the pH meter, the doctor prescribes effective complementary treatment methods. During the measurement process, the patient can still eat and drink and live normally.

High-resolution esophageal manometry is a diagnostic tool for esophageal motility disorders. It can accurately assess upper and lower esophageal sphincter pressure, gastroesophageal junction morphology, and esophageal motility disorders.

The patient had high resolution esophageal manometry (HRM). Photo: Provided by the hospital

According to Dr. Tung, based on the diagnosis of the type, cause and severity of the disease, the doctor will prescribe the appropriate treatment method. Some mild conditions can be controlled by medical treatment combined with lifestyle and nutritional changes. More serious cases require appropriate surgical intervention.

Each method of diagnosing esophageal disease has its own requirements. Dr. Tung recommends that patients follow dietary and lifestyle instructions before diagnosis to ensure accurate diagnosis results.

Le Thuy

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