- Diseases and pathologies that cause pain
- Video on topic
Pain in the esophagus during swallowing can be an independent pathology or be a complication of the underlying gastrointestinal disease. What exactly caused the pain when swallowing can be determined by analyzing the clinical picture.
Pains can appear after eating or physical and emotional loads, sometimes they increase in prone position, often accompanied by a violation of swallowing( dysphagia) and dyspepsia.
Diseases and pathologies that cause pain
The human esophagus has four layers( mucosal, submucosal, muscular, adventitial), with violation of the function or integrity of at least one of them there is a swallowing disorder. The wall of the organ has nerve endings, but despite this, under normal conditions a person does not feel the movement of liquids and solid food along it.
Pain in swallowing occurs in the esophagus, if a pathological process is occurring in the tissues. What became the cause of pain when swallowing can be understood by establishing the attendant symptoms:
- nausea and vomiting indicates gastrointestinal diseases;
- heartburn appears if the secretion of hydrochloric acid is increased, and it penetrates into the esophagus;
- regurgitation occurs with achalasia of the cardia, tumor, diverticula;
- weakness and pallor is characteristic if there is internal bleeding, for example, with a burn, trauma to the esophageal mucosa.
With this disease, the acid content of the stomach penetrates into the esophagus, causing inflammation of the mucous layer. The causes of the pathology are:
- the activity of the antireflux barrier is reduced( the esophageal sphincter relaxes frequently and for long periods of time due to worsening of the peristalsis of the esophagus);
- acidity in the esophagus is poorly regulated( the neutralizing effect of bicarbonate mucus of the esophagus and saliva is reduced);
- decreased mucosal protective function;
- increased production of hydrochloric acid.
The disease is also indicated by symptoms such as heartburn, belching with a sour or bitter smell, food, difficulty swallowing, coughing, hoarseness, dryness in the throat, caries, anemia, drooling.
Reflux( casting) most often occurs when a person is in a horizontal position, so in most cases severe pain and burning sensation is felt when the stomach and esophagus are at the same level( at night, when tilted).
To reduce the likelihood of penetration of hydrochloric acid into the esophagus it is recommended to sleep with a raised head for 10-15 cm. If the inflammatory process has begun, then it takes time to restore the mucous tissue. During this period, you must abandon the rough, spicy, acidic, salty, pickled food, as it strongly irritates the mucous, which provokes the appearance of burning sensation when swallowing.
The power of pain is affected by the stage of the disease. In severe cases, pain may appear even if swallowed water or saliva. The pain syndrome behind the sternum or in the region of the xiphoid process is localized, but can irradiate into the back, neck, esophagus, clavicle, jaw.
The appearance of a symptom is not related to physical or nervous tension, which is different from coronary pains.
A bone of a bird or fish, cartilage, nut shell may get stuck in the esophagus. Sometimes surgeons remove small items, for example, pins, coins, buttons, clips. Most often, the subjects swallow children 1-3 years, which is promoted by the underdevelopment of the dentoalveolar system, swallowing insufficiently chewed food, insufficiency of innervation of the larynx, inattention.
The most dangerous are stuck large foreign bodies and sharp objects that can injure or pierce the esophagus. If there is a stenosis of the esophagus, then food starts to get stuck in it, which under other circumstances would easily reach the stomach( this happens if the baby is fed and does not pay attention that it pains him to swallow).
When ingested, the foreign body injures the esophagus tissues, which leads to the development of an inflammatory process and increases the risk of stratification of bacterial infection. The patient experiences the sensation of a lump in the throat, the salivation increases, the pain is more intense when swallowing.
Symptoms depend on where the foreign body is stuck in the esophagus:
- If something is stuck in the neck of the organ, the person must tilt the head down and slightly forward, refuses to eat, feels pain while swallowing, vomiting may begin, salivation may occur. If the object is acute, then in the saliva is visible blood, and if large, there are difficulties with breathing;
- with a jammed swallowed in the chest, the clinic is less bright. It hurts the esophagus when swallowing, spreading sensation into the area between the shoulder blades or in the arm;
- foreign body, stuck in the diaphragmatic part, causes shingles or epigastric pain. Trying to eat solid food leads to vomiting. Salivation is not typical.
On the second day the patient's condition worsens due to the inflammatory process.
Burns can be chemical or thermal. In the first case, the digestive tract was exposed to chemicals, alkalis, acids, with a thermal burn mucous burnt by too hot food. Pain occurs throughout the entire tube of the esophagus, as well as in the mouth, pharynx, stomach.
It appears immediately after the ingestion of substances, so it is easy to diagnose. Clinical symptoms are pain, vomiting with an admixture of blood and mucous particles, drooling, difficulty swallowing, pallor, fever, low blood pressure, weak pulse.
Chemical burns are often received by children, having tried vinegar or ammonia, household chemicals. The most dangerous alkalis used in everyday life, slightly less harm detergents with ammonia, bleaching or disinfecting, part of the medication. Acid more harms the gastric mucosa than the esophagus.
In the absence of burns in the mouth and dysphagia, it is impossible to judge the extent of damage to the
organs. When receiving a burn, immediate intake of corticosteroids and broad-spectrum antibiotics is necessary. Even with the provision of timely medical care for a long time( even years), strictures, non-healing bleeding sites can form on the esophagus mucosa.
With diaphragmatic hernia, abdominal organs move through the resulting defect or through an enlarged aperture opening. There is a hernia due to the weakness of the tissues that connect the diaphragm, and increased intra-abdominal pressure( due to nauseous cough, severe vomiting, physical exertion, constipation, etc.).
The severity of symptoms depends on the diameter of the hernia gates, the localization of the hernia and its shape, and also on the organs that fall out. The pains appear not only when swallowing, but also when turning the torso. They are intense, often radiating to the left arm, back, lower jaw.
If the hernia is large, then soreness can be felt in the spine. Clinical picture of the disease is supplemented by a feeling of heaviness in the pit of the stomach, shortness of breath, palpitations, rumbling in the chest area.
The greatest danger is the infringement of the hernia, as it can lead to peritonitis
About a quarter of patients with non-cardiogenic chest pain have a pathology in which the motor function of the esophagus is impaired. Unpleasant sensations during swallowing can be caused by a tumor or neuromuscular disorders. Pain occurs due to spasm of the muscles of the esophagus, stretching of the walls of the organ or slowing of the peristalsis.
For these reasons, soreness often spreads up the esophagus and gives back and neck, with the attack lasting for hours. With achalasia of the cardia( the sphincter of the esophagus does not relax reflexively when swallowing) a similar crisis appears once in several months.
Tumors develop over time. Factors predisposing to cancer include the use of very hot drinks, rough, spicy food, alcohol, as well as a lack of vitamins( A and B) and microelements, smoking.
The degeneration of healthy cells into cancer cells can occur due to esophagitis, peptic ulcer disease, achalasia, polyps, lipomas, and Barrett's esophagus. Most often, the symptoms of pathology appear at the stages when a spasm of the esophagus occurs due to irritation of the area of appearance, thereby causing a painful sensation when swallowing.
Primary symptoms include dysphagia( difficulties with ingestion of food progress), it appears long before the narrowing of the lumen of the esophagus, so when you have pain in the esophagus during swallowing, you should immediately call your doctor.
Dysphagia can have 4 degrees: at the first degree of difficulty in the passage of solid food, and at the fourth, the lumen is completely blocked. With the development of the tumor, the following symptoms are noted:
- a feeling of overstuff after the sternum with food;
- increased salivation;
- vomiting with undigested food;
- bad breath.
Symptoms such as anemia, weight loss, weakness appear with esophageal stasis and intoxication of the body
Find out why there are pains in the esophagus when swallowing, the doctor will be able to after the necessary tests and tests. At the initial examination, the gastroenterologist will collect an anamnesis, ask in detail about the intensity of the pain, its nature, duration, time of onset, and the stomach will prolapse to check for abnormalities in the abdominal cavity.
To examine the wall of the esophagus and stomach, as well as evaluate their motor function, instrumental diagnostic methods will help. Doctor appoints:
- X-ray study;
- daily pH-metry;
- manometry( test with water);
- ultrasound study.
If a tumor is detected, a biopsy is performed, and the tissue is sent for histological examination, which will establish whether the cells are malignant.
Self treatment for pain in the area of the esophagus is unacceptable, since very serious complications can occur until organ contraction and perforation. In most cases, surgical intervention is required( for neoplasm, foreign body, hernia).
If the cause of pain in the mucous burn, then it is necessary to wash the stomach, and in severe cases, bougie( the introduction of a special tool to expand the esophagus).With severe pain, anesthetics will help: Novocain, Anestezin, Lidocaine. Heartburn will pass after taking medications that protect the mucosa from irritation( Almagel, Simethicone).
Before going to a doctor, you can resort to symptomatic treatment.
Will relieve spasm No-Shpa, Nitroglycerin. When taking antacids, proton pump inhibitors, H2-blockers, the production of hydrochloric acid decreases. With a decrease in peristalsis and spasms, prokinetics, antispasmodics or calcium channel blockers are prescribed.
Regeneration of tissue will be faster if you adhere to a diet that excludes any rough, spicy, sour food, and also give up alcohol and smoking. There is a need for small portions and preferably a mashed food, cooked steamed or boiled. At the first opportunity, it is necessary to visit a doctor to find out the cause of pain in the esophagus and get adequate medical care.