6 ways to diagnose esophageal disease

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

The esophagus is an important part of the digestive system, performing functions such as swallowing, transporting food down to the stomach, and preventing gastric reflux. Several diseases commonly occur in the esophagus, including gastroesophageal reflux disease, achalasia, esophagitis, Barrett's esophagus, and esophageal cancer.

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

The group of paraclinical imaging survey subjects includes:

Esophageal X-ray with contrast medium helps to examine the morphology of the esophagus. The patient swallows a liquid containing a contrast agent (usually barium). The bright contrast color on the film highlights the image of the esophagus, including its inner lining and any changes in its shape during swallowing.

According to Dr. Tung , chest and abdominal CT scans help detect changes in the esophageal wall, local lesions, their correlation with adjacent structures, and assess distant metastases – something that other methods cannot do.

Esophageal-gastric-duodenal endoscopy is a procedure that involves inserting a flexible endoscope with an attached camera to transmit images for examination of the esophagus, stomach, and duodenum. According to Dr. Tung, this method is highly regarded for its safety and provides optimal effectiveness in detecting and assessing lesions of the upper digestive tract.

During endoscopy, doctors can also biopsy suspected lesions to determine the nature of the pathology or use special instruments to remove polyps, control bleeding, remove foreign objects from the digestive tract, dilate narrowed areas, and ligate esophageal varices... This method both supports endoscopy and contributes to the intervention and treatment of digestive diseases.

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

Endoscopic ultrasound is performed using a gastrointestinal endoscope with an integrated ultrasound probe, allowing access to lesions from within the esophagus. Thanks to endoscopic ultrasound, doctors can identify and differentiate blood vessels, determine the origin of the lesion, and assess the structure, size, degree of invasion, and stage of tumor development in patients.

For the group of paraclinical functional assessment methods, the specific methods include:

24-hour esophageal pH impedance monitoring is commonly used in the diagnosis and detection of gastroesophageal reflux disease (GERD). Based on the data from the pH meter, doctors can prescribe effective supplementary treatment. During the monitoring process, patients can still eat, drink, and go about their normal activities.

High-resolution esophageal manometry is a diagnostic tool for various types of esophageal motility disorders. This method can accurately assess upper and lower esophageal sphincter pressure, the morphology of the gastroesophageal junction, and the specific types of esophageal motility disorders.

The patient underwent high-resolution esophageal pressure (HRM) measurement. 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 with medical treatment combined with lifestyle changes and diet. More severe cases require corresponding procedures or surgery.

Each diagnostic method for esophageal disease has its own requirements. Dr. Tung advises patients to follow dietary and lifestyle guidelines before diagnosis to ensure accurate results.

Le Thuy

Readers can ask questions about digestive diseases here for doctors to answer.

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