What You Need to Know About Your Esophagus

Your esophagus is a muscular tube that helps move food and liquid from your throat to your stomach. Connecting your throat and your stomach, your esophagus stretches from behind your trachea and heart to the front of your spinal column, and then through your diaphragm before finally reaching your stomach.

As the key component of swallowing, having conditions that impact the esophagus can result in difficultly eating or drinking. Here is what you need to know about the anatomy and function of the esophagus as well as the conditions that can impact its health.  

Anatomy of the Esophagus

The esophagus, which is about nine to 10 inches long in adults, is a muscular tube that connects the back of your throat to the top of your stomach. Your esophagus begins with the upper esophageal sphincter, which is formed in part by a muscle known as the cricopharyngeus muscle, and ends with the lower esophageal sphincter.

The esophagus contains three anatomical segments: cervical, thoracic, and abdominal.

The cervical segment begins at the cricopharyngeus muscle. This first part of the esophagus is located behind your trachea and is actually connected to your trachea by loose connective tissue.

The thoracic segment is located between the vertebral column and the trachea. This middle section of the esophagus extends from the visible dip in between the neck between the collarbones to the diaphragm.

The abdominal segment, the final segment of the esophagus, runs from the diaphragm to the opening of the stomach. 

Unlike all the other organs in the body, your esophagus is made up of both skeletal muscle and smooth muscle. The upper portion of the esophagus, including the upper esophageal sphincter, is entirely skeletal muscle. The middle portion is a mix of skeletal and smooth muscle. The lower part, including the lower esophageal sphincter, is entirely smooth muscle like the rest of your digestive tract.

What Does the Esophagus Do?

The primary role of your esophagus is to transport the food you eat down your throat and into your stomach. When you eat something, it enters your mouth and mixes with saliva as you chew. The enzymes in your saliva convert the food in your mouth into a mass called a food bolus. Once you are ready to swallow the food, it reaches the pharynx, and you start the process of swallowing.

Swallowing involves the relaxation of the upper esophageal sphincter, which allows the food bolus to enter your esophagus. This mass of food then travels down the esophagus with the help of contractions of your esophageal muscles. When the food bolus finally reaches the end of the esophagus, the lower esophageal sphincter relaxes and allows the food into your stomach.

The esophagus also allows for the liquid you drink, as well as mucus and saliva, to go down your throat and into your stomach.

In addition to aiding in the swallowing process, your esophagus is also responsible for keeping substances found in your food from getting into your bloodstream. And when functioning properly, the esophagus should also prevent the reflux of stomach contents back into your esophagus.

The esophagus is also responsible for expelling material from your stomach when you vomit. This, of course, is a less desirable function and can result in damage to your esophagus if it occurs frequently.

Associated Conditions

Typically, if there is something wrong with your esophagus, you may first experience trouble swallowing. Fortunately, most issues with your esophagus can be treated. And when the issues are detected early, treatment can prevent further damage to the esophagus.

Here are some of the most common conditions that impact the esophagus.

Gastroesophageal Reflux Disease (GERD)

As the most common problem with the esophagus, GERD occurs when the muscle at the end of your esophagus does not close properly. When this happens, your stomach contents leak back, or reflux, into your esophagus and irritate it.

Barrett's Esophagus

In Barrett's esophagus, the lining of your esophagus changes in a way so that the lining of your esophagus becomes more like the lining of your stomach and small intestine. The condition increases the risk of esophageal cancer. People with GERD are at greater risk for Barrett's esophagus.

Esophagitis

Esophagitis is inflammation or irritation to your esophagus. There are different types of esophagitis, each named based on the its cause. The most common type is reflux esophagitis. Another type, eosinophilic esophagitis, is believed to be an allergic condition related to food or environmental allergies. Radiation treatment and allergies are other potential causes of the inflammation. Esophagitis can impact the structure and function of the esophagus.

Achalasia

Achalasia is a swallowing disorder. The condition impacts the nerve and muscle function of the esophagus and lower esophageal sphincter. With achalasia, the muscles in the esophagus do not contract to move food and the lower esophageal sphincter does not relax to allow food into the stomach. 

Hiatal Hernia

A hiatal hernia occurs when part of the stomach protrudes through an opening in the diaphragm. This has a negative effect on the lower esophageal sphincter, making it so that the sphincter cannot work as well at keep gastric content out. Although the cause is not known, researchers speculate that hiatal hernias are caused by increased pressure on the abdomen or a weakness in the diaphragm or surrounding muscles.

Laryngopharyngeal Reflux

With this type of reflux, the stomach contents pass through the esophagus, through the upper esophageal sphincter, and into the back of the throat. The refluxed material may even reach the nasal cavity. People with laryngopharyngeal reflux often experience voice challenges, a feeling as though there is a lump in the throat, hoarseness, chronic cough, and frequent throat clearing.

Esophageal Cancer

Esophageal cancer occurs when cancer cells form in the tissues of the esophagus. The type of cancer is rare. Barrett esophagus, heavy drinking, and smoking all increase the risk of this type of cancer. People who have esophageal cancer usually experience weight loss and difficulty swallowing.

Diagnostic Testing

If a healthcare provider suspects an issue with your esophagus, there are a number of tests that can be used to help them diagnose what is causing your symptoms. Here are some of the most commonly used diagnostic tests:

• Barium swallow radiograph: You will drink a barium solution and receive an X-ray. This test can help spot abnormalities such as ulcers or an esophageal stricture.
• Endoscopic ultrasound: This test involves using a special endoscope that produces images of the lining and walls of your digestive tract. When using this test, a healthcare provider can determine the thickness of the muscle that lines your digestive tract and may be able to detect cancer or pre-cancerous lesions.
• Esophageal impedance: This test assesses the regurgitation of non-acidic substances. Ultimately, it measures the gas or liquids that reflux into your esophagus.
• Esophageal manometry: A thin, pressure-sensitive tube is slowly passed back through your esophagus. This tube allows a healthcare provider to see if your esophagus is contracting and relaxing properly.
• Functional lumen imaging probe (FLIP): This test, which is usually done during an endoscopy, is used to evaluate the function of your esophagus by measuring its dimensions.
• pH monitoring examination: Using a small tube that is inserted into your esophagus for 24 to 48 hours, this test monitors how and when acid enters the esophagus. During this test, you may be asked to keep a food diary, which allows your healthcare provider see if there is a connection between your symptoms and reflux.
• Upper endoscopy: With this test, a tube that contains a camera (endoscope) is inserted down your throat while you are lightly sedated. Your healthcare provider will be able to see the surface of your esophagus and will sometimes perform a biopsy.

Tips for Keeping Your Esophagus Healthy

While not all conditions impacting the esophagus can be prevented, there are things you can do to keep your esophagus as healthy as possible. For instance, the most common issue with the esophagus is GERD. And while you may not be able to keep the condition from developing, you can do things to lessen the damage it can do to your esophagus.

To begin, you can try elevating your head when you sleep by using additional pillows or by raising the head of the bed. You also can avoid certain foods that can lead to GERD like acidic foods, chocolate, caffeine, high-fat foods, mint, and spicy foods. Even reducing the size of your meals and stopping eating when you are 75% full can be helpful in preventing GERD and protecting your esophagus.

Meanwhile, to reduce your risk of esophageal cancer, one of the best things you can do is to quit tobacco products and limit alcohol consumption. Both increase your risk of esophageal cancer—especially when both are done.

A Quick Review

Your esophagus is muscular tube in your throat that plays a crucial role in eating and drinking. But when it becomes damaged or doesn't work properly, it can impact your health and overall wellbeing, especially if you have trouble swallowing. There are a number of conditions that can impact the health of your esophagus, most commonly GERD. Other conditions that can affect your esophagus are esophagitis, achalasia, and cancer. While you may not be able to prevent some of these conditions, there are things you can do to keep the tube healthy like limiting alcohol, quitting smoking, and avoiding foods that might bring on acid reflux.