Upper Gastrointestinal Disease
The gastrointestinal tract (GI) extends from the mouth to the anus. It is divided into upper and lower GI tracts. The upper gastrointestinal tract encompasses the mouth, esophagus, stomach and duodenum, the first part of the small intestine. There are many diseases of the upper digestive tract; some of which include hiatal hernia, gastritis, ulcers, gastro-esophageal reflux disease (GERD), Barrett’s esophagus, and mouth, esophageal, gastric and small intestinal cancers.
Some of the causes of upper gastrointestinal disease include inflammation, smoking and alcohol consumption, long-term use of medications, bacterial infections and excess secretion of digestive fluids.
Disorders of the upper gastrointestinal tract can significantly impact your health. The symptoms can substantially affect your quality-of-life and psychological wellbeing. Conditions such as GORD can severely interfere with your life as it can hinder a good night’s sleep, thereby affecting alertness and productivity the next day. Common symptoms such as heartburn and nausea can significantly interrupt your life.
The gastrointestinal system is a long tube with specialized sections that are capable of digesting and extracting useful components entering the mouth and expelling waste products from the anus. The upper gastrointestinal region of the body encompasses the mouth, esophagus, stomach and duodenum. Food is chewed and mixed with saliva in the mouth and swallowed. It then enters the esophagus (food pipe), a long, narrow tube. The food pipe is lined by muscles that expand and contract, pushing food into the stomach. The stomach secretes acid and other digestive enzymes for digestion and stores food before it enters into the intestine. The duodenum is the first part of the small intestine attached to the stomach which helps digestion.
Symptoms of upper gastrointestinal diseases vary depending upon the condition. Some of the symptoms include difficulty swallowing, nausea, vomiting, heartburn, difficulty in the passage of food, belching, bloating, regurgitation of food and loss of appetite.
Your doctor may order some of the following tests to diagnose upper gastrointestinal diseases:
Upper GI endoscopy or esophagogastroduodenoscopy: examination of the upper digestive tract using an endoscope, a thin tube with a camera on the end. The endoscope is inserted down your throat and into your esophagus, stomach or small intestine to detect the problem.
Upper GI series: involves swallowing a barium preparation, which can be detected through X-rays.
Twenty- four hour pH monitoring: involves inserting a tube with a sensor through your nose and extending it till the lower esophageal sphincter (muscles present at the junction of the esophagus and stomach) to measure the pH of its contents. The tube is left there for 24 hours to detect level of acids, which can indicate reflux of stomach’s acids into the esophagus (GERD).
Impedance study: requires two probes; one is placed in the stomach and the other just above it. The dual sensor helps to detect both acidic and alkaline reflux.
Biopsy: sample of tissue removed through endoscopy to further examine in the lab.
Imaging tests such as PET (positron emission tomography), CT (computed tomography), MRI (magnetic resonance imaging) and ultrasound.
Treatment depends on the condition and its progression. Several treatment options are available, some of which are mentioned below.
Medication: prescription and over-the-counter medicines including antacids provide relief for heartburn and indigestion by neutralizing the acids in the stomach. Antibiotics are prescribed to treat infections.
Lifestyle changes: change in diet, eating smaller and more frequent meals, avoiding smoking and excess intake of alcohol.
Endoscopic resection: cancerous tissue removal with the help of an endoscope, which is inserted through the mouth and extended to the concerned area. Surgical tools passed through it help in cutting and excising the cancerous tissue. When lesions or cancer involves only the top layer of the esophagus, the lining is lifted by injecting a solution under it or by suction, and cut by a procedure called endoscopic mucosal resection. Endoscopic resection is non-invasive and does not involve any incisions on the body.
Balloon dilation of the esophagus: A deflated balloon is passed through an endoscope and inflated at the constriction in the esophagus to allow the free flow of food.