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The Upper Gastrointestinal Tract: Stomach, Esophagus and Duodenum
The Upper Gastrointestinal Tract
The upper gastrointestinal tract is where you begin digesting your food. Stating the obvious, everything in your body is connected. In most cases if you experience trouble swallowing or digesting food, you most likely need to see a gastroenterologist. That said, some health concerns in this area may need to be treated by an Ear, Nose and Throat Specialist (also called an ENT) or even a dentist.
Working down the upper gastrointestinal tract, the tube from the back of the mouth to the stomach is called the esophagus. This area can become inflamed or irritated leading to a feeling of having a lump in your throat. It can feel like food is stuck in your throat and you may even have trouble swallowing (called dysphagia). Dysphagia has several possible causes including heartburn (also called acid reflux or gastroesophageal reflux disease or GERD for short). If you experience a burning sensation in your throat, it may be a sign of an ulcer (essentially an open wound) in this area.
When the esophagus is damaged due to heartburn, infections (including some autoimmune disorders such as Hashimoto's Thyroiditis), surgery, radiation, or medication (including aspirin or ibuprofen) it can heal but leave behind scar tissue. This scar tissue actually makes the esophagus narrower and can cause problems swallowing. This narrowing is called a stricture. Patients with long-term illnesses that required a feeding tube can also develop strictures.
Dysphagia is a symptom that can be treated. Knowing the cause is what will keep it from coming back. One possible cause is reflux esophagitis. This is a complication of chronic acid reflux. When stomach acid backs up into your esophagus repeatedly there can be damage to the lining of the esophagus. Treating the acid reflux prevents further damage. If the damage occurs from ibuprofen, switching to a different pain-medication will prevent further damage. In some cases the cause may be obvious while in others there may be a bit of detective work required to find the root cause.
Dysphagia (feeling like you have a lump in your throat) is a symptom that can be treated. Finding the cause is necessary to stop it from coming back.
Another type of damage to your esophagus is called Barrett's Esophagus. The repeated exposure to stomach acid causes the cells lining your throat to mutate so that they resemble cells lining your small intestine. These cells are better able to withstand stomach acid exposure but because they have mutated these cells are also at higher risk of developing throat cancer.
Other symptoms of acid reflux include tasting regurgitated food or a sour taste at the back of your mouth. Heartburn or acid reflux can be triggered by the foods you eat but the foods themselves do not cause ulcers. Chronic or repeated acid reflux occurs when a muscle called the lower esophageal sphincter (LES) fails to work properly. This muscle is like a valve that lets food and liquids into your stomach. If it opens and allows stomach acid to flow up you will experience heartburn. The LES can be damaged due to medication or illness. Hiatal hernias can also cause acid reflux. The stomach pushes through an opening in the diaphragm. Essentially this makes the stomach into a smaller container for food causing increased pressure on the valve leading it to weaken.
The stomach and digestive tract, when healthy, are lined with mucus. The mucus protects us from stomach acid. If the mucus layer thins or the acidity increases then the stomach and the rest of the digestive tract is not protected and ulcers can form.
Helicobacter pylori (H. pylori) is a type of bacteria that can live in this mucus layer. It is possible to have H. Pylori without it causing a problem however it can cause inflammation and this can lead to the formation of ulcers. H. pylori can be transmitted through food, water and human contact.
Remember how ibuprofen and aspirin could cause damage to the esophagus? Well, they can also cause ulcers or sores in the stomach or digestive tract (and liver damage!) so be careful to follow all dosage guidelines.
When ulcers occur in the stomach or the first part of the small intestine (called the duodenum) they are called peptic ulcers. If you have chronic or repeated peptic ulcers, your condition is called peptic ulcer disease or PUD.
There are no pills that will let you eat whatever you like without side effects. If a particular food causes upset stomach, it is much safer to not eat that food.
Spicy food and stress do not cause ulcers but once you have an ulcer, either can make it feel worse. There are no pills that will let you eat whatever you like without side effects. If a particular food causes upset stomach, it is much safer to not eat that food. If you had a headache or fever, while you might take something to treat it initially, if it kept coming back, it would make sense to find out the cause and avoid that.
GERD or gastroesophageal reflux disease simply means you have stomach acid that is not staying in the stomach. It is traveling up into the esophagus. If it instead travels into the throat, larynx or the nasal passage and irritates these areas it is called silent reflux or laryngopharyngeal reflux. Instead of having heartburn, you will have a chronic cough. Silent reflux is more common in infants and in bedridden individuals because their prone position shifts the location of the acid.
If you have heartburn or acid reflux or experience frequent upset stomach
please schedule an appointment so that we can assist you.
Resources on Acid Reflux or Heartburn:
Procedures for the Upper GI Tract
Tips For Better Health
- Pay attention to what causes symptoms in your body -- and avoid problem foods.
- Repeated heartburn is not normal. Let us find out the cause. Schedule an appointment.