Paralysis of esophagus is a rare condition. Actually it may be referred as stenosis because it exclusively acts by segmentary stimulation of the nerves. Esophagus is a muscular tube through which the food and liquid that you swallow is propelled into the stomach. The muscular tube contracts and relaxes to pass on the food downwards. The two sphincters, UES and LES are affected. Gravity has little role in passage of the bolus towards stomach. However, when esophagus is paralyzed solids and liquids cannot pass into stomach. Mostly together with esophageal paralysis, there is associated paralysis of muscles of deglutition and upper palate muscles.Esophagus paralysis can develop due to many reasons such as infections like diphtheria, neuritis, stroke, etc. In all cases the nerve innervating the esophagus may be damaged. Difficulty in passage of solid and liquid food is one of the marked features of this condition. Regurgitation, heaviness in chest etc are some of the symptoms. Medical therapy, endoscopic therapy and lastly surgery may be necessary to necessary to treat paralyzed esophagus.
Causes of Paralyzed Esophagus
Esophagus paralysis causes motility disorder of the esophagus. Paralyzed esophagus results from damage to the nerves supplying esophagus as well as damage to the two sphincters.The upper esophageal sphincter and lower esophagus sphincter play active role in passage of solid and liquid to stomach. When they lose their contraction and relaxation mechanism food cannot pass forwards. The nerves may get damaged due to infections such as diphtheria or due to any toxic conditions or as a result of inflammatory changes in sensory nerves or due to cerebral stroke. Functional paralysis of esophagus occurs in people suffering from hysteria. Mainly the Vagus nerve and its branches that plays primary role in initiating peristalsis of esophagus is at fault in producing esophageal paralysis.
Paralyzed Esophagus Symptoms
The esophagus is a muscular tube. The neuromuscular coordination is best at its work when food or liquid enters into the esophagus. With peristalsis of the esophageal wall and opening and closing event of the two sphincters the bolus or liquid can easily pass into the stomach. However, due to paralysis the whole mechanism goes awry. This will lead to several symptoms pertaining to esophageal paralysis. As the peristaltic activity of the muscular wall fails food does not pass forward or patient even finds difficulty in gulping the food because many times the associated muscles of deglutination are also paralyzed. This will cause sensation of food stuck in the chest, regurgitation of undigested food, chest pain etc. A condition called achlasia is one example of paralysis of esophagus. In this condition the lower esophagus sphincter is at fault. Patient also experience cough, nasal regurgitation, and choking sensation when he tries to swallow.
Treatment for Paralyzed Esophagus
Depending on the cause patient may require medications of surgical intervention. For example in case of achlasia medications such as calcium channel blocker is tried. This medication helps to relax the smooth muscles. However, the result with medication is not promising and patient usually needs endoscopic balloon dilatation of the lower esophageal sphincter. This relaxes the muscles and gives some chance for the food to pass into the stomach. Surgical option includes a procedure called Heller myotomy. In case of functional paralysis, patient is treated with medications to control hysteria. In majority cases of stroke the esophagus starts to function normally after some time. Food passes easily after few months. The associated paralyzed muscles of deglutination also regain their function.