Esophageal Diseases

1. Halitosis
2. Gastroesophageal Reflux Disease
3. Dysphagia (Difficulty Swallowing)
4. Odynophagia (Painful Swallowing)
5. Esophageal Working Irregularities
6. Barrett Esophagus
7. Esophageal Cancer

What are the Causes of Bad Breath (Halitosis)?

The most common cause of bad breath is tooth and gum diseases. Inadequate oral hygiene is the leading cause of bad breath. In addition, bad breath may develop in case of nasal discharge due to sinusitis, frequent tonsil infections, stone formation in these areas after tonsil infection, adenoid infections, mouth breathing due to nasal congestion or cleaning of microbes entering the mouth due to underoperation of the salivary gland. Apart from these, lung infections and some lung diseases can cause bad breath.

When we look at the causes that can cause bad breath from a gastroenterological point of view, esophageal working irregularities, a disease that affects the muscles in the lower end of the esophagus, which we call achalasia, the excess of food in the esophagus, the condition that the lower end of the esophagus remains open all the time, such as reflux, the infections in the stomach caused by the stomach microbe we call helicobacter pylori in the stomach, the stomach. ulcer, stomach cancer, gastric dysfunction, previous stomach surgeries can cause bad breath.

It can cause bad breath in accompanying systemic diseases. For example ; such as diabetes (diabetes), cirrhosis, liver failure.

Which Doctor Should I Go To For Bad Breath?

Individuals with bad breath usually apply to the dentist first. However, since the mouth is the entry point of many systems, complaints should be evaluated and directed accordingly. Taking a disease history plays an important role at this point.

How is Bad Breath Passed?

When the underlying cause is resolved, bad breath will go away on its own. In addition to these, frequent mouth cleaning and avoiding foods that cause bad breath will make your job easier.

How do we know that bad breath originates from the stomach?

Generally, in patients with bad breath, if the problem is caused by the stomach, symptoms such as intermittent stomach pains, indigestion, belching, and bitter water in the mouth accompany bad breath. When we question the patient's complaints well, he will give us clues on this subject. When other causes are excluded, endoscopy can be performed for bad breath and it can be evaluated whether there is a condition in the pharynx, esophagus and stomach that may cause bad breath.

Gastro - Esophageal Reflux Disease

Gastro-esophageal reflux is the backflow of stomach contents into the esophagus. When this condition causes damage to the esophagus and adjacent upper respiratory tract or causes complaints, it is defined as gastroesophageal reflux disease. Dr Meral Sözen asks you "What are the complaints related to reflux disease?", "What are the symptoms of reflux disease?", "Which tests are used in the diagnosis of reflux?" When should endoscopy be performed in a reflux patient? Why is endoscopy performed on patients with reflux?” “Does reflux cause esophageal cancer?” “What should be considered in the treatment of reflux?”, “When is surgery required in reflux disease?”, “What can be experienced after reflux surgery?”, “Where are the centers dealing with the diagnosis and treatment of reflux in Ankara?” will inform you about it.

What are the Complaints Related to Reflux Disease?

Patients may have complaints arising from the esophagus such as pain in the chest, acid reflux, difficulty in swallowing, painful swallowing, heart attack-like chest pain, increased salivary gland secretion, as well as coughing, wheezing, constant nasal cleaning desire, narrowing of the trachea, leakage of stomach contents into the lungs. There may be extra-esophageal findings such as pneumonia and lung tissue damage as a result of the disease.

Which Tests Are Used in the Diagnosis of Reflux?

Many tests can be used for diagnosis. However, the most important factor in the decision of whether there is reflux disease is the patient's history, from which we received the patient's complaints. In addition to the history, acid reflux can be measured at a certain time interval, which we call PPI test, radiological examinations, endoscopic examinations, manometric measurements, PH monitoring. All of the tests used in the treatment of reflux can be performed in Ankara. However, tests applied in the treatment of reflux cannot be performed in many cities other than big centers in Ankara.

Is Endoscopy Required for Patients with Reflux? When Should Endoscopy Be Performed in Reflux Patients? Why is Endoscopy Performed to Patients with Reflux?

• Patientsed 50 years and older or the patient's complaints last longer than 5 years
• Obese, smokers
• The patient has complaints every day
• Patients with a first-degree relative with Barrett's esophagus or upper gastrointestinal tract cancer
• If the patient's complaint persists despite drug therapy
• Persistent vomiting, difficult agy swallowing, painful swallowing, involuntary weight loss, and anemia with no other cause

What are the Points to Consider in Reflux Treatment?

The most important treatment step is lifestyle regulation. If these recommendations are not followed, the most important part of the treatment will be skipped. First of all, wearing tight clothes that will increase intra-abdominal pressure should be avoided. Another precaution is not to leave meal times too late. Having a high head of the bed or sleeping with two pillows, avoiding fatty and spicy foods, carbonated drinks, salted foods and chocolate will be helpful in reducing reflux symptoms.

Which Drugs Are Used in Reflux Treatment?

Many drug treatments used in the treatment of reflux can be used. The choice of drug in reflux varies according to the patient's clinic and the dominant complaint. Although intermittent and continuous drug treatment methods are used, this decision should be individualized according to the patient by evaluating the patient's complaint and response to treatment.

Is it possible to treat reflux with endoscopy?

Treatment can be done with endoscopic methods, but the treatment methods in this group are still in the development stage and more studies are needed to evaluate the results clearly. There are many centers in Ankara that treat reflux. It is possible to perform all examinations and treatments from the first stage of the disease to the last stage in the centers dealing with reflux in Ankara. There are many doctors who deal with reflux disease in Ankara. If reflux is not treated, it invites many problems. Doctor Meral Sözen is very successful in the treatment of reflux. It diagnoses reflux using advanced technology and improves the quality of life of its patients with appropriate reflux treatment.

When is Surgery Necessary in Reflux Disease?

Surgical methods are another treatment method and the number of patients who are given surgery is less. These patients may experience difficulty in swallowing and bloating due to gas accumulation in the abdomen after surgical intervention. Surgical intervention should be considered in patients who require continuous drug therapy, patients with complications due to GERD, drug resistance, reflux affecting the respiratory tract and pharynx, and treatment-resistant asthma patients with reflux and gastric hernia. There are many doctors in Ankara who perform reflux surgeries. However, if certain rules are not followed in the follow-ups after reflux treatment, the complaints of the patients continue.

What Can Happen After Reflux Surgery?

After reflux surgeries performed without the necessary evaluation, patients may face difficulty in swallowing and painful swallowing. Although this situation is relieved by consuming liquid foods for a while, in some cases it can be severe enough to cause re-evaluation with surgery. Therefore, the decision for surgery should be made by an experienced gastroenterology and general surgery specialist.

What is Swallowing Difficulty?

Some events progress in series during eating or swallowing saliva in the mouth. When there is trouble during this progression, we perceive it as difficulty in swallowing. After the swallowing event, the food entering the mouth is crushed by the teeth and divided into smaller pieces, the tongue acts as a shovel and advances the food towards the pharynx, and then the food is advanced towards the stomach by the contraction and relaxation of the esophagus. In this process, we encounter difficulty in swallowing in the disease of various regions. Dr. Meral Sözen gives information about the problems experienced in the swallowing process and its solution. In this article, “What are the causes of dysphagia?”, Is there a relationship between dysphagia and other psychiatric diseases?”, “What causes dysphagia after drug use?”, “What should be done in the treatment of dysphagia after drug use?”, “Is there any drug treatment for dysphagia?”, “Is swallowing difficulty a sign of cancer?”, "Which tests are used to determine the cause of swallowing?" You will find answers to your questions.

What are the Causes of Swallowing Difficulties?

Causes of swallowing difficulties include diseases that prevent muscle work, neurological diseases affecting the pharynx and esophagus, previous partial paralysis, esophageal wounds due to drug use, some psychiatric diseases and esophageal cancer.

Is There a Relationship between Difficulty in Swallowing and Panic Attacks and Other Psychiatric Diseases?

In some sensitive individuals, in what we call depression and panic attacks, patients talk about difficulty in swallowing. In this case, these patients can be identified by psychiatric evaluation after excluding other diseases. After regular treatment, these patients have difficulty in swallowing.

What causes dysphagia after drug use?, What should be done in the treatment of dysphagia that develops after drug use?

In case of drinking with little water, the capsules, which are given for various diseases in certain patient groups, stick to the esophagus and cause scar formation there. In this case, swallowing difficulties are observed, especially with solid foods. After its detection, regular drug treatment and a liquid diet for a while 

After e, his complaints regress rapidly. In case of frequent recurrence of this situation, patients should be examined for esophageal dysfunction.

Is There a Medication for Swallowing Difficulty?

Treatment of swallowing difficulty develops depending on the cause. When the cause of swallowing difficulty is determined, treatment protocols change according to the underlying problem.

Is Swallowing Difficulty a Sign of Cancer?

While there is no early symptom in esophageal cancers, with the progression of the cancer and narrowing of the esophagus, swallowing difficulties are observed first during the consumption of solid foods and then during consumption of both solid and liquid foods.

Which Tests Are Used to Determine the Cause of Swallowing Difficulty?

First of all, tests related to the evaluation of the neurological system, contrast radiographs, endoscopy, and manometric examinations can be performed according to the accompanying findings that determine when the dysphagia started and whether there is a problem that triggers the swallowing difficulty.

What is Painful Swallowing (Odynophagia)?

Some events progress in series during eating or swallowing saliva in the mouth. During this progression, no pain sensation occurs under normal conditions. After the swallowing event, the food entering the mouth is crushed by the teeth and divided into smaller pieces, the tongue acts as a shovel and advances the food towards the pharynx, and then the food is advanced towards the stomach by the contraction and relaxation of the esophagus. During this process, we may feel pain while swallowing for various reasons. Dr. Meral Sözen gives information about the problems experienced in the swallowing process and its solution. In this article, “What are the causes of painful swallowing?”, “What tests are performed in patients with painful swallowing (odynophagia)?”, “What is the treatment for those with painful swallowing?”, “Is there any painful swallowing in achalasia?”, “There is medication for painful swallowing. Is it?”, “Is painful swallowing a sign of cancer?” You will find answers to your questions.

What Causes Painful Swallowing?

Infections, esophageal working irregularities, foreign bodies in the esophagus, ulcers in the esophagus, esophagus infections and esophageal cancers can be counted among the causes of painful swallowing.

Which Tests Are Performed in Patients with Painful Swallowing (Odynophagia)?

After questioning the patient's accompanying problems, when the painful swallowing started, its relationship with food, and drug use are evaluated. After these, x-rays, blood tests, endoscopic examinations and manometric evaluations can be performed. After these, different radiological methods can be used for further examinations.

What Is The Treatment For Those With Painful Swallowing?, Is There Medication For Painful Swallowing?
If the condition causing painful swallowing is an infection, antibiotic treatments, antifungal drugs in fungal infections such as candida, drugs that will affect motility in cases such as achalasia, drugs that allow this wound to heal in esophageal ulcers, and surgical treatment, radiotherapy or chemotherapy can be applied according to the stage of the cancer in the case of esophageal cancer. If there is painful swallowing due to foreign body, this body can be removed by endoscopic methods.

Does Achalasia Have Painful Swallowing?

Achalasia is a disease that progresses with problems related to the relaxation of the muscle structure at the lower end of the esophagus and causes ulcers in the esophagus and painful swallowing when food stays in the esophagus for a long time. In the treatment, treatments are applied to reduce the pressure at the lower end of the esophagus. Drug treatments for accompanying conditions are also given. In addition, endoscopic botox application and treatments for achalasia are applied in selected patient groups.

Is Painful Swallowing a Sign of Cancer?

Although painful swallowing can be seen in esophageal cancers, this condition is usually accompanied by symptoms such as weight loss, difficulty swallowing, nausea, vomiting, and food returning.

Esophageal Working Irregularities

The esophagus is a tubular organ consisting of muscles stretching between the mouth and the stomach, and its task is to deliver the food we take to the stomach. The musculature of the esophagus has a special structure and consists of striated and smooth muscles. The difference here shows the difference in the study pattern and the prominent findings in diseases. The working principle of the esophagus is to relax when the food comes in, then contract and push it forward. Impairment of this function for various reasons leads to problems in the advancement of the meal. In this article, Dr. Meral Sözen will tell you "What are the working disorders of the esophagus?", "Do rheumatic diseases affect the work of the esophagus?", "What is achalasia?", "How is achalasia disease diagnosed?", "How is achalasia disease treated?" ”What is esophageal spasm?”, “What are the symptoms of esophagus spasm?”, ”How is esophageal spasm treated?” will answer your questions.

What are Esophageal Working Irregularities?

Esophageal working irregularities; Diverticulum and webs, deterioration of nerve conduction of the esophagus due to neurological diseases (such as partial paralysis, multiple sclerosis, Parkinson's disease, Alzheimer's disease), diseases affecting muscle structure (muscular dystrophies, myasthenia graves, systemic diseases) impair the functioning of the esophagus.

Do Rheumatic Diseases Affect Esophageal Operation?

Diseases affecting connective tissue such as scleroderma, dermatomyositis, polymyositis, systemic lupus erythematosus, rheumatoid arthritis may affect the esophagus and cause working irregularities. It is important that these patients, who are followed up in the rheumatology unit, apply for drug therapy when they need to be evaluated for digestive system problems. In case of difficulty in swallowing in patients followed for rheumatic diseases, they should be evaluated by a gastroenterology specialist.

What is Achalasia?

Achalasia is a disease that occurs with the irregularity of the functioning of the region that functions as a valve between the esophagus and the stomach, which is formed as a result of the muscle structuring called the lower esophageal sphincter, which is located in the lower part of the esophagus at the junction with the stomach. There are many centers in Ankara dealing with the treatment of achalasia.

What Are the Symptoms of Achalasia?

Difficulty in swallowing in people with achalasia, painful swallowing, weight loss due to feeding problems, consuming plenty of water during meals to ensure the progress of food, formation of irritations and wounds in the esophagus after a meal due to prolonged stay in the esophagus, chest pain, aspiration due to reflux of food escaping the food we call into the lungs; related shortness of breath, cough, frequently recurring lung infections and bad breath.

How Is Achalasia Diagnosed?

The diagnosis of achalasia is made by taking a history of the disease, X-ray with contrast, endoscopic examinations and manometric pressure measurements.

How is Achalasia Disease Treated?

After the detection of achalasia, drug treatments, endoscopic treatment methods and surgical treatments are applied to reduce the pressure of the high pressure area at the lower end of the esophagus. In addition to these, the treatment of accompanying problems should also be applied.

What is Esophageal Spasm?

The esophagus sequentially relaxes and contracts, pushing the food forward. During this contraction, pressure increase and decrease should progress in wave form, while disruption of this wave structure results in esophageal spasm.

What are the Symptoms of Esophageal Spasm?

Due to the irregular contractions in the esophagus, the proper progress of the meal cannot be achieved. Therefore, chest pain in the chest with food is the main complaint of patients.

How is Esophageal Spasm Diagnosed?

When diagnosing the disease, first of all other causes are excluded. Diagnosis is made by contrast-enhanced x-ray, endoscopic examinations and manometric pressure measurements. Here, the images during the manometric evaluation are typical.

How Is Esophagus Spasm Treated?

In this patient group, some drugs that affect smooth muscle function, drugs that regulate stomach acid, antireflux drugs and, when necessary, antidepressant drugs are used. Endoscopic botox can be applied to patients whose complaints do not go away with drug treatments.

What Is Barrett's Esophagus?

The term Barreth esophagus is the change of the cellular structure at the lower end of the esophagus to resemble the cells in the stomach wall, with the effect of stomach acid in genetically predisposed individuals. Gastroesophageal reflux disease is a precursor to the development of Barrett's esophagus. In this article, “What are the symptoms of Barrett esophagus?”, “How is the diagnosis of Barrett esophagus made?”, How should Barrett esophagus be followed up?”, “What should be done in the treatment of Barrett esophagus?”, “Does Barrett esophagus cause esophageal cancer?” You will find answers to your questions.

What Are the Symptoms of Barrett's Esophagus?

Although there is no clinical symptom specific to Barrett's esophagus, reflux symptoms are frequently seen in these patients. As symptoms of reflux, symptoms such as post-meal burning in the thorax and upward reflux of food can be observed.

How Is Barrett Esophagus Diagnosed?

The diagnosis of Barreth's esophagus is suspected when the esophagus and gastric mucosa appear to be intertwined during endoscopic examinations and is then made during the pathological examination of biopsies taken from here. Endoscopically, according to the length of this transition area, the short segment is named as barreth and the long segment as barrett.

How Should Barrett Esophagus Follow Up?

The follow-up intervals vary according to the presence of dysplasia after the pathological examination in the biopsy taken after Barrett's esophagus was detected. Since the change in this region may pave the way for the formation of lower end cancer of the esophagus in the future, the patients should be followed up regularly. 

It is important to come. Follow-up intervals may show individual differences.

What Should Be Done in the Treatment of Barrett Esophagus?

In the treatment of Barrett's esophagus, treatment should be arranged according to the complaints. In case of pathological dysplasia, endoscopic treatments and surgical treatments come to the fore.

Does Barrett Cause Esophageal Cancer of the Esophagus?

The cellular change that develops in the Barrett esophagus can gradually turn into cancer. It is known that many factors play a role here. Obesity, diet, smoking, familial predisposition can be counted among the factors that increase the risk of cancer development.

Esophageal Cancer (Esophageal Cancer)

Cancer of the esophagus (oesophageal cancer) is irregular cellular overgrowth originating in the various layers of the esophagus. Esophageal cancers most commonly develop from the mucous layer, which is located in the innermost layer. Apart from these, it also develops from the muscle layer or supporting connective tissue. Many centers in Ankara show outstanding success in diagnosis and treatment of esophageal cancer. While esophageal cancers are diagnosed by gastroenterology specialists, follow-ups require the teamwork of gastroenterology, general surgery, oncology and thoracic surgeons. In this article, Dr. Meral Sözen explains, “What are the causes and symptoms of esophageal cancer?”, “How is the diagnosis of esophageal cancer made?”, “What should be done in the follow-up and treatment of esophageal cancer?” will answer your questions.

What are the Causes and Symptoms of Esophageal Cancer?

The causes of esophageal cancer vary according to the location of the cancer. Cancers that develop at the lower end are mostly in the group called adenocarcinoma, and they develop on the background of reflux, while squamous cell cancers are more common in the upper regions. Nutritional habits, smoking, alcohol, reflux, genetic characteristics are important in the formation of esophageal cancer. Patients mostly apply with the complaints of difficulty in swallowing, painful swallowing, weight loss and the return of food, which we call regurgitation.

How is Esophageal Cancer Diagnosed?

The patient presented with the complaints of progressive dysphagia and weight loss, and his history of the disease was evaluated. The diagnosis of esophageal cancer was made as a result of the detection of the cancer focus in the endoscopy and the pathological examination of the biopsies taken. We can use endoscopic ultrasonography, computed tomography and magnetic resonance imaging to evaluate how common esophageal cancer is.

What should be done in the follow-up and treatment of esophageal cancer?

Surgery, chemotherapy, and radiotherapy may be administered after the extent of esophageal cancer has been evaluated. While only surgical treatments may be sufficient in the early period, surgical intervention may be considered after radiotherapy and chemotherapy combinations in advanced esophageal cancers.