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Alexander Marmureanu
Alexander Marmureanu
Esophageal Diseases
Esophageal Cancer
The two most common types of esophageal cancer are squamous cell carcinoma, most often occurring in the upper and middle portions of the esophagus, and adenocarcinoma, affecting the mucous-secreting cells in the lower portion near the stomach.
Risk factors for esophageal cancer include smoking, heavy alcohol use, and Barrett's esophagus, a condition in which the glandular cells of the lower portion of the esophagus are irritated by repeated exposure to stomach acid, often because of gastro-esophageal reflux disease (GERD).
To permit optimum therapeutic decision-making in treating patients with esophageal tumors, accurate staging is necessary. We use endoscopic transesophageal ultrasound (EUS) to visualize tumor depth, surrounding lymph nodes, and the tumor's relationship to adjacent structures. In combination with PET (positron emission tomography) and CT scanning, EUS is highly effective in properly staging tumors of the esophagus
Esophageal Motor Disorders
The muscles of the esophagus may function abnormally in multiple conditions, including GERD, in which the lower esophageal sphincter does not close properly or achalasia in which that muscle does not relax with each swallow. Patients with esophageal motor disorders should undergo careful radiographic, manometric (pressure), and motility (movement) studies. Achalasia is the most common motor disorder of the esophagus. A variety of treatments are available, including pneumatic dilatation, botox, and minimally invasive laparoscopic myotomy.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) is a common digestive disorder with symptoms of heartburn in which stomach contents regurgitate (reflux) into the esophagus often causing inflammation and damage to the esophagus and occasionally to the lungs and vocal cords. Afflicting an estimated 25 million Americans, GERD has a variety of different causes. Most patients respond well to conservative measures including dietary modification, weight loss and antacid therapy; however, lasting control of symptoms is sometimes difficult to attain.
