The esophagus is a hollow, muscular tube that carries food and liquid from the throat to the stomach. It lies behind the windpipe (trachea) and in front of the spine. At its opening, the esophagus is closed by a ring of muscle (called the upper esophageal sphincter), which relaxes when it senses that food or liquid is coming. The sphincter also keeps the esophagus from absorbing stomach acid and other digestive juices.
Esophageal cancer develops when cells in the lining of the esophagus begin to grow out of control. Cancer cells can spread to nearby tissues and can grow into tumors that block the flow of food and fluids through the esophagus.
There are several types of esophageal cancer. Squamous cell carcinoma, the most common type in the United States, starts in flat squamous cells that line the lining of the esophagus. It occurs most often in the upper part of the esophagus.
Adenocarcinoma starts in gland cells that produce mucus in the lower part of the esophagus. The most common adenocarcinoma in the United States starts in the esophagus near the stomach, and it is linked to long-term acid reflux disease and Barrett’s esophagus. Adenocarcinoma can also be caused by heavy alcohol use, smoking and organ transplants.
Some problems with the esophagus can be treated with over-the-counter or prescription medication, diet changes or procedures. Other problems can be more serious and require medical, surgical or endoscopic treatment.
Esophageal atresia
The esophagus is made up of two segments that are joined together in the middle by a tube-shaped muscle called the thoracic diaphragm. A birth defect called esophageal atresia (EA) is when one or both of these segments don’t form or aren’t connected to the thoracic diaphragm. There are four types of esophageal atresia. Most babies born with EA have the more severe type C, which is when the upper segment ends in a blind pouch, but the lower segment joins to the trachea (instead of the stomach). The rarer types are type A, where the upper and lower segments are both connected to the trachea, and types B and D, where the upper and lower segments are connected but don’t connect to each other. EA/TEF can occur alone or be combined with other birth defects to form VACTERL syndrome, which includes spina bifida, spinal column abnormalities and cardiac anomalies.
