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Pain in the epigastric region, heaviness after eating, the occurrence of an unpleasant aftertaste in the mouth or belching will not always indicate problems with the stomach. Sometimes all these symptoms can indicate a disease of the esophagus, which acts as a link between the oral cavity and the stomach.
Diseases of the esophagus can very often cause significant discomfort to patients. In cases of frequent or unbearable pain, you should consult a doctor, since it will not be possible to independently determine the cause of complaints and determine which disease it is – all organs of the gastrointestinal tract can give the same symptoms. That is why doctors rarely do without certain diagnostic procedures in such cases. The main procedure for diagnosing diseases of the esophagus is radiography.
An x-ray of the esophagus is a diagnosis of the degree or stage of disorders in this organ. With the help of an examination, it is possible to diagnose with sufficient quality all possible pathological changes, inflammation, erosion, ulcers, tumors, and so on that occur in the organ.
Research objectives
X-ray of the esophagus refers to sparing procedures for examining the organ if it is not possible to do fibrogastroscopy (the patient is afraid of the procedure, spasms occur that prevent the introduction of the gastroscope, etc.).
An x-ray of this organ, in addition to diagnosing various pathological processes, can visualize the entry into its cavity of various foreign bodies and objects that can be accidentally swallowed. In adults, x-rays of the esophagus often show the bones of fish, vegetables or fruits, and in children, all kinds of small details of designers, figures and other small toys.
There are times when an x-ray shows casuistic options in the form of the presence of needles, pins and other piercing and cutting objects in the body (there are even knives and forks!). This state of affairs requires immediate surgical intervention, otherwise the situation may end very badly for the patient.
X-ray indications and contraindications
Indications for x-ray examination of the esophagus are various complaints of patients – from severe discomfort to severe pain in the projection of the esophagus. Also, an indication for x-rays is the impossibility, for one reason or another, of carrying out other diagnostic procedures.
When complaints of the following nature come from patients, the gastroenterologist necessarily directs patients for x-rays of the esophagus and stomach:
- regular bouts of heartburn;
- eructation into the oral cavity of the acidic contents of the stomach;
- pain and heaviness after eating;
- the occurrence of spasms when swallowing solid food;
- pain when drinking plain water.
Radiography in this case can act as the main diagnostic procedure, but can also serve as an addition to a more informative study in the form of endoscopy.
Contraindications for x-ray examination of the esophagus are the following patient conditions:
- the occurrence of gastric bleeding or other serious condition in the patient, as well as a relatively recent similar diagnosis (to avoid unnecessary exposure to x-rays);
- periods of pregnancy and breastfeeding, when radioactive radiation is especially dangerous for the development of the fetus;
- Allergy to components of contrast agents used in radiography, in particular to iodine.
Preparation and conduct of radiography
When radiography is performed without the use of contrast agents, the walls of the esophagus will not be visualized in the pictures, which will not allow a full diagnosis of pathological changes. Barium sulfate is used as a contrast agent for x-rays of this organ. A whitish suspension from this component is offered to the patient for ingestion by drinking. Barium sulfate can thus fill the hollow tube of the esophagus and visualize its borders. It is important to know that barium sulfate is a substance that is completely inert to the human body, which does not affect it in any way and is quickly excreted along with the feces.
Among the special prescriptions for the preparation of the study, doctors single out only that an x-ray of the esophagus is performed on an empty stomach. Eating before the start of the study can not be at least 6 hours. A day before the examination, it is necessary to exclude such food that provokes flatulence in the gastrointestinal tract – legumes, cabbage, sweets, fresh pastries, and so on. On the day of the study, you can not eat or drink liquids, including alcohol, and it is also undesirable to smoke. With a pronounced gag reflex at the time of the procedure and the use of contrast, doctors sometimes give patients antiemetic drugs, but more often there is no need for this.
The x-ray procedure is performed while standing. After drinking barium sulfate, the patient should lie vertically in a special X-ray machine, then the X-ray technician adjusts the machine and offers to remain motionless and not breathe for several seconds, during which a picture is taken. Sometimes it is necessary to change the posture in order to obtain other projections of the examined organ.
After passing the study, the radiologist for some time deciphers the picture and writes a conclusion for the attending physician. When conducting an x-ray examination of the esophagus, no side effects can occur, except for the effect on the body of radiation. Its dose is very small, but it is often not recommended to take x-rays.
X-ray results
In a normal state of health, an x-ray of the esophagus should not show any abnormalities in the visual picture of this organ. The esophagus should not differ from the norm either in shape or size, its walls should have a normal thickness, neoplasms should not be visualized in the structure, there should be no foreign bodies in the cavity. Otherwise, any visible deviations will indicate the presence of certain diseases. An experienced radiologist will immediately see all the violations and will be able to give them an objective assessment. Sometimes anomalies may require examination of some organs adjacent to the esophagus to make an accurate diagnosis. In this case, an x-ray of the esophagus will be an additional measure for diagnosing suspected diseases.
When identifying all kinds of pathologies, specialists can immediately determine which disease will need to be treated. For example, the presence of any foreign objects in the esophagus will definitely become the basis for surgical intervention. When a protrusion of the organ wall and its stretching, clamping of the mucous membrane between the muscles and the formation of a saccular cavity are detected, doctors diagnose the patient with a diverticulum. In the diverticulum, food remains enter the hollow tube, which often leads to its further stretching or rupture.
With dyskinesia of the esophagus, the movement of incoming food through it is slowed down or accelerated. This pathological condition is usually accompanied by disorders in the work of the sphincter and other anomalies of other organs. When the esophagus descends into the abdominal cavity or when part of the stomach moves through the hole in the diaphragm into the chest cavity, doctors diagnose a hernia of the esophageal part of the diaphragm. And after chemical or thermal burns, esophagitis occurs, which is expressed by swelling of the mucous membrane of the organ, a decrease in its tone and disturbances in motor function. With ulcers of the esophagus, doctors observe violations of the integrity of the mucous membrane of the organ. Often the same is in the stomach at the time of the examination, so it should also be considered carefully. All kinds of neoplasms in the esophagus are well visualized, while benign ones have clear boundaries, and cancer is always indicated by blurry contours without clear boundaries.
Also, during the x-ray of the esophagus, dysphagia is detected, that is, all kinds of violations of the swallowing process, the causes of which can be various conditions that can sometimes be seen in the picture.
Features of the diagnostic method
X-ray of the esophagus is an effective non-invasive and painless method for diagnosing this organ. This study is quite informative, and in cases of determining foreign bodies in the esophagus, it is simply irreplaceable. The X-ray technique is quite simple, the study is very fast, and the doctor can diagnose the patient as soon as possible and prescribe therapeutic measures. The radiography itself lasts no more than 10 minutes, and the same amount of pictures are developed and a conclusion is written, although the latter may take a longer time.
X-ray of the esophagus is not a traumatic procedure, besides, it can perfectly replace gastroscopy if the patient is either afraid of this technique, or it is not available for some reason. Sometimes a person has an overly pronounced reaction to the introduction of foreign bodies into the esophagus, which also prevents a normal study and a qualitative picture of the state of the organ – in such cases, X-rays are also used. The most “terrible” in this procedure is the need to drink a contrast agent without taste and smell, but this is much easier for many people to survive than all sorts of interventions in the body.
In modern medical practice, there is an opinion that the X-ray examination of the gastrointestinal tract is becoming obsolete, but this does not negate its availability, information content, and, in some situations, non-variability of use.