There is a weak valve at the lower end of the oesophagus, where it enters the stomach. This valve is called the cardiac sphincter. The cardiac sphincter prevents food, drink and stomach juices from flowing back up into the oesophagus, unless you vomit. The oesophagus is part of the digestive system, called the gastrointestinal tract.
What has gone wrong?
There may be something blocking the oesophagus, such as food or a swallowed coin. There may be a narrowing (stricture), a thickening of the wall of the oesophagus or something pressing on the oesophagus from inside the chest. Sometimes the lining of the oesophagus becomes inflamed and sensitive. This may be because the cardiac sphincter is letting irritating stomach juices leak up into the oesophagus. Rarely, the cardiac sphincter muscle is too weak or overactive so it does not work properly. A pouch (diverticulum) in the wall of the oesophagus may be causing the problem.
The main aim of the procedure is to examine the inside of the oesophagus. The surgeon passes a special telescope down the back of the throat into the oesophagus. This instrument is called an oesophagoscope or scope for short. Some scopes are rigid metal tubes and others are flexible. With a flexible scope, the surgeon can usually examine the back of the throat and the inside of the stomach, as well as the oesophagus.
The surgeon can use the scope to inspect all the different parts in detail. If there is anything blocking the oesophagus, the surgeon can usually remove the blockage using fine grasping instruments passed down the scope.
The surgeon can remove small pieces of any diseased lining of the oesophagus by passing other instruments down the scope. The specimens are called biopsies. They are sent to the laboratory for tests. Biopsies are very small and the lining of the oesophagus heals quickly without stitches.
If there is a narrowing (stricture) in the oesophagus, the surgeon may be able to stretch it open by passing special balloons or stretching instruments, called bougies, down the scope. This is called oesophageal dilatation.
You will have a general anaesthetic and be completely asleep while the operation is done.
This examination of the oesophagus will help to find out if anything has gone wrong. We may also be able to treat the problem through the scope. The examination may tell us that all is well with your oesophagus.
Are there any alternatives?
X‑rays are not very good for showing the inside of the oesophagus. It is possible to use a barium swallow or a barium meal to outline the oesophagus on an x-ray. These x-ray examinations outline the oesophagus using barium liquid, which shows up on x-rays.