Be Nice to Your Esophagus

We have only one esophagus so we have to be really good to it. And the esophagus has one job: to squeeze whatever we swallow down to our stomach. It’s important to remember that the esophagus is a muscular tube. A muscle when used repetitively or when stress is placed on it, can fatigue. So what does that mean? Let’s look at a muscle that we can control like our bicep. We lift a 5 lb weight and after 20-30 repetitions, our bicep gets tired or worn out.

Another fun fact about our esophagus? The esophagus is more constricted in the morning which means it feels tighter! It also means that the esophagus is “generating a higher pressure” or squeezing more first thing in the morning. Do you feel tighter in the mornings? Can’t get that coffee down first thing? Well that’s normal it turns out! When the esophagus squeezes so hard, it gives you the feeling of something being stuck or of chest pain in the middle of your chest. This has a lot of correlation for patients with gastric banding and also immediately after gastric bypass or sleeve gastrectomy.

If you have a gastric band, the effect of that tightness is magnified. Imagine that your esophagus has to squeeze harder to get food or liquids that you swallow across the band. The esophagus squeezes and generates a high pressure to get the swallow across the band and into the stomach because the band causes a high-pressure zone where we put it.

If you take a big bite and swallow it, the esophagus has to squeeze harder. If you don’t chew your food well, the esophagus has to squeeze harder. If you take a bite and then take another one right away (we call it stacking the swallows), your esophagus has to squeeze harder. If you drink big gulps or chug a glass or bottle of water, your esophagus has to squeeze harder to get that bolus of liquids across the band into your stomach. So what you ask? Well remember that with repetitive use, any muscle can fatigue. When your esophagus gets tired – of all the gulping, and eating fast and not chewing well and trying to wash the food thru the band with liquids – it will stop squeezing so hard and be tired. When the esophagus doesn’t squeeze and give its all, the esophagus dilates. Especially if you have a band, the esophagus can’t generate enough force to get food and liquids across the band, and this can cause esophagitis, reflux, heartburn, fluid coming out of your nose at night and night cough.

Perhaps the bests way of avoiding loosening and dilating your esophagus are: don’t take too big a bite and don’t stack your swallows (waiting 30 seconds between bites can really help with this), and don’t wash down your food with liquids. Your esophagus doesn’t get irritated because you swallowed too big a bite once, or that you gulped down a ½ liter of water once. It dilates because of repetitive behavior. We have all heard those touchy-feely expressions: Be kind to one another or Be kind to the world, it’s the only one we have. Well here’s a new one for you: Be kind to your esophagus, it’s the only one you got!

By Dr. Marina Kurian