Crohn’s disease is an inflammatory disease of the gastrointestinal tract. This chronic, painful and debilitating disease affects any section of the gastrointestinal tract, from mouth to anus. Crohn’s disease of the esophagus or Crohn’s esophagitis occurs in less than 1 percent of patients. Symptoms include dysphasia, painful swallowing and heartburn. Endoscopic findings show fistulas and strictures.
The Merck Manual defines dysphasia as difficulty swallowing associated with the hindrance in the transport of liquids and solid from the esophagus to the stomach. Severe inflammation of the esophagus causes this symptom. Dysphasia leads to malnutrition and dehydration. Symptoms of esophageal dysphasia include the sensation of pressure in the mid-chest area and a feeling that food is stuck in the throat.
Pain with swallowing is a sign of Crohn’s esophagitis. Inflammation of the lining of the esophagus caused by the disease is responsible for this symptom. A person feels the pain high in the neck or low behind the breastbone. MedicineNet differentiates the pain associated with odynophagia or painful swallowing as a strong feeling of uncomfortable squeezing and burning. Odynophagia limits adequate food and fluid intake. Malnutrition and dehydration are possible consequences.
Heartburn is a symptom of inflammation associated with Crohn’s esophagitis. Heartburn refers to the sensation of chest discomfort or burning . The cause is the reflux of stomach acid into the esophagus. Damage to the esophagus from chronic inflammation interferes with the normal function to prevent reflux.
Endoscopic examination reveals similar findings of the effects of Crohn’s disease on the esophagus as on the other parts of the gastrointestinal tract. Strictures or narrowing of the lumen of the esophagus are visible. Inflammation causes restriction within the tubular space of the esophagus. Fistulas, which are passageways caused by weakening of the lining because of chronic inflammation, are seen in the esophagus. In an article in the American Journal of Gastroenterology, James C. Rholl, M.D. writes that esophageal fistulas associated with Crohn’s disease are rare. The most common passage of esophageal fistulas is to the trachea and airways of the lungs.