Gullet

General characteristic of a gullet

The gullet belongs to the main departments of a digestive tract. Connecting a throat to a stomach, he participates in a food proglatyvaniye. Peristaltic muscles of a gullet which, being reduced, push food to a stomach allow to carry out this process.

Length of this body at the adult is in limits of 23-30 cm whereas thickness makes from only 4 to 6 mm.

The gullet consists of three parts:

• Cervical part. Length makes it about 5-6 cm, it is located between a rachis and a trachea;
• Chest part which length about 17-19 cm, is along a postmediastinum. Also passes between a backbone and a trachea, is located between an aorta and heart below;
• Belly part is between a cardial part of a stomach and a diaphragm. Length makes it from 2 to 4 cm.

Width of a gullet is uneven, it is narrowed in the field of a joint of a gullet and a throat, further – in the area where adjoins to the left bronchial tube, and, at last, there is a narrowing in that place where the gullet passes through a diaphragm.

Gullet structure

The gullet represents a hollow tube which wall consists of several layers:

• The mucous membrane covers a gullet cavity. The mucous glands allocating a secret which facilitates advance of food during swallowing are its part;
• The muscular coat is located in two layers: outside longitudinal and circular internal. They work by the principle of antagonists: the first expands a gullet, the second – narrows. The lower part of a muscular coat forms a so-called lower esophageal sphincter – the dense muscular education separating a gullet from a stomach;
• The adventitious layer consisting of connecting fabric covers an external surface of body. Thanks to it the gullet is connected to the bodies surrounding it. Due to friability of a cover the gullet has an opportunity to change the sizes: to stretch, be narrowed, etc.

Functions of a gullet

The main objective of body consists in delivery of a food lump to a stomach, otherwise this function is called transport or motor.

Also the problem of a gullet consists in greasing of the food passing through it. Material for lubricant is produced by secretory glands of the mucous membrane covering a cavity of body.

At last, the gullet is designed to serve as protection against penetration of food from a stomach back, that is it promotes advance of food only in one direction.

Gullet diseases

The body is subject to the whole range of various diseases. Lack of adequate treatment of a gullet not just leads to emergence of pain, but also is capable to break all work of digestive organs. The most widespread diseases are described below:

• The cardiospasm concerns to group of neuromuscular diseases. It is expressed in disturbance of reflex opening of a sphincter owing to what food cannot get into a stomach. Origins of a disease are studied not up to the end. Against the background of a cardiospasm there are various complications caused by a food delay in a gullet. At adults it can lead to development of cancer of gullet and stomach, various inflammations. At children – to abscesses of lungs, bronchial pneumonia, etc.;
• Gullet hernias as kind of phrenic hernias. The disease has the inborn, traumatic or acquired character. It is characterized by the shift of a part of a stomach, a belly zone of a gullet in a chest cavity through an esophageal opening of a diaphragm. At hernia of a gullet there are complaints to an eructation, thorax pain and an upper part of a stomach, heartburn. Most often such symptoms are observed after plentiful meal. Developing of vomiting is in certain cases possible;
• High-quality new growths. Their development proceeds slowly and seldom is followed by symptoms. As a rule, they are found accidentally when the patient addresses with complaints to swallowing disturbances which he observes within several years;
• Cancer of a gullet has the expressed symptomatology. At early stages the patient can feel discomfort in a breast, a dysphagy, weight loss and the increased salivation. Later the expressed gullet pains develop. Now gullet cancer – one of the most often found diseases of body (60-80% of total number of the diagnosed diseases). As a rule, develops at patients whose age about 50-60 years, is more often observed at smokers and abusing alcohol;
• The erosion of a gullet is followed, as a rule, by feeling of heartburn and pains which become more distinct at absorption of rigid and dry food. During the morning periods nausea owing to hit of a gastric juice to the area of a gullet can be observed. As the result – develops the irritation of a mucous membrane flowing in an inflammation and then – in a gullet erosion. It is possible to find this disease only when carrying out gastroscopic inspection. Treatment of a gullet in this case has to bear immediate character as the probability of developing of bleeding and development of hems is high. As a rule, at an erosion of a gullet appoint the special diet including the products which are not influencing release of hydrochloric acid;
• The foreign body in a gullet though does not belong to diseases directly, however is the frequent reason of the address to the doctor. As a rule, in a gullet food pieces, accidentally swallowed objects, etc. can get stuck. Most often in such situations gullet pain is felt, difficulties when swallowing are noted and if in time not to remove the cause, the general state worsens.

Gullet research methods

Adequate treatment of a gullet the doctor to appoint capable only if the diagnosis is correctly made. For this purpose in medicine various methods of inspection are applied:

• The X-ray contrast research allows to find changes in position of a gullet, to reveal existence of narrowing, squeezing, and also other disturbances. This method at statement of such diagnoses is effective as gullet hernia, change of a relief of an internal (mucous) cover of a gullet and some other;
• At an ezofagoskopiya it is possible to consider in detail an internal wall of a gullet, to specify its state, and also, in case of need, to make a biopsy. This way is often used when diagnosing inflammatory and tumoral processes in a gullet;
• Ezofagotonografiya and ezofagokimografiya are used for registration of reductions, a tone and pressure in a gullet wall;
• Dysfunction of a cardial sphincter allows to estimate the gullet pH level.