Your Care at NYP

Esophageal Diseases

Diseases affecting the esophagus can range from common, treatable conditions like heartburn to more serious issues such as esophageal cancer.

At NewYork-Presbyterian, we unite the extraordinary expertise of gastroenterologists, including esophagologists and interventional endoscopists, surgeons, pathologists, and radiologists to diagnose and treat all types of esophageal disorders, using therapies based on the latest advances.

What Are Esophageal Diseases?

What Are Esophageal Diseases?

Esophageal diseases are disorders that affect your esophagus. The esophagus is the hollow, muscular tube that moves food and liquid from your mouth into your stomach. Esophageal diseases include heartburn, acid reflux, swallowing problems, and esophageal cancer.

What We Treat

What We Treat

At NewYork Presbyterian, we diagnose and treat all esophageal diseases, including but not limited to:

  • Gastroesophageal reflux disease (GERD) or acid reflux: This is a spectrum of disorders where acid from your stomach travels into your esophagus. This can cause symptoms of burning and regurgitation as well as less common cough, hoarseness, and sore throat.
  • Achalasia: Achalasia is a swallowing disorder that occurs when the nerves in the esophagus become damaged. As a result, the muscles in the esophagus no longer work properly. The muscles in the esophagus are also unable to push food down the length of the tube.
  • Barrett’s esophagus: This esophagus disease primarily affects people with untreated acid reflux. Over time, the lining of the esophagus becomes damaged by acid, which then causes the lining to become irritated.
  • Eosinophilic esophagitis (EoE): This is a chronic disease where a certain type of white blood cell, called eosinophils, builds up in the esophagus. This build-up of white blood cells causes the lining within the esophagus to become inflamed or swollen. 
  • Esophageal cancer: Esophageal cancer occurs when malignant (cancer) cells form in the tissues of the esophagus. The two most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma.
    • Adenocarcinoma is the most common form of esophageal cancer in the United States. It typically occurs in patients who have long standing acid reflux and Barrett’s esophagus. It is typically found in the bottom part of the esophagus and/or the upper part of the stomach.
    • Squamous cell carcinoma is the second most common form of esophageal cancer in the United States and most common worldwide. It occurs when squamous cells (normal lining of thes esophagus) start to grow uncontrollably. Smoking and drinking alcohol in abundance, radiation, and HPV are strongly linked to the development of squamous cell carcinoma.
  • Esophageal diverticulum: This disorder causes outpouching in weak parts of the esophagus. Many types of diverticula can occur, and they are categorized based on their location within the esophagus.
  • Distal Esophageal Spasm and Hypercontractile Esophagus: These disorders have abnormal muscle spasms (contractions) in the esophagus. These conditions can cause difficulty swallowing and pain with swallowing.
  • Esophageal strictures: An esophageal stricture is a narrowing that occurs in the esophagus. This can lead to discomfort and cause foods and liquids to get stuck or move more slowly through the esophagus.
  • Hiatal hernias occurs when the stomach’s upper part protrudes above into the chest through the opening in the diaphragm. A small hiatal hernia may go unnoticed and undiagnosed. Still, a large hiatal hernia can cause food and acid to travel back up into your esophagus, causing heartburn and more acid reflux.
  • We also treat more rare diseases including but not limited:
    • Infections of the esophagus (Candida, Herpes, Cytomegalovirus)
    • Esophagogastric junction outflow obstruction (EGJOO)
    • Ineffective esophageal motility, Esophageal Atresia
    • Lichen Planus
    • Epidermolysis Bullosa
    • Epidermoid metaplasia
    • Disorders of Tylosis.

Signs & Symptoms of Esophageal Diseases


Symptoms of esophageal disorders can vary depending on the type. You may experience:

  • Heartburn (a burning feeling in your chest)
  • Difficulty swallowing or the feeling of food being stuck in your throat (dysphagia)
  • Regurgitation (stomach acid or contents rising back up your esophagus and into your mouth) or vomiting
  • Discomfort while eating
  • Abdominal, chest, or back pain
  • Chronic cough or sore throat
  • Hoarseness or wheezing
  • Indigestion (a burning feeling in your stomach)
  • Unexplained weight loss
  • Aspiration of food

Comprehensive Diagnosis of Your Esophagus Problems


Diagnosing an esophageal disorder requires specialized testing, equipment, technicians, and doctors to determine the cause of your symptoms. NewYork-Presbyterian has dedicated motility labs and advanced approaches to assess the appearance and function of your esophagus.

These approaches include upper endoscopy, wireless pH capsule, EndoFLIP, high-resolution esophageal manometry, and ambulatory pH impedance testing. We will evaluate your symptoms and conduct a physical exam or diagnostic test to determine the type and severity of your esophageal disease.

Diagnostic tests for esophageal disorders include:

  • Upper endoscopy or Esophagogastroduodenoscopy (EGD): a gastroenterologist inserts a flexible camera through your mouth to look at your esophagus, stomach and small bowel for any abnormalities.
  • Modified barium swallow study: a speech-language pathologist gives different liquids and foods coated in barium to assess how you swallow. The barium allows images of your mouth, throat and esophagus to be seen with x-ray images.
  • Esophagram: in this test, you are given liquid barium and x-rays are taken to evaluate your swallow as well as your entire esophagus as it empties into your stomach.
  • Hi-Resolution Esophageal Manometry: A thin tube is inserted through your nose, into your esophagus and stomach and you are given small sips of salt water. This is used to measure the strength of your esophageal muscles squeezing as you swallow as well as the function of the sphincter valve (lower esophageal sphincter) between the stomach and the esophagus.
  • Wireless pH Capsule (Bravo): During an endoscopy, a tiny device called a wireless pH capsule (Bravo) is clipped onto your esophagus. This device measures the amount of acid coming into your esophagus over 96 hours.
  • Esophageal pH impedance: A thin tube is placed through your nose into your esophagus to measure the amount of fluid coming into your esophagus from the stomach (reflux) over a 24-hour time period
  • Endoluminal functional lumen imaging (EndoFLIP): During an endoscopy, a small balloon is inserted that can measure the dimensions and movement of the esophagus.

Our Approach to Care

Our Approach

When you come to us at NewYork-Presbyterian, our multidisciplinary care team, including gastroenterologists focused on esophageal diseases, surgeons, pathologists, and radiologists, will provide diagnosis and treatment for all esophageal diseases.

Treatment of Your Esophageal Disease, Relieving Your Discomfort

There are many ways to relieve the discomfort caused by the esophageal disorder and prevent the worsening of symptoms and progression of certain esophageal diseases. Some of the treatments we can provide include:

  • Interventional endoscopic techniques. Many esophageal disorders can be diagnosed and treated through endoscopy — inserting a flexible tube into the esophagus with a camera at its tip. NewYork-Presbyterian offers advanced interventional endoscopic techniques not widely available elsewhere, enabling our doctors to treat people with disorders such as GERD, achalasia, Barrett’s esophagus, and esophageal cancer with technologies such as:
    • Endoscopic therapy for GERD
    • Peroral endoscopic myotomy (POEM) for achalasia
    • Radiofrequency ablation (destroying diseased tissue with intense heat) for Barrett’s esophagus or early cancer
    • Cryotherapy (treating diseased tissue with intense cold) for Barrett’s esophagus or early cancer
    • Endoscopic mucosal resection (removal of abnormal esophageal tissue through a scope)
  • Nutritional guidance. Some esophageal disorders, such as GERD and eosinophilic esophagitis, may improve with changes in diet. Your team includes registered dietitians who can guide you regarding the best foods for you, as well as which foods to avoid.
  • Medical therapies. You may be prescribed antacids, proton pump inhibitors, and histamine receptor (H2) blockers to reduce stomach acid.
  • Endoscopic dilation to open a stricture (narrowed esophagus) or to relax the sphincter muscle.
  • Botulinum toxin injections can temporarily stop esophageal spasms and relax the sphincter muscle.
  • Heller myotomy and peroral endoscopic myotomy (POEM) loosen the esophageal muscles to treat achalasia or esophageal spasm.
  • Laparoscopic antireflux surgery (or fundoplication) is available to treat GERD or a hiatal hernia by reinforcing the LES (lower esophageal sphincter).
  • Multidisciplinary cancer treatment. Our esophageal cancer care teams include specialists from surgery, medical and radiation oncology, and interventional endoscopy who have many years of experience and provide treatments based on the latest scientific studies.
  • Investigational therapies. Clinical trials of promising new treatments are also available, providing access to innovative therapies that may not be available in many other hospitals.
Get Care

Get Care From Our Team of Esophageal Disease Specialists

Esophageal diseases are complex and require treatment from specialists who are well-versed in the latest research-based therapies. At NewYork-Presbyterian, we can diagnose, treat, and help alleviate the symptoms of your esophageal and swallowing disorders, providing many treatment methods and support.

Make an appointment to learn more about what we can offer you.