Areas of the Pharynx Where Cancer May Occur. Courtesy Wikimedia.
What Is Cancer Of The Pharynx?
[dropcap]C[/dropcap]ancer of the pharynx is a malignant growth of stratified squamous cells that line the pharynx, or throat.
Q: What are stratified squamous cells that line the pharynx?
A: Stratified squamous cells are thin, flat epithelial cells consisting of several layers forming the surface mucosa that protects underlying layers of the pharynx. These cells lie very close together and have no blood vessels.
The pharynx is the upper passageway of the throat where swallowing food and fluids from the mouth first pass on the way to the esophagus and breathing air passes from the nose and mouth to and from the lungs.
The pharynx provides for speech production, adequate taste reception, and proper hearing through equalization of air pressure in the eustachian tubes.
The pharynx has three areas and pharyngeal cancer can occur in any of them: the nasopharynx behind the nose, the oropharynx behind the mouth, and the hypopharynx or laryngopharynx, just above the larynx. Tonsils, adenoids, and other lymph tissue lie at the back of the throat.
Unfortunately, cancers of the pharynx tend not to be detected until late in their course when symptoms become evident. This makes the prognosis poor. See symptom below.
What Is Cancer Of The Pharynx In Celiac Disease and/or Gluten Sensitivity?
Arrows Show Abnormal Movement of Gastric Acid in Gastroesophageal Reflux Disease.
What Is Gastroesophageal Reflux Disease (GERD)?
[dropcap]G[/dropcap]ERD is an upper digestive disorder that is characterized by a decrease in lower esophageal sphincter pressure (LES,) which allows the abnormal reflux or backflow of stomach contents into the esophagus. It is also called erosive esophagitis or reflux esophagitis and is the most common disorder of the esophagus.
The esophagus is a muscular tube that transports swallowed substances to the stomach. It begins at the cricoid cartilage (Adam’s apple) as a continuation of the pharynx and ends at the lower esophageal sphincter (LES).
The lower esophageal sphincter is located at the junction of the esophagus and the stomach. It functions like a circular band to tighten after food is ingested in order to prevent its going back up the esophagus.
Q: How does reflux damage the esophagus?
A: Damage to the lining of the esophagus is induced by the caustic, chemical action of acid and pepsin in gastric juice and, in severe cases, also bile salts, that back upwards from the stomach through an impaired LES. Gastric acid combined with pepsin or bile salts seems to be more harmful to the esophageal epithelial layers than gastric acid alone.1
Pepsin is normally produced by the stomach to dissolve protein in swallowed food. Unfortunately, when the esophagus is inflamed, pepsin will act on it to break down the protein in its sore wall. These sores are called erosions.
Importantly, refluxate to the esophagus in patients with acid suppression therapy is different from those in patients without. Higher levels of secondary bile acids are detected in patients with acid suppression therapy. Even if acid suppression is successful, weakly acidic reflux with bile acids can damage the esophagus.1
Damage starts at the luminal surface (inside where food passes through) of the squamous epithelium (tough surface cells) and progresses through the underlying layers into the submucosa.
One of the primary functions of the esophageal epithelium is to protect the underlying tissue from mechanical and chemical damage by acting as a barrier. The epithelial layers of the distal esophagus need to withstand reflux from the stomach and its contents. When the epithelium fails to protect the underlying tissue from this damage, it leads to erosions, esophagitis, and may lead to Barrett’s esophagus.1
Barrett’s esophagus and esophageal small cell cancer are severe complications of GERD that can be fatal.
GERD can result from too much, or more commonly, too little stomach acid.
What Is Gastroesophageal Reflux Disease (GERD) In Celiac Disease and/or Gluten Sensitivity?
Sources:
Chen X, Oshima T, Tomita T, Fukui H, Watari J, Matsumoto T, Miwa H. Acidic bile salts modulate the squamous epithelial barrier function by modulating tight junction proteins. Am J Physiol Gastrointest Liver Physiol. 2011 Aug;301(2):G203-9. doi: 10.1152/ajpgi.00096.2011. Epub 2011 May 26. [↩] [↩] [↩]
What Is Intraepithelial Lymphocytosis In Normal Small Bowel Samples? [dropcap]I ntraepithelial lymphocytosis is characterized by an abnormal increase in the numbers of intraepithelial lymphocytes (IELs) that are present in the small intestinal mucosa. Q: What…
What Is Dysphagia? [dropcap]D[/dropcap]ysphagia is a functional upper digestive disorder characterized by difficulty in swallowing or food getting stuck and swallowing that takes longer than 10 seconds to complete. Q: What determines the symptoms? A:…
Beaded Barium Swallow Shows Spasms of Espophagus. Courtesy Quizlet.com
What Are Esophageal Motor Abnormalities?
[dropcap]E[/dropcap]sophageal motor abnormalities are disorders of the esophagus involving altered muscular motility characterized by impaired esophageal peristalsis, or the progressive wave-like movement that occurs automatically when food or fluids are swallowed.
Q: What is altered motility?
A: Altered motility describes the lack of coordinated muscular movements or weak muscular movement needed to rapidly propel food and fluids through the highly muscular esophagus from the throat to the stomach.
The esophagus is a tube-like organ that begins at the cricoid cartilage (Adam’s apple) as a continuation of the pharynx and ends at the lower esophageal sphincter (LES).
The LES is a very strong, circular muscle surrounding the junction of the esophagus and stomach. The LES opens to allow swallowed food and liquids to enter the stomach and closes to prevent their travelling back into the esophagus.
Failure of the lower esophageal sphincter to remain tightly closed after swallowing allows stomach contents to reenter the esophagus giving symptoms of heartburn.
On the other hand, failure of the LES to relax traps the contents of the esophagus so that it cannot quickly empty into the stomach as it should. Because the esophagus is not designed to hold food/fluids, the abnormal expansion results in pain, anxiety and possibly vomiting and choking. If the contents are aspirated into the windpipe upon choking, there will be coughing with attempts to clear it.
What Are Esophageal Motor Abnormalities In Celiac Disease and/or Gluten Sensitivity?
A rare iron deficiency disorder that is characterized by a combination of postcricoid esophageal webs (upper throat area), iron deficiency anemia, dysphagia and koilonychia (nail spooning), predisposing to esophageal cancer. Click for full description.
A malignancy with early metastasis and poor prognosis arising in the hypopharynx, the region of the throat lying behind the voice box (larynx). Symptoms start out as difficulty swallowing (dysphagia) that progress to the feeling…
A malignant growth of cells in the pharynx (throat) that is a major complication of celiac disease, developing as a consequence of gluten exposure and deficiencies of selenium, vitamin E and possibly, omega-3 fatty acids.…
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