When from any cause there is stricture of the esophagus near the cardiac orifice erf the stomach, a gradual dilatation of the walls of the esophagus is apt to occur above the stricture. This results from distention and from degeneration of the structure of the muscular coats, is usually localized in character and occurs more in the form of a diverticulum. Dilatations of this kind are found, in rare cases, in patients of relaxed fiber who bolt their food without proper mastication. Occasionally dilatation may occur uniformly throughout the entire extent of the tube. This is classed as diffused dilatation, and is atonic in character and may be congenital. Fatty degeneration of the muscular wall of the tube may result in diffused dilatation, also.
Symptomatology:—Persistent difficulty in swallowing is the commonest symptom of dilatation. Regurgitation may follow, not immediately, as in stricture, but occurring in from one to three hours after eating. The substance regurgitated may be partially decomposed and it may cause strangling. Occasionally the decomposition or fermentation of the retained food induces irritation and an actual inflammation, which may be conveyed to the walls of the stomach. When this occurs the regurgitation may be immediate and resemble that of stricture, rendering a diagnosis difficult. Sometimes a considerable quantity of water will be retained for some time, in a diverticulum.
Treatment:—But little is accomplished by treatment in these cases, as medicine will not influence the actual condition. There may be indications for specific remedies, which, when met, will produce temporary alleviation of the symptoms or conditions depending upon the dilatation, or which may entirely cure them, but the dilatation will yet remain. The use of the galvanic current is of service in some cases, and in the early stage of the milder cases there is no doubt that the persistent use of hydrastis canadensis, with or without collinsonia and hamamelis, will retard the progress of the condition, and may prevent further development.
The Eclectic Practice of Medicine with especial reference to the Treatment of Disease, 1910, was written by Finley Ellingwood, M.D.