Tortuous Esophagus: Causes, Symptoms, and Treatment

A tortuous esophagus is an elongated, twisted esophageal course. Causes include:

• Congenital: Developmental anomaly.
• Aging: Loss of muscle tone and elasticity.
• GERD: Chronic acid reflux → inflammation, fibrosis, shortening/twisting.
• Hiatal hernia: Gastric herniation distorts esophageal anatomy.
• Connective tissue disorders: Scleroderma, amyloidosis.

Symptoms

• Dysphagia (difficulty swallowing)
• Chest/abdominal pain
• Regurgitation
• Heartburn
• Nausea/vomiting

Management

• PPI therapy for GERD.
• Dietary modification (small meals, avoid triggers).
• Endoscopic dilation for strictures.
• Surgery (rare): Esophagectomy or fundoplication for severe refractory cases.

Diagnosis via barium swallow, endoscopy, or manometry. Treatment targets underlying etiology and symptom relief.