The primary goals in treating esophageal disease are to identify and treat the primary disease, provide adequate nutrition and treat any associated complications. Although most animals with esophageal disease are treated as outpatients, certain individuals with extremely severe cases do warrant hospitalization for intensive therapy and support. Therapy for various esophageal diseases includes: Gastric (stomach) acid inhibitors (blocking agents) and sucralfate are recommended in most cases of esophageal disease, especially if esophagitis is a component. Gastric acid inhibitors block acid secretion, therefore diminishing the volume of acid that can leak backward into the esophagus. Examples include a group called H2 receptor antagonist (cimetidine (Tagamet®), ranitidine (Zantac®), famotidine (Pepcid®)) proton pump inhibitors such as omeprazole (Prilosec®). Sucralfate (Carafate®) liquid helps smooth and coat an inflamed stomach and esophagus.
Motility modifying drugs are drugs that promote movement within the gastrointestinal tract, such as metoclopramide (Reglan®), and can be used to stimulate movement within the esophagus and promote gastric emptying.
Dietary modification should include small, frequent feedings of an easily digestible product. The specific disease should be addressed with the appropriate feeding regime. In particular, megaesophagus, or at least cases where esophageal motility is decreased, need very special attention. Generally, elevated feedings tend to be tolerated thoroughly, and it is best to try different consistency foods, ranging from liquid or gruel, to solids.
Endoscopic placement of a gastric feeding tube may be indicated in those patients who need nutritional support and cannot tolerate oral feeding. Intravenous feeding is another option; however, it necessitates that the patient remain in the hospital.
Balloon dilatation or bougienage are techniques used to open up an esophageal stricture. There are risks of esophageal perforation; however, if performed in the hands of an experienced individual, many of these patients can do quite well. There are cases where, despite treatment, recurrent strictures occur and ultimately do not do well.
Surgery may be indicated for several conditions associated with the esophagus, including vascular ring anomaly, hiatal hernia, diverticula, and foreign objects that cannot be removed via endoscopy.