Abnormalities of the esophagus can consist of structural problems, motility disorders, inflammatory disorders or malignancies. Our center addresses the complete range of esophageal and motility disorders and involves specialists in gastroenterology, endoscopy, surgery, oncology, pathology, radiology and nutrition who utilize a multidisciplinary approach to diagnosis and treatment.
Some common esophageal disorders cause patients considerable distress, such as swallowing problems. These conditions can be triggered by acid injury, allergies, infections and tumors. The UCLA Center for Esophageal Disorders focuses on providing patients with an efficient and precise evaluation and treatment for all conditions, including esophageal cancer, Barrett's esophagus, gastroesophageal reflux disease (GERD), eosinophilic esophagitis (EoE) and achalasia.
Many diagnostic procedures and treatments are offered on an outpatient basis utilizing state-of-the-art technologies such as radiofrequency ablation (RFA), endoscopic mucosal resection (EMR), photodynamic therapy (PDT) and laparoscopic procedures. Staging of esophageal and stomach cancers is accomplished with endoscopic ultrasound (EUS) combined with fine needle aspiration. UCLA physicians treat a high volume of esophageal strictures and have advanced skills in aggressive dilation in patients considered refractory to dilation as well as the use of removable stents for benign stricture.
Our center also includes the nation's leading experts in motility disorders; motility disorders can affect any part of the gastrointestinal tract. Treatments for esophageal motility disorders utilize the latest techniques, including high resolution manometry, impedence pH testing and wireless pH testing (BRAVO), and wireless capsule motility. Our team is credited with ground-breaking research demonstrating that nitric oxide is the neurotransmitter controlling relaxation of the lower esophageal sphincter and peristalsis in the smooth-muscle esophagus.
Physicians in our center are also pursuing research objectives that will help to refine treatments for esophageal and motility disorders. While radiofrequency ablation is an accepted treatment for Barrett's esophagus, our studies are aimed at identifying factors governing successful eradication and indicators to guide optimal patient selection. Moreover, we are investigating techniques to improve early diagnosis of the condition, including participation in a clinical trial of a non-invasive technique to obtain esophageal tissue samples for analysis of biomarkers indicating cell abnormalities.
Additionally, researchers are studying changes in esophageal function following laryngectomy. In association with colleagues in rheumatology and pulmonology, the center is also exploring esophageal and gastrointestinal motor function in scleroderma and esophageal function in lung transplant patients. Another project involves characterization of the human microbiome in scleroderma to investigate the potential role of microorganisms in causing or modulating the disorder.
Other research projects include the creation of an eosinophilic esophagitis database and a study to assess the outcomes and cost effectiveness of stents compared to dilation in treating esophageal strictures.