Summary about Disease
Esophageal atresia (EA) is a rare congenital defect where the esophagus, the tube connecting the mouth to the stomach, doesn't form properly. It usually ends in two separate segments, preventing food from reaching the stomach. Often, it occurs with a tracheoesophageal fistula (TEF), an abnormal connection between the esophagus and the trachea (windpipe).
Symptoms
Excessive drooling or mucus in the mouth
Choking or coughing during feeding
Cyanosis (bluish skin due to lack of oxygen)
Difficulty breathing
Regurgitation of feeds
Abdominal distension (in some cases, especially with TEF)
Causes
The exact cause of esophageal atresia is not fully understood. It's believed to be a combination of genetic and environmental factors disrupting the normal development of the esophagus during early pregnancy (typically between the 4th and 10th weeks of gestation). It is not considered to be directly inherited.
Medicine Used
There is no medicine to treat the condition. It is surgically treated. Antibiotics are used to prevent or treat pneumonia. Acid suppression medication may be used after surgery to reduce acid reflux.
Is Communicable
No, esophageal atresia is not a communicable disease. It is a birth defect, not caused by an infection or transmissible agent.
Precautions
Esophageal atresia is a congenital condition, so preventive precautions are not directly applicable before pregnancy. Prenatal care and genetic counselling can help to identify some potential risks. After surgical repair:
Position the baby to avoid aspiration (sitting up after feeds)
Careful monitoring for respiratory problems.
Follow feeding guidelines provided by the medical team.
How long does an outbreak last?
Esophageal atresia is not an outbreak-related condition.
How is it diagnosed?
Prenatal Ultrasound: Occasionally detected before birth during routine prenatal ultrasounds, showing polyhydramnios (excess amniotic fluid).
Inability to pass a feeding tube: After birth, the condition is suspected when a feeding tube cannot be passed down the esophagus into the stomach.
X-ray: An X-ray of the chest and abdomen, often after attempting to pass a feeding tube, will show the tube coiled in the upper esophagus and may reveal the presence of air in the stomach (depending on whether a TEF is present).
Timeline of Symptoms
Symptoms are typically present immediately after birth or during the first feeding attempts. The key indicator is the inability to feed properly due to the obstruction in the esophagus, leading to choking, coughing, and/or cyanosis.
Important Considerations
Esophageal atresia requires prompt surgical intervention.
Long-term follow-up is essential to monitor for complications such as esophageal strictures (narrowing), tracheomalacia (weakness of the trachea), and gastroesophageal reflux.
Feeding difficulties may persist even after successful surgical repair, and specialized feeding techniques or gastrostomy tube feeding may be necessary.
Associated anomalies are common (VACTERL association - Vertebral defects, Anal atresia, Cardiac defects, Tracheo-Esophageal fistula, Renal anomalies, and Limb abnormalities). Therefore, a thorough evaluation for other potential problems is crucial.