difficulties and chest or upper abdomi-
nal pain. The spasm may be caused by
reflux oesophagitis, but often occurs for
no apparent reason. Women are more
commonly affected. A barium swallow
(see barium X-ray examinations) and
endoscopymay be used to rule out a
more serious condition, such as cancer.
Treatment is of the underlying cause.
oesophageal speechA technique for
producing speech after surgical removal
of the larynx(see laryngectomy). Air is
trapped in the oesophagusand is gradu-
ally expelled while the tongue, palate,
and lips form distinguishable sounds.
oesophageal strictureNarrowing of
the oesophagusthat may cause pain,
swallowing difficulties, weight loss, and
regurgitation of food. It may be due to
cancer (see oesophagus, cancer of) or, for
example, persistent reflux oesophagitis.
Diagnosis may include a barium swallow
(see barium X-ray examinations), endos-
copy, and biopsy. Usually, the narrowed
area is widened by oesophageal dilatation.
oesophageal varicesWidened veins in
the walls of the lower oesophagusand,
sometimes, the upper part of the stom-
ach. Varices develop as a consequence of
portal hypertension. Blood in the portal
vein, passing from the intestines to the
liver, meets resistance due to liver
disease. The increased blood pressure
causes blood to be diverted into small
veins in the walls of the oesophagus and
stomach. These veins may become dis-
tended and rupture, causing vomiting of
blood and black faeces. There are usually
other symptoms of chronic liver disease.
To control acute bleeding, a balloon
cathetermay be passed into the oesoph-
agus to press on the bleeding varices.
The varices may be treated with an intra-
venous injection of vasopressinand/or by
injection, via an endoscope, of a scle-
rosant that seals off the affected veins.
oesophagitisInflammation of the oeso-
phagus. In corrosive oesophagitis, which
is caused by swallowing caustic chemi-
cals such as cleaning fluids, there is
immediate severe pain and swelling in
the throat and mouth. Antidotes are of
limited value, and washing out the
stomach (see lavage, gastric) increases
the damage. Treatment consists mainlysevere cases, fluid accumulates in large
body cavities, such as the peritoneal
cavity of the abdomen in ascitesor the
pleural cavity of the lungs in pleural
effusion. In pulmonary oedema, the air
sacs of the lungs become waterlogged.
Causes include heart failure, kidney
failure, and nephrotic syndrome. Often,
the underlying cause of oedema cannot
be treated. Treatment is focused on
increasing urine output by restricting
salt intake and using diuretic drugs.
Oedipus complexA psychoanalytic
term that describes the unconscious
sexual attachment of a child for the
parent of the opposite sex, and the con-
sequent jealousy of, and desire to
eliminate, the parent of the same sex.
oesophageal atresiaA rare birth
defectin which the oesophagus forms
into 2 separate, blind-ended sections
during development. There is usually an
abnormal channel (tracheoesophageal
fistula) between one of the sections and
the trachea. The condition may be sus-
pected before birth if the mother had
polyhydramnios. The infant cannot swal-
low, and drools and regurgitates milk
continually. If there is an upper tracheo-
esophageal fistula, milk may be sucked
into the lungs, provoking attacks of
coughing and cyanosis. Immediate
surgery is needed to join the blind ends
of the oesophagus and close the fistula.
If the operation is successful, the baby
should develop normally. Some babies,
however, do not survive.
oesophageal dilatationA procedure to
stretch the oesophaguswhen it has been
narrowed by disease (see oesophageal
stricture) and swallowing is difficult.
Endoscopyis used to locate the obstruc-
tion. The narrowed area is then stretched
by passing bougies (cylindrical rods with
olive-shaped tips) down the oesopha-
gus, or by using balloon catheters.
oesophageal diverticulumA sac-like
protrusion of part of the oesophagus
wall in which food becomes trapped,
causing irritation, difficulty swallowing,
halitosis, and regurgitation. A diverticu-
lum is usually removed surgically.
oesophageal spasmUncoordinated
muscle contractions in the oesophagus,
which cause intermittent swallowing
OEDIPUS COMPLEX OESOPHAGITIS
O