Esophageal Center Launches

Northwestern's new Center for Esophageal Disease is comprised of an extraordinary team of physicians primarily from Gastroenterology offering state-of-the-art treatment for patients with benign (non-cancerous) and malignant (cancerous) disorders of the esophagus. These disorders include gastro-esophageal reflux disease (GERD), hiatal hernia, achalasia, Barrett's esophagus, cysts, diverticulums (including Zenker's diverticulum), benign tumors, and esophageal cancers. The Center works closely with colleagues in allergy, thoracic surgery, surgical oncology, dietary, pathology, radiation and clinical oncology to ensure that the best possible therapies are chosen.

Physicians within the Center for Esophageal Disease are experienced in the different approaches used for disorders of the esophagus including minimally invasive techniques, transhiatal, and transthoracic resection of the esophagus, partial and complete fundoplications for reflux disease, lengthening procedures for complex esophageal repairs and transoral stapling (without an incision) of Zenker's diverticulum. In addition, nonsurgical therapies such as photodynamic therapy, laser, and stenting are offered to appropriate patients.

There are two physicians leading the Center, Dr. Peter J. Kahrilas and Dr. John E. Pandolfino.

Dr. Peter J. Kahrilas is a global leader in Esophageal Disease and has been at Northwestern since 1996.  His research focus is on esophageal and oropharyngeal physiology and pathophysiology. Oropharyngeal studies are aimed at describing the normal mechanics of swallowing and the modifiability that can be imposed therapeutically. These studies use computerized analysis of manometric and videofluorographic swallowing studies. Pathophysiologic studies of the oropharynx focus on mechanisms that result in dysphagia and the efficacy of volitional compensatory strategies in modifying these defects.

Assisting patients with their overall quality of life.Esophageal research has centered on the motor activity of the upper esophageal sphincter, peristaltic function, the pathophysiology of esophageal motor disorders, and the pathophysiology of gastroesophageal reflux disease. Upper esophageal sphincter investigations utilized manometry and videofluoroscopy to describe reflexive response to esophageal stimuli, as well as normal activity during sleep, acid reflux, meals, and swallowing. Studies of the esophageal body have described the contractile pattern of longitudinal muscle during peristalsis and are examining the efficacy of peristaltic function in effecting volume clearance and relating this quantitative assessment of peristaltic efficacy to the subjective experience of dysphagia. Investigations of reflux disease are examining the mechanisms by which anatomic variables, inclusive of but not limited to hiatus hernia, interact with physiological responses to modulate disease severity.

A current research focus is on applying high-resolution solid-state manometry to the analysis of esophagogastric junction pathophysiology both with respect to reflux disease and esophageal motor disorders. Previous research interests have included central nervous system neurophysiology, autonomic nervous system neurophysiology as it relates to sodium homeostasis, and screening for esophageal cancer.

Dr.John E. Pandolfino is part of multiple NIH grants awarded for esophageal research and is published in the New England Journal of Medicine and American Journal of Gastroenterology to name a limited few.

Northwestern is the field leader regarding the education, research, and care of Esophageal Disease, as well as, technology for patient treatment.  Visiting physicians and researchers from around the world come to Northwestern each year.  The Esophageal Center also has the largest base of medical specialty residents within the Department of Medicine.