The term cardias comes from kardía, a Greek word that can be translated as “stomach”. The concept is used to name the opening that, in terrestrial vertebrate animals, allows communication between the esophagus and the stomach.
The cardia, which can be called the gastroesophageal junction, is located in the sector where the stratified squamous epithelium of the esophagus meets the columnar epithelium that is part of the digestive tract. It is generally considered that the cardia belongs to the stomach, although this question is often debated by specialists. The notion also overlaps with other structures, a peculiarity that can lead to confusion.
The functioning of the cardia, which develops unconsciously, prevents the reflux of the food that a person eats. For this reason, cardiac disorders can cause gastric reflux. When cancer occurs in the cardia, for example, the subject cannot eat solid food.
According to DigoPaul, the cardia has smooth muscle fibers, which also make up the lower esophageal sphincter. The coordinated relaxation of these fibers allows swallowing, while the contraction prevents the aforementioned reflux. If the cardia does not close properly and allows reflux, it is often referred to as an incompetent cardio.
Incompetent cardio does not allow proper closure of the lower esophageal sphincter, and there are several tips to counteract this disorder. On the one hand, it is necessary to improve eating behavior, respecting schedules, preventing meals from being too widely spaced and reducing portions, as well as controlling the level of fat we eat.
There are certain foods that can accentuate the decrease in the tone of the sphincter, among which are coffee and chocolate, two favorites of millions of people and very difficult to leave, especially in times of low temperature or stress. Losing weight can also have a positive impact on fighting incompetent cardio, since intra-abdominal pressure decreases and this facilitates the sphincter closure.
One of the drugs most used in these cases is omeprazole, a proton pump inhibitor that serves to reduce the acid secretion of the stomach, precisely the one that can generate the most damage when reflux into the esophagus occurs. For young patients, since incompetent cardio can have a negative impact on their quality of life, surgical or endoscopic antireflux treatments are usually applied.
If a disease requires the extirpation of the cardia, a surgical intervention is carried out that is part of the set of gastrectomies: operations that involve removing, either totally or partially, some structure of the stomach. It should be noted that the cardia can be replaced by an artificial organ.
One of the diseases associated with cardia is achalasia, defined as the inability to relax the fibers of the apparatus gastrointestinal along the entire structure. It is called esophageal achalasia when the gastroesophageal sphincter is unable to relax during swallowing because the ganglion cells in the wall have degenerated. Additionally, the peristaltic activity (the normal contraction and relaxation movements) of the thoracic esophagus also decreases and dilates to produce what is known as the megaesophagus.
Among the most obvious symptoms of achalasia are the following: intermittent pain in the retrosternal area, which gradually becomes more frequent; food stuck once swallowed; regurgitation, abnormal weight loss, and chest pain that may give the idea of esophageal cancer; constant reflux that can lead to dehydration. In part, these problems stem from pressure on the cardio and esophagus.