Oesophagus
The equine esophagus is a muscular tube roughly 125–150 cm long that transports food from the pharynx to the stomach by coordinated peristaltic waves. In the neck it runs along the left side of the trachea (palpable in the left jugular groove), then passes through the thorax and enters the stomach at a sharp angle. The combination of this oblique entry and a strong cardiac sphincter prevents vomiting: a unique equine characteristic with major clinical implications. The upper third has striated muscle, the lower third smooth muscle, and the middle third mixed. Because horses cannot vomit, gastric rupture can occur before contents can escape retrograde. Endoscopy is the gold standard for evaluating esophageal disorders.
Esophageal obstruction (“choke”) is common and usually caused by rapid eating of dry feed, dental problems, or foreign material. Classic signs are greenish, frothy nasal discharge containing food, excessive salivation, coughing, and neck extension. Prolonged choke risks aspiration pneumonia and esophageal damage or rupture. Strictures can develop after severe episodes.
## Overview Esophageal obstruction, or choke, is blockage of the esophagus by feed or foreign material. It is the most common esophageal emergency in horses. Unlike human choking, the airway is usual
## Overview Esophageal stricture is fibrous narrowing of the esophagus, usually after severe choke, esophageal injury, or surgery. It predisposes the horse to recurrent obstruction and may require pe
## Overview Esophageal rupture is a full-thickness tear of the esophageal wall. It is most often iatrogenic from nasogastric intubation or secondary to prolonged severe choke. Leakage of feed and sal
## Overview Megaesophagus is dilation and loss of motility of the esophagus. It may be congenital or acquired after severe choke, stricture, grass sickness, or other neuromuscular disease. Horses reg
If you see feed or saliva coming from the nostrils, remove all food and water immediately and call the veterinarian. Do not attempt to force anything down the throat. Prevent choke by soaking dry feeds (especially beet pulp or hay cubes), providing adequate water, and maintaining dental health. Slow feeders can help horses that bolt their grain.
## Overview Esophageal obstruction, or choke, is blockage of the esophagus by feed or foreign material. It is the most common esophageal emergency in horses. Unlike human choking, the airway is usually patent, but the horse cannot swallow and risks aspiration pneumonia. ## Causes Rapid eating of dry feed, dental disease impairing chewing, inadequate water, or underlying esophageal abnormality. ## Diagnosis Clinical signs of nasal discharge of feed, repeated swallowing, and neck extension. Passage of a nasogastric tube confirms obstruction. ## Treatment Sedation and esophageal lavage to soften and relieve the obstruction. Antibiotics if aspiration has occurred. Most cases resolve medically. ## Recovery and Prognosis Good if relieved promptly and aspiration is minimal. Prolonged choke risks stricture or rupture. ## Prevention Slow feeders, soaked feeds for at-risk horses, and regular dental care. Signs include: bilateral frothy nasal discharge containing feed; repeated swallowing; arched neck; coughing; palpable mass in the neck
## Overview Esophageal stricture is fibrous narrowing of the esophagus, usually after severe choke, esophageal injury, or surgery. It predisposes the horse to recurrent obstruction and may require permanent dietary modification. ## Causes Scarring from previous mural injury or inflammation. ## Diagnosis Recurrent choke plus contrast radiographs or endoscopy showing a narrowed segment. ## Treatment Dietary management with soaked feeds. Balloon dilation or surgical resection in selected cases. Many horses are managed long-term with feed changes. ## Recovery and Prognosis Fair with dietary adjustment. Surgical results are variable. ## Prevention Prompt treatment of choke to minimize mural damage. Signs include: recurrent choke; difficulty swallowing; salivation; weight loss; need for soaked feeds
## Overview Esophageal rupture is a full-thickness tear of the esophageal wall. It is most often iatrogenic from nasogastric intubation or secondary to prolonged severe choke. Leakage of feed and saliva causes severe cellulitis, subcutaneous emphysema, and potentially fatal mediastinitis or pleuritis. ## Causes Trauma from tubing or pressure necrosis from prolonged obstruction. ## Diagnosis History of choke or tubing, plus crepitus, swelling, fever, and imaging or endoscopy confirming the tear. ## Treatment Aggressive wound management, antibiotics, nutritional support (often via esophagostomy or parenteral routes), and drainage. Prognosis is poor, especially for thoracic ruptures. ## Recovery and Prognosis Guarded to poor. Many horses do not survive. ## Prevention Careful nasogastric intubation and prompt resolution of choke. Signs include: subcutaneous emphysema in the neck; fever; cellulitis; crepitus; often follows choke or tubing
## Overview Megaesophagus is dilation and loss of motility of the esophagus. It may be congenital or acquired after severe choke, stricture, grass sickness, or other neuromuscular disease. Horses regurgitate feed and water through the nose, lose weight, and are at high risk for aspiration pneumonia. ## Causes Congenital neuromuscular abnormality or acquired damage from chronic obstruction or autonomic dysfunction. ## Diagnosis Contrast radiographs showing a dilated esophagus, endoscopy, and clinical signs of chronic regurgitation. ## Treatment No cure for most cases. Management includes feeding small, soft meals from an elevated position and treating aspiration pneumonia. Prognosis is poor for long-term athletic use. ## Recovery and Prognosis Guarded to poor. Aspiration pneumonia is the main life-limiting complication. ## Prevention Prompt treatment of choke to reduce the risk of secondary dilation. Signs include: chronic dysphagia; nasal return of food and water; weight loss; recurrent aspiration pneumonia; dilated esophagus on contrast radiographs
Esophageal obstruction (“choke”) is common and usually caused by rapid eating of dry feed, dental problems, or foreign material. Classic signs are greenish, frothy nasal discharge containing food, excessive salivation, coughing, and neck extension. Prolonged choke risks aspiration pneumonia and esophageal damage or rupture. Strictures can develop after severe episodes.
If you see feed or saliva coming from the nostrils, remove all food and water immediately and call the veterinarian. Do not attempt to force anything down the throat. Prevent choke by soaking dry feeds (especially beet pulp or hay cubes), providing adequate water, and maintaining dental health. Slow feeders can help horses that bolt their grain.
See the Esophagus on our interactive 3D horse model. Open 3D Model