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Definition

What is esophageal stricture?

An esophageal stricture is a narrowing of your esophagus. Inflammation or damage to your esophagus may cause scar tissue that leads to narrowing.

How common is esophageal stricture?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of esophageal stricture?

The common symptoms of esophageal stricture are:

  • Acid reflux, or burning pain in your chest
  • Bitter or acid taste in your mouth
  • Pain or trouble swallowing
  • Frequent burping or hiccups
  • Weight loss without trying

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes esophageal stricture?

This narrowing of the esophagus can be caused by many different conditions. The most common is a benign stricture. This is the result of peptic esophagitis or gastroesophageal reflux disease and can occur at any age, though it is more common after the age of 40.

The fundamental abnormality is excessive acid reflux from the stomach up into the esophagus, resulting in an inflammatory reaction in the lower esophagus. This inflammation leads to scarring after repeated injury and healing. Eventually, scar tissue is formed and a benign stricture develops in the form of a concentric ring that narrows the opening of the esophagus. A hiatal hernia is often present in association with the reflux.

This concentric lower esophageal ring sometimes called a Schatzki’s ring often occurs at the junction between the esophagus and the stomach and sometimes can be present for years. When diagnosed, it can be easily treated by passage of a dilator through the area to break open the scar tissue and relieve the narrowed area.

Benign esophageal strictures may be congenital, such as a membranous diaphragm – or web – that can occur anywhere in the esophagus, but frequently occurs in the upper portion. This is also treated by dilation, either through an endoscope or by passage of Bougie dilator.

Other conditions leading to benign strictures include corrosive injury to the esophagus from swallowing a toxic substance (i.e. cleaning solutions), radiation injury to the esophagus, post-surgical strictures, or achalasia, which is a gradual thickening of the musculature at the lower end of the esophagus.

In addition, there are other conditions that could cause dysphasia (difficulty swallowing), even though no stricture is present. In that case, various neurological conditions, vascular abnormalities, diverticulums, spastic motility disorders, or skeletal muscle disorders like muscular dystrophy and myasthenia gravis are possibilities.

Risk factors

What increases my risk for esophageal stricture?

There are many risk factors for esophageal stricture, such as:

  • Long-term acid reflux
  • Birth defects, such as stenosis (narrowing) or diverticulosis (pouches)
  • Medicines, such as aspirin, pain medicines, or antimalarial antibiotics
  • Surgery, radiation, or sclerotherapy on the esophagus
  • Long-term placement of a nasogastric (NG) tube, or chemicals such as household cleaning liquids that are swallowed
  • Infections, skin diseases, scleroderma, esophagitis, or esophageal cancer

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is esophageal stricture diagnosed?

A barium swallow is an x-ray of your throat and esophagus. This may also be called a barium esophagram. You will drink a thick liquid called barium. Barium helps your esophagus and stomach show up better on x-rays.

A CT scan, or CAT scan, is a type of x-ray taken of your esophagus and stomach. You may be given contrast dye to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

An endoscopy is a procedure used to find the cause of the narrowing of your esophagus. Healthcare providers use an endoscope to examine your esophagus. An endoscope is a bendable tube with a light and camera on the end.

How is esophageal stricture treated?

Treatment of a benign esophageal stricture consists of esophageal dilation. This is most commonly done at the time of an upper endoscopy. In an upper endoscopy, a video endoscope is placed through the mouth into the esophagus while the patient is under IV sedation. The esophagus is then examined and if a benign stricture is present it can be dilated in various ways.

A balloon dilator passed through the endoscope is often inflated within the confines of the stricture, thus opening the area and relieving the patient’s symptoms. Other types of dilators may also be passed although not through the endoscope. These are called Mallony or savory dilators in increasing sizes in order to break open the stricture. In either case, the patients are sedated and should not feel anything during the procedure.

The risks of dilation include potential bleeding, infection or a tear. If a tear is deep enough, on rare occasion, it might require surgical repair.

Treatment of a malignant stricture of the esophagus is available but can often be disappointing. If the malignancy is determined to be small and localized, without any spread beyond the esophagus, then a surgical repair is often opted for and may, on rare occasion cure the cancer. If the tumor is not curable, then often, palliative treatments are employed. These include chemotherapy, radiation therapy, esophageal dilation, laser treatments, injections, tumor probes or placement of an esophageal stent (wire mesh tube) to keep the esophagus open.

In any situation, the patient must work closely with his or her physician to decide what the best approach is for that individual.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage esophageal stricture?

The following lifestyles and home remedies might help you cope with esophageal stricture:

  • Rest as needed. Slowly start to do more each day. Return to your daily activities as directed.
  • Ask about safe foods to eat. You may not be able to eat solid foods for a period of time. You may be allowed to drink water, broth, apple juice, or lemon-lime soft drinks. You may also suck on ice chips or eat gelatin. As you improve, you may be given soft foods to eat or thickened liquids to drink. You may return to eating normal foods as your swallowing gets better.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 6, 2017 | Last Modified: November 6, 2017

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