Esophageal Stricture

Definition

Esophageal stricture is when the esophagus narrows making it hard to swallow. The esophagus is a muscular tube that carries food and liquids from the mouth to the stomach.
Esophageal Stricture
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Causes

Esophageal stricture is typically caused by scar tissue that develops as a result of the following:
  • Ingestion of damaging substances, such as household cleaning agents
  • Treatment of esophageal varices —enlarged veins in the esophagus
  • Injuries caused by an endoscope—a thin, lighted tube used to see inside the body
  • Esophageal cancer
  • Tracheoesophageal malformations

Risk Factors

Factors that may increase your chance of esophageal stricture include:
  • Gastroesophageal reflux disease (GERD)
  • Prolonged use of a nasogastric tube—a tube that is inserted through the nose to the stomach
  • Eosinophilic esophagitis
  • Systemic sclerosis
  • Barrett esophagus
  • Certain medications, such as those used to treat osteoporosis, or some antibiotics

Symptoms

Symptoms may include:
  • Difficulty swallowing
  • Pain when swallowing
  • Unintentional weight loss
  • Regurgitation of food—when food flows back from the stomach into the esophagus or mouth
  • Esophageal stricture may cause large chunks of food to get stuck in the esophagus

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Esophageal Dilation

Esophageal dilation is a procedure your doctor performs to stretch or widen your esophagus. An endoscope will be passed through your mouth and into the esophagus, stomach, and duodenum. A small balloon or tapered plastic dilators will be used to stretch your esophagus. For your comfort, this procedure may be performed while you are sedated. A local anesthetic spray may be applied to the back of your throat. Repeat dilations are often required to adequately stretch the esophagus.

Proton Pump Inhibitors

When esophageal stricture is caused by GERD, proton pump inhibitors or acid-blocking medications are used to prevent the stricture from returning. If you are diagnosed with esophageal stricture, follow your doctor's instructions . If you are diagnosed with esophageal stricture, follow your doctor's instructions .

Surgery

Surgery may be necessary if the stricture is too tight or wide.

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Prevention

To help reduce your chance of getting esophageal stricture, take these steps:
  • See your doctor if you have GERD.
  • Treat any other high risk cause as directed by your doctor
  • Avoid ingesting corrosive substances.
  • Keep corrosive substances locked up and away from children.

RESOURCES

American Academy of Family Physicians
FamilyDoctor.org
http://familydoctor.org

American Society for Gastrointestinal Endoscopy
http://www.asge.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology
http://www.cag-acg.org

Canadian Medical Association Journal
http://www.cmaj.ca

References

Caustic esophageal stricture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 2, 2010. Accessed July 15, 2013.

Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 25, 2013. Accessed June 16, 2014.

Oesophageal strictures, webs, and rings. Patient.co.uk website. Available at: http://www.patient.co.uk/doctor/Oesophageal-Strictures-Webs-and-Rings.htm. Updated March 18, 2011. Accessed July 15, 2013.

Understanding esophageal dilation. American Society for Gastrointestinal Endoscopy website. Available at: http://www.asge.org/patients/patients.aspx?id=392. Accessed July 15, 2013.

Tracheoesophageal malformations. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 3, 2012. Accessed June 16, 2014.

Systemic sclerosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 4, 2014. Accessed June 16, 2014.

Barrett esophagus. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 6, 2014. Accessed June 16, 2014.

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