ESOPHAGEAL STRICTURE

 Basic information

description

Esophageal stricture is a narrowing of the tube (esophagus) that connects the throat to the stomach. The narrowing interferes with swallowing.

FREQUENT SIGNS & SYMPTOMS

• A gradual decrease in the ability to swallow. At first, it becomes difficult to swallow solid foods. Then it becomes difficult to swallow liquids.
• Uncomfortable feeling when swallowing.
• Food feels like it gets stuck in the throat.
• Stomach acid washing back into mouth.
• Vomiting (sometimes with mucus or blood).

causes

Scarring of the lining of the esophagus. As the scar tissue builds up, it forms a ring that narrows the opening of the esophagus. The scarring most often results from excessive gastric acid in the stomach backing up (called reflux) into the esophagus. This causes repeated inflammation (esophagitis), which damages the lining of the esophagus. Other risk factors may also lead to scarring.

risk increases with

• Gastroesophageal reflux disease (GERD).
• Hiatal hernia (part of the stomach protrudes through the diaphragm).
• Prolonged use of feeding (nasogastric) tubes.
• Swallowing of corrosive (e.g., acid or lye) chemicals.
• Infections of the esophagus.
• Radiation injury to the esophagus.
• Injury from an endoscope (a tube-like device used to examine the internal organs).
• Cancer of the esophagus.
• Certain drugs that can irritate the esophagus.

PREVENTIVE MEASURES

• Get medical care for any problems that involve difficulty swallowing or acid reflux.
• Keep dangerous products out of children's reach.
• Don't swallow any substance that may harm the esophagus.

expected outcomes

Treatment can help relieve the stricture, but treatment may need to be repeated.

possible complications

• Not able to eat and drink enough foods and fluids.
• Perforation (hole) in the damaged esophagus.
• Inflammation that may lead to internal bleeding.
• Stricture recurs after treatment.
• Aspiration, which is the passage of food or liquid through the vocal folds ("going down the wrong way"). The food, fluid, or vomit may enter the lungs.

 diagnosis & treatment

general measures

• Your health care provider may do an endoscopy. This is a medical test using an instrument with a lighted tip (endoscope) that is inserted into the esophagus. A small amount of tissue may be removed for testing (biopsy) to make sure the stricture is benign. A special x-ray of the esophagus may be done.
• Treatment will be provided for any underlying disorder, such as gastroesophageal reflux disease.
• Treatment for the stricture usually involves a medical procedure to widen (dilate) the esophagus. Different types of procedures are available. They are normally done with the patient sedated. Your health care provider will explain the options to you.
• Surgery to remove the stricture may be recommended, if other treatments fail.
• Stop smoking. Smoking may make symptoms worse.
• See your dental care provider to be sure dentures and oral prostheses are fit well and are not loose.

medications

Drugs for reflux problems may be prescribed (e.g., proton pump inhibitors).

activity

Usually no limits.

diet

• Eat a soft or liquid diet after treatment, until normal swallowing is possible. Avoid spicy foods that irritate the esophagus.
• A diet that helps avoid acid reflux may be recommended.

 notify our office if

• You or a family member has symptoms of esophageal stricture.
• The following occur during treatment
  • Chest pain or fever.
  • Inability to speak.
  • Swallowing problems do not improve.

Special Notes: