Esophageal Stricture (Stenosis)

Esophageal stricture or stenosis is the narrowing of the esophagus caused by a scar or cancer.

Symptoms of Stricture or Stenosis of the Esophagus

The symptoms of stricture are:

  • Difficulty and discomfort in swallowing
  • The feeling that food is stuck on the throat

At first, the patient may not realize that they have difficulty in swallowing, as they automatically compensate by chewing the food more or eating smaller pieces.

Diagnosis of Esophageal Stricture

Tests for stricture include:

  • Upper Endoscopy
    A flexible tube with an attached camera or imaging lens is used to observe the physical narrowing of the esophagus.

  • Barium swallow test

  • Biopsy

Cause of Esophageal Stricture

Causes of esophageal stricture include:

  • Gastroesophageal reflux disease
    Esophageal stricture commonly develops after gastroesophageal reflux disease or GERD, caused by chronic tissue injury because of stomach acid backing up into the esophagus.

  • Toxic or caustic chemicals
    Swallowing toxic or caustic chemicals can cause injury to the tissue which heals with a fibrous scar tissue.

  • Side effects and complications of medications

  • Side effects of a sclerotherapy treatment
    Sclerotherapy is a medical treatment where sclerosing or scarring agent is injected to destroy tissues locally. In some cases, scar tissue develops at the site of injection.

  • Chronic or severe infection

  • Scars from previous surgery

  • Esophageal cancer

Treatments of Esophageal Stricture

To treat stricture, various techniques below are used to enlarge the narrowed opening of the esophagus:

  • Bougie
    A bougie (“boojie”) is a tapered rubber device that flattens the tissue and enlarges the opening of the esophagus.

  • Pneumatic dilator
    A balloon is placed on the narrowed portion and then inflated.

  • Guided wire dilator
    Here, a tapered dilator is threaded through the esophagus with the aid of guided wire during endoscopy.

Note that several treatments may be required, as scar tissues are naturally difficult to eliminate and the stricture itself may recur even after the esophagus opening is widened.

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