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
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:
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.