Esophageal Stricture – Causes, Symptoms and Treatment

Esophageal stricture

is the abnormal narrowing of the esophagus ( the tube starting in the mouth and ending in the stomach). It is known to inhibit the swallowing of food. It is mostly a benign condition without any background of cancer. However, esophageal cancers or malignancy can lead to this condition.

Benign esophageal stricture

Causes of esophageal stricture

The causes of the above condition are as follows:

  • Gastroesophageal reflux disease (GERD)

    : Prolonged presence of gastroesophageal reflux disease or GERD can result in the discussed condition. GERD is caused by a weakened sphincter muscle at the base of the esophagus. Frequent acid reflux is caused when the sphincter muscle opens up letting the gastric acids to get drawn back in to the esophagus. The acid irritates and erodes the esophagus and can cause the damage and narrowing.

  • Acute esophagitis

    : Acute esophagitis or inflammation of the esophagus can cause it.

  • Abnormal esophagus

    : Abnormal narrowing or stenosis of the esophagus may be present as a congenital defect. Diverticulum ( the walls of the esophagus protrudes out forming pouches) or hiatal hernia ( a part of the stomach finds its way through an opening in the diaphragm and moves toward the chest) can lead to the condition.

  • Esophageal cancer

    : The formation of a cancerous mass in the esophagus can cause the abnormal narrowing.

  • Drugs

    : Certain medicines, drugs or ingested caustic agents may irritate and erode the esophagus. For example pain medications, certain antibiotics etc.

  • Injury or Trauma

    : Injury caused to the esophagus by radiation or procedures where a nasogastric tube has to be inserted as in endoscopy. Prolonged feeding through a nasogastric tube in severely ill patients can also lead to a narrowing of the esophagus.

  • Surgeries or Sclerotherapy

    : Previous surgeries done on the esophagus may leave behind scar tissue which tightens and hardens over time causing the esophagus to become narrow and rigid. Sclerotherapy is a procedure where bleeding from a tear or hole in the esophagus is arrested by injecting a coagulating agent in the blood vessels.

Symptoms of the condition

  • Heart Burn
  • Bitter or acid taste in the mouth
  • Choking
  • Coughing
  • Shortness of breath
  • Difficulty swallowing food
  • Excessive burping or hiccups
  • Frequent vomiting
  • Sustained weight loss

Treatment of esophageal stricture

  • If it is caused by infection as in esophagitis, it is treated with antibiotic therapy.
  • Various techniques to dilate or widen the tissues of the esophagus are prevalent. Endoscopic therapies which involve cautery ( burning away the abnormal cells and scar tissue with the use of electric charge), injections ( chemicals are injected to widen and relax the muscles of the esophagus), ablation therapy ( the narrowed esophagus is exposed to argon gas or thermal heat energy) are in use.
  • The surgeon can use a weighted tube (bougie) to widen the narrowed esophagus.
  • H2 blockers (ranitidine) and proton pump inhibitor (omeprazole) can help to manage the associated acid reflux problem.

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