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Esophageal strictures / Esophageal stenosis

What is an Esophageal Stricture?

An esophageal stricture which is also known as esophageal stenosis is were the esophagus gradually narrows. Which can lead to problems with swallowing.

The strictures are caused by inflammation in the esophagus which leads to scar tissue building up causing it to slowly over time narrow.

The esophagus in very server cases may be reduced to an opening the size of a pencil or smaller which then causes food and fluids to be delayed and to move across the opening into the stomach slowly.

Symptoms

The symptoms may be

  • A feeling that food is getting stuck in the esophagus
  • difficulty in swallowing (this may gradually occur over time)
  • Swallowing may be uncomfortable, (not necessarily painful)
  • stomach content and acid coming back up from the stomach into the mouth.

How is it dagnoised?

An endoscopy is the usual way that esophageal stricture in diagnosed, this is were a narrow tube is inserted down though the mouth into the throat. This enables the doctor to have a look and see if any scaring or narrowing has occurred he will also take biopsies to check but also at the same time he will take biopsy to check for Barrett's esophagus and esophageal cancer.

an endoscopy, a procedure in which a narrow tube is inserted into the esophagus to check for scarring or gastro-oesophageal reflux disease a biopsy, to take a sample of tissue to check for esophageal cancer an x-ray study called a cine-esophagram, in which the person swallows a radio-opaque liquid to help determine the location and length of the stricture.

Treatment

Quite often the main treatment for this is dilation, which may be done at the same time as the upper endoscopy examination and diagnosis. Dilation is were they try and stretch and widen the esophagus with one of the following techniques

  • Bougie - soft rubber or plastic dilators are moved across the stricture, gently opening it., and the surgeon with increase the size of the dilator accordingly.
  • Guided wire - A thin wire, placed across the stricture, is used to guide increasingly wider dilators over it.
  • Balloons - balloons shaped like sausages can be placed across the stricture. Then the balloon is sharply inflated to open the narrowed area.
Your consultant or surgeon will decide which is the best form of dilation.

The only other option to dilation is surgery but this is only used in extreme cases were dilation has failed.

If gastroesphageal reflux has been the cause of the stricture it needs to be treated with medications that are known as proton pump inhibitors

Complications

Complications can arise in with patents

  • Patients may not be getting enough nutrients and liquids though not wanting to eat and drink.
  • In very server cases foods may get stuck in the esophagus
  • During the dilation there may be a rick of a puncture of the esophagus, or esophageal perforation
  • There may also be a need to change your diet to ease problems with swallowing
  • The stricture may return after dilation

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