Esophageal stricture
Encyclopedia
Benign esophageal stricture is a narrowing or tightening of the esophagus
that causes swallowing difficulties.
, esophagitis
(inflammation of the esophagus), dysfunctional lower esophageal sphincter, disordered motility, lye ingestion, or a hiatal hernia. Strictures can form after esophageal surgery and other treatments such as laser therapy or photodynamic therapy
. While the area heals a scar forms, causing the tissue to pull and tighten which leads to difficulty in swallowing.
), by a computerized tomography scan (an X-Ray that can take pictures of the esophagus), a biopsy, to take a sample of tissue to check for esophageal cancer or by an endoscopy (in which a scope is passed into the esophagus).
(GERD) affects approximately 40% of adults. Strictures occur in 7 to 23% of patients with GERD who are untreated.
, a weighted tube used to dilate the constricted areas in the esophagus. It can also be treated during an endoscopy with a special balloon that inflates in the esophagus (called "Dilation of the stricture"), or with other medications. For example, an H2 blocker medicine (e.g., ranitidine
) or a proton-pump inhibitor (e.g., omeprazole
) can treat underlying acid reflux disease.
Esophagus
The esophagus is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. During swallowing, food passes from the mouth through the pharynx into the esophagus and travels via peristalsis to the stomach...
that causes swallowing difficulties.
Causes
It can be caused by or associated with gastroesophageal reflux diseaseGastroesophageal reflux disease
Gastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...
, esophagitis
Esophagitis
Esophagitis is inflammation of the esophagus. It may be acute or chronic. The acute esophagitis can be catarrhal or phlegmonous, whereas the chronic esophagitis may be hypertrophic or atrophic.-Infectious:...
(inflammation of the esophagus), dysfunctional lower esophageal sphincter, disordered motility, lye ingestion, or a hiatal hernia. Strictures can form after esophageal surgery and other treatments such as laser therapy or photodynamic therapy
Photodynamic therapy
Photodynamic therapy is used clinically to treat a wide range of medical conditions, including malignant cancers, and is recognised as a treatment strategy which is both minimally invasive and minimally toxic...
. While the area heals a scar forms, causing the tissue to pull and tighten which leads to difficulty in swallowing.
Diagnosis
It can be diagnosed with an X-Ray while the patient swallows barium (called a barium study of the esophagusBarium swallow
A barium swallow is a medical imaging procedure used to examine the upper GI tract, which includes the esophagus and, to a lesser extent, the stomach.-Principle:...
), by a computerized tomography scan (an X-Ray that can take pictures of the esophagus), a biopsy, to take a sample of tissue to check for esophageal cancer or by an endoscopy (in which a scope is passed into the esophagus).
Incidence/prevalence
Gastroesophageal reflux diseaseGastroesophageal reflux disease
Gastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...
(GERD) affects approximately 40% of adults. Strictures occur in 7 to 23% of patients with GERD who are untreated.
Symptoms
Symptoms of esophageal strictures include heartburn, bitter or acid taste in your mouth, choking, coughing, shortness of breath, frequent burping or hiccups, pain or trouble swallowing, throwing up blood, or weight loss.Treatment
If it is caused by esophagitis, then it is treated by treating the infection (typically with antibiotics). In order to open the stricture, a surgeon can insert a bougieEsophageal dilatation
Esophageal dilatation is a therapeutic endoscopic procedure that enlarges the lumen of the esophagus.-Indications:It can be used to treat a number of medical conditions that result in narrowing of the esophageal lumen, or decrease motility in the distal esophagus...
, a weighted tube used to dilate the constricted areas in the esophagus. It can also be treated during an endoscopy with a special balloon that inflates in the esophagus (called "Dilation of the stricture"), or with other medications. For example, an H2 blocker medicine (e.g., ranitidine
Ranitidine
Ranitidine is a histamine H2-receptor antagonist that inhibits stomach acid production. It is commonly used in treatment of peptic ulcer disease and gastroesophageal reflux disease . Ranitidine is also used alongside fexofenadine and other antihistamines for the treatment of skin conditions...
) or a proton-pump inhibitor (e.g., omeprazole
Omeprazole
Omeprazole is a proton pump inhibitor used in the treatment of dyspepsia, peptic ulcer disease , gastroesophageal reflux disease , laryngopharyngeal reflux and Zollinger–Ellison syndrome...
) can treat underlying acid reflux disease.
Prevention
In order to try and avoid strictures, one should eat solid foods which naturally stretch the esophagus. However, one can still develop a stricture even if they do eat solid foods.See also
- Esophageal diseaseEsophageal diseaseEsophageal diseases can derive from congenital conditions, or they can be acquired later in life.Many people experience a burning sensation in their chest occasionally, caused by stomach acids refluxing into the esophagus, normally called heartburn...
s - Esophageal spasm
- Esophageal cancerEsophageal cancerEsophageal cancer is malignancy of the esophagus. There are various subtypes, primarily squamous cell cancer and adenocarcinoma . Squamous cell cancer arises from the cells that line the upper part of the esophagus...
- EsophagitisEsophagitisEsophagitis is inflammation of the esophagus. It may be acute or chronic. The acute esophagitis can be catarrhal or phlegmonous, whereas the chronic esophagitis may be hypertrophic or atrophic.-Infectious:...