ESOPHAGEAL STRICTURE – Causes and Risk Factors, Clinical Manifestations, Diagnostic Evaluations and Treatment

An esophageal stricture is a gradual narrowing of the esophagus, which can lead to swallowing difficulties. The strictures are caused by scar tissue that builds up in the esophagus.

When the lining of the esophagus is damaged, scarring develops. When scarring occurs, the lining of the esophagus becomes stiff. In time, as this scar tissue continues to build up, the esophagus begins to narrow in that area. The result then is swallowing difficulties. Scarring will result after repeated inflammatory injury and healing, re-injury and rehealing.

CAUSES AND RISK FACTORS


  • Gastroesophageal reflux (GERD)
  • Prolonged use of a nasogastric tube
  • Ingestion of toxic or caustic chemicals
  • Ingestion of corrosive substances, such as household cleaning agents
  • Chronic or severe viral or bacterial infections
  • Injuries caused by endoscopes
  • Scars from previous surgery
  • Esophageal cancer
  • Treatment of esophageal varices (enlarged veins in the esophagus)


CLINICAL MANIFESTATIONS


  • Difficulty swallowing
  • Discomfort with swallowing
  • A felling that food gets stuck in the esophagus
  • Regurgitation of food
  • Weight loss


 

DIAGNOSTIC EVALUATIONS

Barium swallows: Patient will swallow barium and x-rays can be taken to show the narrowing of the esophagus.

An endoscopy exam: This narrow tube is inserted into the esophagus and it can show any narrowing of the esophagus.

TREATMENT OF ESOPHAGEAL STRICTURES

        The esophagus is stretched by the use of one of several methods. Two of the methods of dilation are performed by passing a dilator or air-filled balloon (Pneumatic dilator) is passed through an endoscope. Repeated dilation may be necessary to prevent  the stricture from returning. A bougie (boojie) is a tapered rubber device that flattens the tissue and enlarges the opening of the esophagus.

Proton pump inhibitors, such as omeprazole, lansoprazole or rabeprazole, can keep strictures from returning.

Surgical treatment is rarely necessary. If is performed if a stricture can’t be dilated enough to allow solid food to pass through. Surgery is also performed if repeated dilations do not keep these strictures form returning.

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ESOPHAGEAL STRICTURE – Causes and Risk Factors, Clinical Manifestations, Diagnostic Evaluations and Treatment 

ESOPHAGEAL STRICTURE – Causes and Risk Factors, Clinical Manifestations, Diagnostic Evaluations and Treatment