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Esophageal Strictures

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Updated March 26, 2013

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.

One of the conditions that can lead to esophageal strictures is gastroesophageal reflux disease. Excessive acid is refluxed from the stomach up into the esophagus. This causes an inflammation in the lower part of the esophagus. Scarring will result after repeated inflammatory injury and healing, re-injury and rehealing. This scarring will produce damaged tissue in the form of a ring that narrows the opening of the esophagus.

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Causes, incidence, and risk factors of esophageal strictures:

  • Gastroesophageal reflux (GERD)
  • Prolonged use of a nasogastric tube
  • Ingestion of corrosive substances
  • Viral or bacterial infections
  • Injuries caused by endoscopes


Symptoms of Esophageal Strictures

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


Diagnosis of Esophageal Strictures

  • A barium swallow. 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

  • Dilation. 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 is passed through a endoscope. Repeated dilation may be necessary to prevent the stricture from returning.
  • 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 from returning.


Prognosis For People with Esophageal Strictures

  • After treatment, a patient can usually go back to regular routines and diets.
  • The patient may develop the stricture again in the future.


Complications of Esophageal Strictures

  • Swallowing difficulties may keep the patient from getting enough fluids and nutrients.
  • Increased risk of regurgitated food, fluid, or vomit entering the lungs and cause choking or aspiration pneumonia.
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