• Esophageal Stricture

    Definition

    Esophageal stricture is when the esophagus narrows making it hard to swallow. The esophagus is a muscular tube that carries food and liquids from the mouth to the stomach. Esophageal stricture may cause large chunks of food to get stuck in the esophagus. If you suspect you have this condition, contact your doctor.
    Esophageal Stricture
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    Causes

    Esophageal stricture is typically caused by scar tissue that develops as a result of the following:
    • Chronic heartburn , known as gastroesophageal reflux disease (GERD)—a condition where stomach acid flows into the esophagus, causing a burning sensation in the lower chest
    • Prolonged use of a nasogastric tube—a tube that is inserted through the nose to the stomach
    • Ingestion of damaging substances, such as household cleaning agents
    • Treatment of esophageal varices—enlarged veins in the esophagus
    • Injuries caused by an endoscope—a thin, lighted tube used to see inside the body
    • Esophageal cancer
    • Injuries caused by medications that can irritate the esophagus, such as some medications to treat osteoporosis and some antibiotics

    Risk Factors

    Risk factors increases your chance of getting a disease or condition. Scarring, due to acid irritation, increases your chances of developing esophageal stricture. The most common cause of esophageal stricture is GERD. If you have this risk factor, tell your doctor.

    Symptoms

    If you experience any of these symptoms, do not assume it is due to esophageal stricture. These symptoms may be caused by other, less serious health conditions.
    Symptoms include:
    • Difficulty swallowing
    • Pain when swallowing
    • Unintentional weight loss
    • Regurgitation of food—when food flows back from the stomach into the esophagus or mouth

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may need to see a gastroenterologist—a doctor who specializes in the diagnosis and treatment of disorders of the gastrointestinal tract and liver. The gastrointestinal tract includes the mouth, esophagus, stomach, duodenum, small intestine, large intestine, rectum, and anus.
    • Images may be taken of your esophagus. This can be done with a barium swallow.
    • Your esophagus may be examined. This can be done with endoscopy, which uses a lighted, flexible instrument called an endoscope.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include the following:

    Esophageal Dilation

    Esophageal dilation is a procedure your doctor performs to stretch or widen your esophagus. An endoscope will be passed through your mouth and into the esophagus, stomach, and duodenum. A small balloon or tapered plastic dilators will be used to stretch your esophagus. For your comfort, this procedure may be performed while you are sedated. A local anesthetic spray may be applied to the back of your throat. Repeat dilations are often required to adequately stretch the esophagus.

    Proton Pump Inhibitors

    When esophageal stricture is caused by GERD, proton pump inhibitors or acid-blocking medicines are used to prevent the stricture from returning.
    If you are diagnosed with esophageal stricture, follow your doctor's instructions .
    If you are diagnosed with esophageal stricture, follow your doctor's instructions .

    Prevention

    To help reduce your chances of getting esophageal stricture, take the following steps:
    • See your doctor if you have GERD.
    • Avoid ingesting corrosive substances.

    RESOURCES

    American Academy of Family Physicians http://familydoctor.org

    American Society for Gastrointestinal Endoscopy http://www.askasge.org

    CANADIAN RESOURCES

    Canadian Association of Gastroenterology http://www.cag-acg.org

    Canadian Medical Association Journal http://www.cmaj.ca

    References

    Caustic esophageal stricture. EBSCO DynaMed website. Available at:http://www.ebscohost.com/dynamed. Updated July 2, 2010. Accessed March 20, 2013.

    Oesophageal strictures, webs, and rings. Patient.co.uk website. Available at: http://www.patient.co.uk/doctor/Oesophageal-Strictures-Webs-and-Rings.htm. Updated March 18, 2011. Accessed March 20, 2013.

    Understanding esophageal dilation. American Society for Gastrointestinal Endoscopy website. Available at: http://www.asge.org/patients/patients.aspx?id=392 . Accessed March 20, 2013.

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