An esophageal stricture is a gradual narrowing of the tube that carries food to the stomach. It occurs when scar tissue builds up in the tube.
The esophagus is a muscular tube that connects the throat with the stomach. After food enters the tube, muscles behind and in front of the food contract and relax in a rhythmic sequence to force it along toward the stomach.
When part of the lining of the esophagus is damaged, it may become scarred. This makes it fibrous and stiff. A build-up of scar tissue can gradually cause narrowing of part of the esophagus.
A person may notice: slowly increasing difficulty in swallowinga feeling that food "gets stuck" in the esophagusuncomfortable, but not painful swallowingundigested stomach contents and acid washing back into the mouth
A ring of muscle called the lower esophageal sphincter surrounds the opening between the esophagus and the stomach. Normally, it opens to allow food to pass into the stomach.
If this sphincter weakens or relaxes too frequently, stomach contents splash back up into the esophagus. This is called gastroesophageal reflux (GERD) and is the cause of heartburn. The esophagus is hurt by the repeated burning of the misplaced acid.
If the problem is chronic, scar tissue may form and lead to a stricture. Less common causes of stricture include: severe or prolonged infections of the esophagus, known as esophagitisswallowing a caustic substance, such as lyecomplications of medical treatment, such as pill-induced esophagitis (aspirin, ibuprofin, tetracycline)cancer of the esophagus
A person who has gastroesophageal reflux should talk to his or her healthcare provider about ways to treat it so that scar tissue will not form.A person should avoid swallowing any substance that could harm the esophagus.A person should be sure to wash all prescribed and non-prescribed medicine down well with fluids or food.
To diagnose a stricture, the healthcare provider may order: an endoscopy, a procedure in which a narrow tube is inserted into the esophagus to check for scarring or gastroesophageal reflux diseasea biopsy, to take a sample of tissue to check for esophageal canceran x-ray study called a cine-esophagram or barium swallow, in which the person swallows a dye-like liquid to help determine the location and length of the stricture
Even after successful treatment, strictures may recur. A stricture caused by drinking lye is thought to be associated with esophageal cancer decades later.
There are no risks to others.
Usually, strictures are treated by using a tool to dilate or widen the esophagus. A person may be given a local anesthetic to numb the area. Then a rigid, tapered device, or a special high-pressure balloon is used to stretch the stricture. Periodically this may have to be repeated with increasingly larger tools until the person finds it easy to swallow again.
Gastroesophageal reflux disease must also be treated if it has caused a stricture. Long-term treatment with medications known as proton pump inhibitors, such as omeprazole (i.e., Prilosec), lansoprazole (i.e., Prevacid), esomeprazole (i.e., Nexium), pantoprazole (i.e., Protonix), or rabeprazole (i.e., Aciphex), have been shown to keep these strictures from recurring.
Surgery may be required if a stricture cannot be dilated enough for solid food to pass through, or if repeated dilations fail to keep it open. Occasionally, a temporary expandable stent (tube) is placed across the stricture to stretch it for several weeks, then removed.
Problems related to treatment may include: a puncture of the esophagus (esophageal perforation)a need to change diet to ease swallowingside effects of medication used to treat gastroesophageal reflux, such as allergic reactions or stomach upset
In some cases, an esophageal stricture recurs after treatment. After successful treatment, a person can generally go back to regular activities.
After the esophageal stricture has been treated, the person should report any new symptoms to the healthcare provider.