Esophageal Stricture

Causes

The main cause of esophageal stricture is scar tissue. This may happen because of:

• Eating or drinking harmful substances, such as household cleaners
• Enlarged veins from esophageal varices treatments
• Injuries caused by an endoscope—a thin, lighted tube used to see inside the body
• Esophageal cancer
• Structural problems

Risk Factors

Things that may raise the risk of an esophageal stricture are:

• Gastroesophageal reflux disease (GERD)
• Long-term use of a nasogastric tube—a tube placed through the nose and into the stomach
• Inflammation of the esophagus
• Scleroderma
• Barrett esophagus
• Certain medicines, such as antibiotics and medicines used to treat osteoporosis

Symptoms

Symptoms of an esophageal stricture may be:

• Pain and problems swallowing
• A feeling of food being stuck
• Bringing swallowed food up again
• Drooling, coughing, or choking
• Problems getting enough fluids or nutrition

Diagnosis

The doctor will ask about symptoms and past health. A physical exam may be done.

Tests may be done to confirm the diagnosis of an esophageal stricture. They may include:

• An upper GI endoscopy—to look at the structures from the back of the throat to the stomach
• An upper GI series—to take pictures of the digestive tract using contrast material to highlight abnormalities

Treatment

The goal of treatment is to ease symptoms and stop them from coming back. Options are:

• Medicines to lower stomach acid—in people whose GERD is causing the narrowing
• Esophageal dilation—to stretch or widen the esophagus using a scope and a balloon or plastic dilator

Other treatments may be added, such as:

• Stents—a tube placed to keep the area open
• Corticosteroid injections to the area—to ease inflammation
• Nutritional therapies—to get adequate nutrients

Surgery may be needed when other methods do not help.

Prevention

To lower the risk of esophageal strictures:

• People with GERD should follow the care plan given to them by their doctors.
• Avoid substances that can damage the esophagus.
• Keep harmful substances away from children.

Corticosteroids may help prevent strictures from certain esophageal procedures.