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Digestive Disorders

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Esophageal Stricture

Symptoms

Progressive swallowing difficulty, first with solid foods, then liquids; chest pain after meals; increased salivation.

Regurgitation of foods and liquids. These may be aspirated into the lungs, causing cough, wheezing, and shortness of breath.

Weight loss.

When To Call Your Doctor

Call a doctor if you experience progressive difficulty in swallowing.

Emergency: Call an ambulance if someone has swallowed a corrosive material.

Emergency: Go to an emergency room if food becomes stuck in the esophagus and cannot be dislodged by drinking water or other maneuvers.


What Is It?

An esophageal stricture is a narrowing of the esophagus, the passageway from the throat to the stomach. Stomach acid, esophageal cancer, accidentally swallowed harsh chemicals, and other irritants may injure the esophageal lining, causing inflammation (esophagitis) and the formation of scar tissue. This may gradually lead to obstruction of the esophagus, preventing food and fluids from reaching the stomach.

What Causes It?

Persistent reflux of gastric acid into the esophagus (see Gastroesophageal Reflux for more information).

Systemic sclerosis (scleroderma), which is often associated with severe reflux and esophageal stricture.

Swallowing lye or other corrosive chemicals.

Pills lodged in the esophagus.

Esophageal surgery or protracted use of a nasogastric tube (used in hospitals for feeding).

Esophageal cancer may narrow the esophagus and produce the same symptoms.

Prevention

Aggressive treatment of chronic gastroesophageal reflux is necessary.

Store all corrosive chemicals where they will be inaccessible to children.

Take all pills with a full glass of liquid.

Diagnosis

Barium x-ray studies. You may be required to swallow barium, which helps to create a sharp image of the esophagus on an x-ray.

Endoscopy (insertion of an illuminated scope into the esophagus through the mouth under local anesthesia) may be performed.

How To Treat It

Your doctor may advise a diet of liquids or soft foods until food can be swallowed without difficulty.

Mechanical dilation of the esophagus (esophageal bougienage) may be performed to widen the stricture.

In severe cases the affected portion of the esophagus may be removed and replaced with a segment of the large intestine.

In a few cases patients who are unsuited for surgery may have a feeding tube inserted through the stricture. Alternatively, such patients may have a small tube placed into the stomach (gastrostomy), so that food may bypass the esophagus completely.

 

From Johns Hopkins Symptoms and Remedies, the complete home medical reference. You can order this book now on our secure server.

 

 


 


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2005
WHITE PAPERS
Digestive Disorders

The Digestive Disorders White Paper from The Johns Hopkins White Papers series is an annual, in-depth report written by Hopkins physicians.


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Johns Hopkins Symptoms and Remedies
An easy-to-use reference work that can help you pinpoint the cause of hundreds of symptoms, from abdominal pain to skin rash to swollen glands.

 

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