Esophageal Stricture

ExitCare ImageThe esophagus is the long, narrow tube which carries food and liquid from the mouth to the stomach. Sometimes a part of the esophagus becomes narrow and makes it difficult, painful, or even impossible to swallow. This is called an esophageal stricture.

CAUSES

Common causes of blockage or strictures of the esophagus are:

  • Exposure of the lower esophagus to the acid from the stomach may cause narrowing.

  • Hiatal hernia in which a small part of the stomach bulges up through the diaphragm can cause a narrowing in the bottom of the esophagus.

  • Scleroderma is a tissue disorder that affects the esophagus and makes swallowing difficult.

  • Achalasia is an absence of nerves in the lower esophagus and to the esophageal sphincter. This absence of nerves may be congenital (present since birth). This can cause irregular spasms which do not allow food and fluid through.

  • Strictures may develop from swallowing materials which damage the esophagus. Examples are acids or alkalis such as lye.

  • Schatzki's Ring is a narrow ring of non-cancerous tissue which narrows the lower esophagus. The cause of this is unknown.

  • Growths can block the esophagus.

SYMPTOMS

Some of the problems are difficulty swallowing or pain with swallowing.

DIAGNOSIS

Your caregiver often suspects this problem by taking a medical history. They will also do a physical exam. They may then take X-rays and/or perform an endoscopy. Endoscopy is an exam in which a tube like a small flexible telescope is used to look at your esophagus.

TREATMENT

  • One form of treatment is to dilate the narrow area. This means to stretch it.

  • When this is not successful, chest surgery may be required. This is a much more extensive form of treatment with a longer recovery time.

Both of the above treatments make the passage of food and water into the stomach easier. They also make it easier for stomach contents to bubble back into the esophagus. Special medications may be used following the procedure to help prevent further narrowing. Medications may be used to lower the amount of acid in the stomach juice.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your swallowing is becoming more painful, difficult, or you are unable to swallow.

  • You vomit up blood.

  • You develop black tarry stools.

  • You develop chills.

  • You have a fever.

  • You develop chest or abdominal pain.

  • You develop shortness of breath, feel lightheaded, or faint.

Follow up with medical care as your caregiver suggests.