What is a benign esophageal stricture?
The main symptoms include:
- difficulty swallowing
- food coming back up the throat from the stomach
- unintentional weight loss
There are several different treatment options for benign esophageal strictures, including:
- Taking medications to reduce stomach acid, which can help prevent the stricture from recurring.
- Dilating, or stretching, the esophagus.
- Using a small tube called a stent to reopen the esophagus.
- Surgery is sometimes necessary in severe cases.
Esophageal strictures happen when the lining of the esophagus becomes inflamed, which can cause scarring. This scarring can cause the esophagus to narrow.
A person with a benign esophageal stricture will experience difficulty when swallowing.
People with a benign esophageal stricture may experience the following symptoms:
- swallowing becoming difficult or painful
- food feeling stuck in the throat
- food returning up to the mouth from the stomach
- unintentional weight loss
- frequent hiccupping or burping
- coughing or choking
- dehydration or malnutrition
There are different methods for treating benign esophageal strictures, and the most suitable option will depend on the cause.
The causes of a benign esophageal stricture can include:
- GERD: In people with this disorder, stomach acid comes back up the esophagus from the stomach to the mouth, which can irritate the lining of the esophagus.
- Injury from an endoscopy: Some medical procedures involve the insertion of an instrument called an endoscope into the esophagus, which can sometimes injure this part of the body.
- Frequent use of a nasogastric tube: This tube passes through the nose and esophagus to the stomach, allowing people to take food and liquid through it. Long-term or extensive use of the tube can cause an esophageal stricture.
- Swallowing certain substances: Swallowing toxic substances, such as household cleaning products, can cause an esophageal stricture. Consuming extremely hot or cold liquids can also sometimes damage the esophagus.
- Treatment for esophagus varices: Swollen veins in the esophagus require treatment, which can sometimes scar the esophagus.
- Esophagitis: This immune disorder causes inflammation of the esophagus. It may occur due to an allergic reaction or a severe case of GERD.
- Scleroderma: This autoimmune disorder can affect the lining of the esophagus.
Treatment options for this condition include the following:
If the esophageal stricture is due to GERD, a doctor may prescribe a set of medicines called proton pump inhibitors (PPIs).
PPIs can reduce stomach acid, which may help treat GERD and prevent the narrowing of the esophagus in the future.
In cases where GERD causes an esophageal stricture, making dietary and lifestyle changes can help treat symptoms.
These changes may include:
- Avoiding spicy, greasy, or fatty foods, as well as chocolate, alcohol, tobacco, and caffeine, as these can all cause GERD.
- Losing excess weight.
- Wearing loose-fitting clothing to relieve pressure on the stomach.
- Eating frequent small meals rather than three large meals a day.
- Avoiding lying down until 3 hours after eating.
Esophageal dilation or stretching
A doctor will insert an endoscope with an attached dilator or special balloon into a person's esophagus. The balloon will inflate in the narrowed part of the esophagus to stretch it open.
If the esophageal stricture is severe, a person may need to have additional dilations.
A possible side effect of esophageal dilation is perforation of the esophagus. The medical equipment that doctors use to diagnose or treat the esophagus can sometimes create a small hole in it.
However, this complication is more common in malignant cases of esophageal stricture than in benign esophageal strictures.
A stent is a tube that doctors can insert into the narrowed esophagus to keep it open. Doing this allows people who are having problems swallowing to eat and drink more easily.
People may need surgery for severe cases of esophageal stricture when other treatment methods are not successful.
Diagnosis and when to see a doctor
Doctors may use an upper GI endoscopy to identify a benign esophagel stricture.
People should see a doctor if they experience any symptoms of benign esophageal stricture. A doctor will examine the upper GI tract, which includes the esophagus and stomach.
They may use the following methods to check whether people have a benign esophageal stricture:
An upper gastrointestinal (GI) endoscopy: An endoscope is a thin, flexible tube with a small light and camera at the end.
A doctor will insert this through a person's mouth into their esophagus to examine it on a monitor.
It is also possible to use an endoscope to take a skin sample for examination under a microscope.
Barium swallow: The individual swallows a substance called barium before having an X-ray of their chest. The barium coats the inside of the upper GI and reveals any narrowing of the esophagus.
CT scan: A CT scan uses X-ray and computer technology to provide a detailed image of the esophagus.
Various treatment methods can treat benign esophageal strictures effectively.
However, esophageal strictures can reoccur, and people may need to have repeat dilations to reopen the esophagus. According to one source, 30 percent of people who have an esophageal dilation will require another dilation within a year.
If people have benign esophageal stricture as a result of GERD, they may need to make changes to their diet or lifestyle to manage the condition throughout their life.