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Esophageal stricture - benign

Definition

Benign esophageal stricture is a narrowing of the esophagus (the tube from the mouth to the stomach). It causes swallowing difficulties.

Benign means that it is not caused by cancer of the esophagus.

Causes

Esophageal stricture can be caused by:

  • Gastroesophageal reflux (GERD).
  • Eosinophilic esophagitis.
  • Injuries caused by an endoscope.
  • Long-term use of a nasogastric (NG) tube (tube through the nose into the stomach).
  • Swallowing substances that harm the lining of the esophagus. These may include household cleaners, lye, disc batteries, or battery acid.
  • Treatment of esophageal varices.

Symptoms

Symptoms may include:

Exams and Tests

You may need the following tests:

Treatment

Dilation (stretching) of the esophagus is the main treatment for acid reflux related strictures. You may need to have this treatment repeated after a period of time to prevent the stricture from narrowing again.

Proton pump inhibitors (acid-blocking medicines) can keep a peptic stricture from returning. Surgery is rarely needed.

If you have eosinophilic esophagitis, you may need to take medicines or make changes to your diet to reduce the inflammation. In some cases, dilation is done.

Outlook (Prognosis)

The stricture may come back in the future. This would require a repeat dilation.

Possible Complications

Swallowing problems may keep you from getting enough fluids and nutrients. Solid food, especially meat, can get stuck above the stricture. If this happens, endoscopy would be needed to remove the lodged food.

There is also a higher risk of having food, fluid, or vomit enter the lungs with regurgitation. This can cause choking or aspiration pneumonia.

When to Contact a Medical Professional

Call your health care provider if you have swallowing problems that do not go away.

Prevention

Use safety measures to avoid swallowing substances that can harm your esophagus. Keep dangerous chemicals out of the reach of children. See your provider if you have GERD.

References

Penman ID, Lees CW. Alimentary tract and pancreatic disease. In: Walker BR, Colledge NR, Ralston SH, Penman ID, eds. Davidson's Principles and Practice of Medicine. 22nd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 22.

Pfau PR, Hancock SM. Foreign bodies, bezoards, and caustic ingestions. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 27.

Ricthter JE, Friendenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44.


Review Date: 8/2/2016
Reviewed By: Raymond S. Koff, MD, Clinical Professor of Medicine, University of Connecticut School of Medicine, Farmington, CT. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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