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Gastrointestinal

Esophageal stricture - benign

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Definition

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

Benign means that it is not caused by cancer. See also: Cancer of esophagus

Causes, incidence, and risk factors

Esophageal stricture can be caused by:

  • Gastroesophageal reflux (GERD)
  • 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, such as household cleaners, lye, disc batteries, or battery acid
  • Treatment of esophageal varices

Symptoms

  • Difficulty swallowing
  • Pain with swallowing
  • Unintentional weight loss
  • Regurgitation of food

Signs and tests

  • Barium swallow shows narrowing of the esophagus
  • Endoscopy shows narrowing of the esophagus

Treatment

Dilation (stretching) of the esophagus is the preferred treatment. This treatment often needs to be repeated after a certain period of time to prevent the stricture from narrowing again.

Proton pump inhibitors (acid-blocking medicines) can keep a peptic stricture from returning. Surgical treatment is rarely necessary.

Expectations (prognosis)

The patient may develop the stricture again in the future.

Complications

Swallowing difficulties may keep the patient from getting enough fluids and nutrients. Solid food, especially meat, can become stuck above the stricture and need endoscopy to remove it.

There is also an increased risk (with regurgitation) of having food, fluid, or vomit enter the lungs and cause choking or aspiration pneumonia.

Calling your health care provider

Call your health care provider if swallowing difficulty persists.

Prevention

Use safety measures to avoid swallowing corrosive substances. Keep dangerous products out of the reach of children. See your doctor if you have GERD.

References

Ginsberg GG, Pfau PR. Foreign bodies, bezoards, and caustic ingestions. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 25.

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