Patient education: Esophageal stricture (The Basics)

What is esophageal stricture? — An esophageal stricture is a narrowing of the esophagus, the tube that connects the mouth to the stomach (figure 1). People can get an esophageal stricture if they have had a disorder called "gastroesophageal reflux disease" ("GERD") for a long time. In people with GERD, acid from the stomach backs up into the esophagus. Over time, the acid can scar the esophagus and make it more narrow.

Other causes of esophageal stricture include:

●Previous surgery or other procedures on the esophagus

●Radiation therapy

●Swallowing a substance that harms the esophagus, such as household cleaners, lye, or disc-shaped batteries

●Cancer

●An allergic condition called "eosinophilic esophagitis"

What are the symptoms of esophageal stricture? — The main symptom is trouble swallowing. Doctors call this "dysphagia." You might also feel like your food or pills are getting stuck in your throat. At first, you might have trouble swallowing only when you eat solid foods. But as the condition gets worse, you might have trouble swallowing liquids.

If you have acid reflux, you might also have symptoms such as:

●Burning feeling in the chest, known as heartburn

●Burning in the throat or an acid taste in the mouth

●Stomach or chest pain

●Raspy voice or sore throat

●Cough for no reason

Is there a test for esophageal stricture? — Yes. If your doctor or nurse thinks that you might have an esophageal stricture, they will probably order 1 or both of these tests:

●Barium swallow – For this test, you drink a special liquid that shows up on X-ray. Then, you have X-rays taken to see if the barium gets stuck or slowed on the way down your esophagus.

●Endoscopy – For this test, a doctor puts a thin tube down your throat and into your stomach. The tube (called an "endoscope") has a light and a tiny camera on the end. It lets the doctor or nurse see inside your esophagus (figure 2).

How is esophageal stricture treated? — The main treatment for esophageal stricture is a procedure to widen the esophagus called "esophageal dilation." This is usually done during an endoscopy.

If you are having esophageal dilation, you will get medicines to help you relax. The doctor can do the dilation using either:

●Solid flexible tubes – For this procedure, the doctor puts a series of solid flexible tubes down your throat. They start with a very narrow tube, and then insert wider and wider ones until the esophagus is stretched open.

●A balloon – For this procedure, the doctor puts a tube with balloon on it through the endoscope into your esophagus. The balloon is then inflated to stretch the narrow part of the esophagus.

After having esophageal dilation, most people also need to start taking a medicine called a "proton pump inhibitor" ("PPI"). PPIs stop the stomach from making acid and can help the esophagus heal and keep the stricture from coming back. PPIs include omeprazole (brand name: Prilosec), esomeprazole (brand name: Nexium), lansoprazole (brand name: Prevacid), pantoprazole (brand name: Protonix), and rabeprazole (brand name: AcipHex). Some PPIs are sold without a prescription.

Some people need more than 1 dilation if the esophagus is very narrow or if symptoms come back. If you still have problems with esophageal stricture after repeat dilations, there are other treatment options that your doctor might suggest.

More on this topic

Patient education: Upper endoscopy (The Basics)
Patient education: Acid reflux and GERD in adults (The Basics)
Patient education: Thickening liquids (The Basics)

Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics)
Patient education: Upper endoscopy (Beyond the Basics)