Patient education: Esophageal stricture (The Basics)

What is an esophageal stricture? — 

This 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 a disorder called "gastroesophageal reflux disease," or "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 procedure 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 an esophageal stricture? — 

The main symptom is trouble swallowing, called "dysphagia." You might also feel like food or pills get stuck in your throat. At first, you might have trouble swallowing only when eating 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:

●A burning feeling in the chest, called heartburn

●A 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 an esophageal stricture? — 

Yes. If your doctor or nurse thinks you might have an esophageal stricture, they will probably order 1 or both of these tests:

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

●Endoscopy (figure 2) – 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.

How is an esophageal stricture treated? — 

The main treatment for an esophageal stricture related to GERD is a procedure called "esophageal dilation." This involves making the esophagus wider. It 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 – The doctor puts a series of solid flexible tubes down your throat. They start with a very narrow tube, and then insert wider ones until your esophagus is stretched.

●A balloon – The doctor puts a tube with a balloon on it through the endoscope into your esophagus. They then inflate the balloon to stretch the narrow part of your esophagus.

After having esophageal dilation, most people also need to start taking a medicine called a "proton pump inhibitor," or "PPI". These 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). Most are available without a prescription.

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

More on this topic

Patient education: Dysphagia (The Basics)
Patient education: Acid reflux and GERD in adults (The Basics)
Patient education: Upper endoscopy (The Basics)
Patient education: Upper gastrointestinal series and esophagram (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)