Esophageal stricture - benign

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

Causes, incidence, and risk factors

Esophageal stricture can be caused by:

     
  • Gastroesophageal reflux (GERD), irritation caused by excess stomach acids  
  • Prolonged use of a nasogastric (NG) tube while under medical care  
  • Ingestion of corrosive substances  
  • Viral or bacterial infections  
  • Treatment of esophageal varices (dilated blood vessels)  
  • Injuries caused by endoscopes (small cameras used during surgery or certain tests)

Symptoms

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

Signs and tests

     
  • A barium swallow shows narrowing of the esophagus.  
  • An endoscopy shows narrowing of the esophagus.

Treatment

Dilation (stretching) of the esophagus is the preferred treatment. Repeated dilation may be necessary to prevent the stricture from returning.

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. 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

Prevention is related to the causes. For example, use safety measures to avoid ingestion of corrosive substances. Keep dangerous products out of the reach of children. Persistent reflux disease should be evaluated by a physician.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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