Esophageal Stenosis

A Few Facts About Esophageal Stenosis

Esophageal stenosis is defined as a narrowing or restriction of the esophagus, usually requiring treatment if the narrowing begins to impede the flow of foods or fluids from the mouth to the stomach. A synonym of esophageal stenosis is esophageal stricture. This synonym is often used when the restriction is due to an acid-reflux condition or GERD.

Various Causes - Esophageal stenosis usually occurs as the result of trauma or of a disease. It can be congenital, caused by an abnormality in an infant's development, but this is rather rare. By far the most common cause of esophageal stenosis is acid reflux.

The structure of the esophagus, which is essentially a pipe or tube, is that it is smooth to allow food and fluid to flow easily, and it also has muscles in the esophageal wall which helps move food down towards the stomach.

In the event of trauma or acid reflux, the lining of the esophagus may become damaged, and, especially in the case where stomach acid is allowed to enter the esophagus, the damage can result in the esophagus walls slowly becoming narrower and more restricted as far as the passage of food and fluid is concerned. This narrowing is the result of a build up of scar tissue.

Esophagitis - Another cause of esophageal stenosis is esophagitis, a prolonged or severe infection in the esophagus, which can also result in the formation of scar tissue as infected tissue attempts to heal. Medication which irritates the esophagus can be yet another cause as can cancer of the esophagus. In somewhat rare instances, where scar tissue has built up following throat surgery, esophageal stenosis may develop.

Reflux Disease - The greatest cause however is gastroesophageal reflux disease. About 8 out of 10 people suffering from esophageal stenosis are affected by reflux disease. While reflux disease carries with it its own symptoms, which we call heartburn, an increased difficulty in swallowing, sometimes accompanied by pain is the usual symptom that stenosis is present. In more severe cases it may become difficult to completely swallow food, which may be regurgitated shortly after. The stenosis can sometimes be accompanied by ulceration, causing mucous, pus, or blood to be vomited along with the food.

Treatment And Prognosis of Esophageal Stenosis - If acid reflux disease is the underlying cause it will have to be treated if any long-lasting relief from stenosis is to be achieved. As far as esophageal stenosis itself is concerned, if in an advanced stage, it may be difficult or impossible to treat. Treatment is usually mechanical, as there are no known medications which are particularly effective. The esophagus must be dilated using one of several methods, and this dilation may have to be done a number of times before the prognosis can be considered positive. Attempts to dilate the esophagus may be done concurrently with an examination of the esophagus, an endoscopy.

 

Wires And Balloons As Dilators - In some instances a wire is placed across the restricted area and the wire serves to help guide mechanical dilators over the right location. Sausage-shaped balloons may also be used. The balloons are fed into the esophageal chamber and inflated rather suddenly. The sharpness of the dilation of the esophagus may tend to make the dilation permanent although the process may have to be repeated several times.

The Bougie Process - Soft rubber or plastic dilators are sometimes used instead of balloons or wires to gradually dilate the passageway, the process being known as the bougie process. As noted, in more advanced cases dilation may not work and the prognosis then will not be a good one.