What is benign esophageal stricture?
Benign esophageal stricture describes a narrowing or tightening of the esophagus. The esophagus is the tube that brings food and liquids from the mouth to stomach. "Benign" means it's not cancerous.
Benign esophageal stricture typically occurs when stomach acid and other irritants damage the lining of the esophagus over time. This leads to inflammation (esophagitis) and scar tissue, which causes the esophagus to narrow.
Although benign esophageal stricture isn't a sign of cancer, the condition can cause several problems. Narrowing of the esophagus may make it difficult to swallow.
This increases the risk of choking. It can also lead to complete obstruction of the esophagus. This can prevent food and fluids from reaching the stomach.
What causes benign esophageal stricture?
A benign esophageal stricture can happen when scar tissue forms in the esophagus. This is often the result of damage to the esophagus. The most common cause of damage is gastroesophageal reflux disease (GERD), also known as acid reflux.
GERD occurs when the lower esophageal sphincter (LES) doesn't close or tighten properly. The LES is the muscle between the esophagus and the stomach.
It normally opens for a short amount of time when you swallow. Stomach acid can flow back up into the esophagus when it doesn't close completely. This creates a burning sensation in the lower chest known as heartburn.
Frequent exposure to harmful stomach acid can cause scar tissue to form. Eventually, the esophagus will narrow.
Other causes of benign esophageal stricture include:
- radiation therapy to the chest or neck
- accidental swallowing of an acidic or corrosive substance (such as batteries or household cleaners)
- extended use of a nasogastric tube (a special tube that carries food and medicine to the stomach through the nose)
- esophageal damage caused by an endoscope (a thin, flexible tube used to look inside a body cavity or organ)
- treatment of esophageal varices (enlarged veins in the esophagus that can rupture and cause severe bleeding)
Symptoms of benign esophageal stricture
Typical symptoms of benign esophageal stricture include:
- difficult or painful swallowing
- unintended weight loss
- regurgitation of food or liquids
- a sensation of something stuck in the chest after you eat
- frequent burping or hiccups
Diagnosing benign esophageal stricture
The doctor may use the following tests to diagnose the condition:
A barium swallow test includes a series of X-rays of the esophagus. These X-rays are taken after the patient drink a special liquid containing the element barium. Barium isn't toxic or dangerous. This contrast material temporarily coats the lining of the patient's esophagus. This allows the doctor to see the patient's throat more clearly.
In an upper gastrointestinal (upper GI) endoscopy, the doctor will place an endoscope through the patient's mouth and into his esophagus. An endoscope is a thin, flexible tube with an attached camera. It allows the doctor to examine the patient's esophagus and upper intestinal tract.
This test measures the amount of stomach acid that enters the patient esophagus. The doctor will insert a tube through the patient's mouth into his esophagus. The tube is usually left in the patient's esophagus for at least 24 hours.
Treating benign esophageal stricture
Treatment for benign esophageal stricture varies depending on the severity and underlying cause.
Esophageal dilation, or stretching, is the preferred option in most cases. Esophageal dilation can cause some discomfort, so you'll be under general or moderate sedation during the procedure.
The doctor will insert an endoscope through the patient's mouth into his esophagus, stomach, and small intestine. Once they see the strictured area, they'll place a dilator into the esophagus. The dilator is a long, thin tube with a balloon at the tip. Once the balloon inflates, it will expand the narrowed area of the esophagus.
The doctor may need to repeat this procedure in the future to prevent the patient's esophagus from narrowing again.