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Esophageal stricture is the abnormal narrowing of the esophagus — a tube connecting the mouth to the stomach. If you have esophageal stricture, you will experience difficulty in swallowing foods.
The most common cause of esophageal stricture is gastroesophageal reflux disease (GERD) or acid reflux - where the acid from the stomach backflows to the esophagus. The acid causesinflammation and scarring of the inner lining of the esophagus, narrowing the esophagus.
The treatment of esophageal strictures involves dilation of the esophagus using different techniques. Diet and lifestyle changes are also important in managing this condition.
Esophageal stricture is the narrowing of the esophagus. This makes it difficult for the food to pass through it. Thus, the most common symptom of esophageal stricture isdysphagia — difficulty in swallowing.
In the initial stage of esophageal stricture, it is difficult to swallow solid foods. As the narrowing continues, passing semi-solid foods and liquids also becomes challenging.
The other symptoms of esophageal stricture usually depend on the underlying cause. Here are a few common symptoms that people with esophageal stricture experience:
Esophageal strictures can be caused by the following:
The lower end of the esophagus has a sphincter — a ring of muscles — that allows food to enter the stomach. The sphincter also prevents the backflow of stomach contents to the esophagus. When the sphincter fails to function properly, stomach acid backflows into the esophagus, causing GERD or acid reflux.
GERD results in theinflammation of the esophageal lining. Persistent inflammation causes scarring and narrowing of the esophageal tube, resulting in esophageal stricture. Reports show that GERD causes70 to 80% of esophageal strictures.
Esophagitis is inflammation of the esophagus, and it has several causes. Eosinophilic esophagitis is an autoimmune condition in which the immune system causes inflammation of the esophagus. The inflammation then leads to scarring and narrowing of the esophageal tube.
Other common types of esophagitis are drug-induced esophagitis and infectious esophagitis. Certain medications, such as NSAIDs, erode the esophageal tube and cause drug-induced esophagitis. Infectious esophagitis is due to chronic viral and fungal infections in the esophagus.
Some other less common causes of esophageal strictures include:
No. Bothachalasia and esophageal stricture are swallowing disorders but they have different causes and so, they affect the esophagus differently.
Inachalasia, the esophagus cannot pass the food to the stomach because of nerve damage. Nerve damage impairs the esophageal muscles and they fail to propel food down to the stomach. Nerve damage also affects the opening of the lower esophageal sphincter, preventing food entry into the stomach.
Inesophageal stricture, food can’t pass down to the stomach due to the narrowing of the esophageal tube. Unlike achalasia, it is due to structural changes in the esophagus.
There is no cure for achalasia, but you can manage the symptoms to an extent with specific treatment options. On the other hand, esophageal stricture is a treatable condition.
Achalasia is comparatively less common than esophageal strictures. According to statistics, achalasia affects1 in every 100,000 people, whereas esophageal strictures affect1.1 in every 10,000 people.
You can fix esophageal stricture by the following treatment options:
The primary treatment option for esophageal stricture is esophageal dilation. In this procedure, the doctor inserts an endoscope into the esophagus to visualize the narrowed area. After analyzing the narrowed area, a dilator, such as a balloon, is inserted into the esophagus.
The doctor inflates the balloon, stretching the walls of the esophageal tube. This procedure is repeated in several sessions until the esophageal tube widens to the required limit.
Esophageal dilation is very effective for simple strictures. However, complex strictures are hard to open using esophageal dilation techniques. The risk of recurrence is also higher for complex strictures.
Medications mainly focus on managing the esophageal stricture and preventing its reoccurrence. For example, steroidal injections prevent inflammation in the esophagus after esophageal dilation.
Medication is also important for the management of acid reflux, which is the cause of 70 to 80% of esophageal strictures. Doctors prescribe medicines to reduce stomach acid production and release. These medicines include:
Surgery is not common for esophageal strictures and is only required when other treatment options fail. The surgical procedure for esophageal stricture is calledesophagectomy.
In esophagectomy, all or a portion of the esophagus is removed. The lost portion is rebuilt using a part of the stomach or large intestine.
Home remedies help manage the symptoms and prevent the condition from worsening. It includes:
1) Eating smaller meals that can pass through the esophagus easily.
2) Consuming plenty of liquids also helps the flow of food through the esophageal tube.
3) Avoiding foods and habits that trigger acid reflux which is a major cause of esophageal strictures.
The “Rule of 3” is a guideline that doctors follow for esophageal dilation procedures. This guideline states thatthe esophagus shouldn’t be dilated more than 3 mm in a single session.
Following this guideline during the dilation procedure lowers the risk of complications. One of the major complications of dilation is perforations in the walls of the esophageal tube. However, differentstudies show that dilation of the esophageal tube up to 5 mm is also safe.
If you have esophageal stricture, you must avoid the following things as they can worsen the condition:
Spicy foods can irritate the esophagus, worsening the pain and discomfort in esophageal strictures.Studies show that consuming spicy foods is associated with heartburn.
Anotherstudy shows that capsaicin, a main ingredient in spices, can delay gastric emptying. Delayed gastric emptyingincreases the risk of acid reflux.
See Also: Gastroparesis Care: The Art of Emptying that Always Full Stomach!
Acid reflux in an individual with esophageal stricture inhibits recovery and worsens the condition.
Caffeine found in caffeinated drinks can increase the risk of acid reflux.Studies show that caffeine relaxes the lower esophageal sphincter muscles. Relaxation of lower esophageal sphincter muscles promotes the backflow of acid into the esophagus, causing acid reflux.
Studies also show that caffeine increases the production and release of gastric acids. Thus, caffeinated drinks can worsen esophageal strictures by triggering acid reflux.
Smoking can harm esophageal stricture by increasing the risk of acid reflux. Smoking weakens the lower esophageal sphincter muscles and increases the stomach acid production.By making these changes, smoking promotes the backflow of stomach acid into the esophagus.
Studies show that alcohol consumption is associated with acid reflux. Alcoholincreases gastric acid release and also impairs the junction between the esophagus and stomach, promoting acid reflux.
Studies show that alcohol also has inflammatory properties. It can trigger inflammation in the esophagus, making the condition worse.
Other risk factors that can worsen esophageal strictures include:
The following tips can help you manage esophageal stricture better:
For esophageal stricture, include easily digestible soft foods in your diet and avoid foods that trigger acid reflux. Some of the easily digestible foods include:
If you have an esophageal stricture, you should prefer canned and cooked vegetables over raw vegetables. Cooked vegetables are soft enough to pass through the narrowed esophageal tube and are easily digestible.
Canned vegetables, canned fruits such as peaches, applesauce, and pineapples are easy to eat in esophageal stricture. They cause very little pressure on the esophageal tube and are easily digestible. Besides canned fruits, you can also eat bananas, watermelons, and other soft fruits that easily pass through the narrowed esophagus.
Studies show that fiber reduces acid reflux symptoms, making it healthy for esophageal strictures. However, fiber-rich sources such as raw vegetables and fruits aren’t an option in esophageal strictures — they are hard to pass through the narrowed esophagus.
In that case, you can get beneficial fiber from soft foods such as oatmeal and mashed potatoes. You can also getfiber powder with digestive enzymes to lower the risk of acid reflux and manage esophageal stricture.
Egg white is an excellent source of healthy fats and protein. Scrambled egg whites are easy to consume with a narrowed esophagus.
If you are experiencing difficulty in swallowing and have a history of gastroesophageal reflux disease (GERD), there is a chance that you have esophageal stricture. GERD triggers inflammation in the esophagus, and repeated inflammation causes scarring and narrowing of the esophageal tube.
Fortunately, esophageal stricture is a manageable condition. Treatment is possible through the dilation of the esophageal tube, medications, and surgery.
It is important to manage GERD or acid reflux for successful treatment and recovery from esophageal stricture. Dietary and lifestyle changes can lower the risk of acid reflux and promote recovery.
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