ESOPHAGEAL STRICTURE

General Information

> Esophageal stricture is narrowing of the esophagus (the tube connecting the mouth to the stomach) caused by inflammation. The narrowing interferes with swallowing.

• Corrosive esophagitis is narrowing of the esophagus caused by chemical damage.

BODY PARTS INVOLVED--Esophagus.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Sudden or gradual decrease in the ability to swallow. Gradual swallowing difficulty affects solid foods first, then liquids.
• Pain in the mouth and chest after eating.
• Increased salivation.
• Rapid breathing.
• Vomiting, sometimes with mucus or blood. Cancer of the esophagus often causes similar symptoms.

CAUSES--

Scarring of the esophagus following inflammation or damage caused by:

• Chronic heartburn or hiatal hernia.
• Prolonged use of feeding tubes.
• Accidental swallowing of lye or other corrosive chemicals by a child. This is an emergency!
• Deliberate swallowing of lye or other corrosive chemicals by a suicidal person.
• Bulimia.

RISK INCREASES WITH--Careless storage of corrosive chemicals, such as lye, kerosene, harsh detergent or bleach.

HOW TO PREVENT

• Store all chemicals out of the reach of young children.
• Avoid prolonged use of feeding tubes.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Surgical diagnostic procedures such as endoscopy (See Glossary). A small amount of tissue will be removed for biopsy to make sure the stricture is benign.
• X-rays of the esophagus (barium swallow).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for supportive care and intravenous nutrition (sometimes).
• Surgery to remove stricture if other measures fail (rare).
• Periodic dilatation of esophagus.

POSSIBLE COMPLICATIONS

• Malnutrition from inability to eat normally.
• Perforation of the damaged esophagus. This may be life-threatening.

PROBABLE OUTCOME--Usually curable with treatment. Normal swallowing can be maintained with regular treatment to stretch the stricture.

How To Treat

GENERAL MEASURES----The stricture must be stretched regularly, about once a month for some people and for others, every 4 to 6 months. There are several methods available and your doctor will provide information about the options. The techniques require an experienced operator. Don't be hesitant to inquire about the experience of the person scheduled to perform the procedure on you. The stricture will eventually return if regular treatments are not continued.

MEDICATION--Your doctor may prescribe:

• Cortisone drugs to reduce inflammation and diminish the possibility of scarring.
• Antibiotics to prevent infection.

ACTIVITY--Resume normal activities gradually.

DIET--

• Eat a soft or liquid diet (see both in Appendix) after treatment until normal swallowing is possible. Avoid spicy foods that irritate the esophagus.
• Don't drink alcohol.

Call Your Doctor If

• You have symptoms of esophageal stricture or corrosive esophagitis.
• The following occurs during treatment: Chest pain. Fever. Inability to speak. Feeling of air bubbles under the skin of the chest.