What is an esophageal stricture?
An esophageal stricture is an abnormal narrowing at some point in the esophagus. It can be due to inflammation or a growth in the esophageal wall protruding into the lumen (intrinsic), compression on the esophagus from a neighboring structure (extrinsic) or dysfunction of the esophageal wall muscle tone or activity (motor).
Narrowing of the esophagus may result in one of more of the following symptoms :
- Difficulty swallowing – dysphagia
- Painful swallowing – odynophagia
- Regurgitation of food
- Coughing during or after eating , at night
- Unintentional weight loss
Causes of Esophageal Strictures
- Esophagitis is the inflammation of the lining of the esophagus which often leads to swelling. Some of the common causes include chronic acid reflux (GERD / gastroesophageal reflux disease), infections or autoimmune causes (eosinophilic esophagitis). Other types of esophagitis that may cause strictures include corrosive esophagitis and drug-induced (pill) esophagitis.
- Gastroesophageal reflux disease (GERD) is worth considering on its own. Apart from esophagitis, chronic acid reflux may lead to fibrosis and other esophageal complications that results in narrowing of the esophagus (peptic stricture). The prevalence of GERD makes it a leading cause of esophageal strictures.
- Esophageal webs and rings are common structural abnormalities of the esophagus more often found in the distal esophagus. It may be congenital or acquired with inflammation and autoimmune causes being major contributing factors.
- Cancer, either of the esophagus or stomach (cardia) may be intrinsic causes of esophageal strictures. Tumors, malignant or benign, outside of the esophagus may cause compression on the esophagus (extrinsic).
- Therapeutic complications may be seen in scarring following surgery (esophageal resection), after radiation therapy or nasogastric intubation (long term).
- Other Causes
- Skin diseases like pemphigus vulgaris
- Crohn’s disease
- Trauma to neck or head
- Foreign bodies
- Autoimmune disorders like SLE (systemic lupus erythematosus)