Esophageal Stricture – Causes of Narrowing of the Esophagus

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
    • AIDS-related
    • Crohn’s disease
    • Trauma to neck or head
    • Foreign bodies
    • Autoimmune disorders like SLE (systemic lupus erythematosus)

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  • Berry

    I had radiation therapy 4 1/2 years ago. I am now cancer – free but have hypothyroidism.
    During cancer treatments I went to a therapist who taught me how to swallow.
    But I still have difficulty swallowing. I have to chew very small bites and take my time or food gets stuck in my throat. I especially have difficulty with ground meats, grains like rice or oats, mashed potatoes and cake. Small particles sick to the back of my throat and make me cough violently and painfully. I had a small bit of cherry peel from my yogurt stuck there this morning for hours.
    Sometimes I cough up a small pill from a capsule hours after taking in yogurt.
    I also just had the flu and think I have developed a hernia from all of the coughing.
    My throat has also been swollen and sore for over a year.
    Is the course of action to see a ENT doctor first?
    Thanks

  • Hi Berry. Yes, it is advisable to consult with the ENT first. The cancer was four and a half years ago and while some of your current symptoms may be complications of the treatment at that time, it is also possible that this is an entirely new unrelated condition. It is also advisable that you speak to your family doctor as well.

  • Berry

    Thank you.
    When I cough I have extreme pain down my arms, wrists and down my legs. It’s similar to an electrical shock.
    The pain feels like muscle soreness the next day.

    I am in the process of finding a new doctor. Thanks to the A.C.A. I now have insurance.

    It’s difficult to decide which doctor to call first. Thank you for your advice. I’ll call the ENT.

    I wish doctors would provide text messing, as sometimes I can barely talk.

    Sincerely.
    Berry

  • You’re welcome Berry. You may also want to look at conditions related to the your spine, and specifically the cervical (neck) vertebrae. Nerves that emerge from this level of the spine run down the arms. The increased pressure during coughing could be exacerbating a spine condition that you have, thereby causing momentary compression of the nerves. Just a possibility to look into. Hope all goes well with your appointment. 🙂