Esophageal stricture treatment

Esophageal strictures occur when your esophagus narrows, making it difficult to swallow food. They are most common in people with a history of gastroesophageal reflux disease (GERD).

While this is often an uncomfortable and scary experience, it’s usually very treatable. Our team at Aurora Health Care works hard to make esophageal stricture treatment as seamless and simple as possible.

What is an esophageal stricture?

An esophageal stricture, also called esophageal stenosis, is a narrowing of the esophagus (the muscular tube that connects your throat and stomach). It’s an esophageal motility disorder that affects your ability to swallow foods and liquids.

The narrow section makes it harder for food to move into the stomach, increasing the chance of food getting stuck in your throat. This often happens when people with strictures eat solid food too quickly. That's why eating slowly and in small bites is important if you have a stricture. If food does get lodged, call 911 immediately.

Esophageal stricture symptoms

• Chest pain or pressure
• Feeling of something stuck in your chest after eating
• Frequent burping or hiccups
• Heartburn
• Pain with swallowing
• Regurgitation of food (when food comes back up into your throat or mouth)
• Dysphagia (trouble swallowing)
• Unintentional weight loss

Seek help if you have these esophageal stricture symptoms. If esophageal narrowing isn’t treated, complications such as these may develop:

• Esophagus contents getting into the lungs due to regurgitation (causing aspiration pneumonia)
• Food getting stuck in the esophagus causing choking or difficulty breathing
• Hole in the esophagus, which can be life-threatening
• Not getting enough food or liquids leading to dehydration or malnutrition

Esophageal stricture causes

The main causes of esophageal strictures are digestive disorders like GERD. When acid from the stomach regularly backs up into the bottom of the esophagus (throat), it causes damage to the lining and may lead to a narrowed esophagus.

Other causes of esophageal stricture are:

• Eosinophilic esophagitis – an allergic condition that causes inflammation
• History of radiation treatment of your chest or neck
• Injuries caused by an endoscope
• Long-term use of medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or tetracycline antibiotics
• Previous treatment of esophageal varices (enlarged veins in the esophagus)
• Swallowing harmful substances or objects such as household cleaners or disc batteries

Esophageal cancer and strictures

An esophageal stricture does not cause esophageal cancer, but it can be a symptom of cancer in rare cases. In those instances, strictures develop more quickly than benign esophageal strictures.

Because esophageal tumors can narrow the esophagus as they grow, the first noticeable symptom of esophageal cancer is often trouble swallowing, known as dysphagia. Early treatment is vital.

Risks for developing an esophageal stricture

Esophageal strictures are more common in adults over 40. One of the biggest risk factors for developing a stricture is chronic acid reflux (GERD). The risk increases if GERD is untreated or present for many years.

Other risk factors include:

• Eosinophilic esophagitis, an allergic condition more common in people with asthma, food allergies and eczema
• Radiation therapy in the chest or neck
• Ingestion of corrosive substances, such as cleaning products or chemicals
• Scar tissue from esophageal surgery or cancer treatments
• Prolonged use of feeding tubes
• Consistently taking pills without enough water
• Recurrent inflammation in your esophagus, known as esophagitis
• Congenital abnormalities

Can esophageal strictures be prevented?

Yes, but prevention depends on addressing risk factors early. Reducing inflammation and managing chronic conditions like GERD is key.

Avoiding triggers like fried or spicy foods, using acid-suppressing medications if prescribed and elevating your head while sleeping can help alleviate acid reflux, too.

Not every stricture can be fully prevented despite the best efforts. These include those caused by radiation therapy, injuries or esophageal abnormalities.

How is an esophageal stricture diagnosed?

If your doctor thinks you have an esophageal stricture, they may use several different tools to take a closer look at your esophagus. These tests will show how narrow the esophagus is, what could be causing a blockage and the best way to treat it.

Some of these tests include:

Barium swallow test

For this test, you’ll be asked to drink a solution with barium in it and then have X-rays taken of your esophagus. The solution temporarily coats the lining of your esophagus and the images taken show the size of your esophagus.

If you have narrowing of the esophagus, the top part of your esophagus will often appear stretched because the liquid will be stuck there as it passes slowly through the narrow part into your stomach.

Upper endoscopy

Doctors also might use an upper GI endoscopy to diagnose a stricture. During the endoscopy, the doctor guides a thin, flexible tube into your throat. It’ll have a camera attached so they can view the tissues. Sometimes an ultrasound is used along with the camera to provide clearer images and aid in finding areas from which to take tissue samples (biopsies).

GERD testing

Testing for GERD is also common. For GERD tests, a tube is inserted into your throat to monitor the pH level in your esophagus. Monitoring the pH level shows whether stomach acid is in the esophagus.

Esophageal stricture treatments

Esophageal strictures are often treated with esophageal dilation, which may be performed using balloon dilation or other dilating devices to gently widen the narrowed area. An endoscope – a thin, flexible tube with a light and camera – is used to place the dilator at the desired spot in your esophagus. Steroids may be injected at the same time to reduce inflammation and prevent the stricture from recurring.

Surgery is rare for benign esophageal strictures. When cancer is present, surgery may be recommended to remove the cancerous tissue.

Balloon dilation for esophageal strictures

A balloon dilation is used to widen the narrow part of your esophagus. It’s performed during an upper endoscopy. You’ll be sedated for the procedure, so you’ll be comfortable, sleepy and unable to feel the balloon expanding.

Once in the correct spot, the balloon will be inflated until your esophagus is the correct size again. Then the balloon is deflated and carefully pulled out of your mouth.

What is the best medicine for esophageal strictures?

Because a narrowing of your esophagus can’t be reversed, any medication prescribed will be to prevent further damage, reduce inflammation and, ultimately, lower your risk of recurrence.

Common medications like antacids only provide temporary relief, and pain medications do not treat the root cause of the stricture. For those whose stricture is caused by acid reflux, many doctors might prescribe a proton pump inhibitor (PPI) like omeprazole.

These medications can help reduce stomach acid and reduce recurrence, but they should not be used as the sole treatment. Always discuss possible prescriptions or over-the-counter treatments with your doctor before you start taking them.

Can an esophageal stricture be cured?

Many find lasting relief after receiving esophageal stricture treatment, but recurrence is possible. If it does recur, our team at Aurora Health Care works with you to both treat the stricture and address the underlying cause. Treating the root issue – often acid reflux – is crucial to ensure your stricture does not return.

Following an esophageal stricture diet

Feeling like you have something stuck in your throat can be an unpleasant and alarming feeling. Following these diet tips can help avoid complications and reduce choking risks:

• Eat soft, easy-to-swallow foods like mashed potatoes, applesauce or Greek yogurt.
• Eat slowly and take small bites.
• Drink plenty of water with meals, as the moisture makes it easier to swallow food.
• Avoid hard, dry, sticky or coarse foods that could get stuck easily.
• Follow a GERD-friendly diet, which is often high in fiber and alkaline foods and low in acidic foods (such as tomatoes, citrus and coffee).