Symptoms
Difficulty swallowing (dysphagia) – feeling like food is getting stuck
Painful swallowing (odynophagia)
Regurgitation of food or saliva
Heartburn
Chest pain
Unexpected weight loss
Frequent choking or coughing
Feeling of food being stuck in the throat
Causes
GERD (Gastroesophageal Reflux Disease): Chronic acid reflux is the most common cause.
Esophagitis: Inflammation of the esophagus caused by infection (e.g., Candida, herpes), allergies (eosinophilic esophagitis), or medications.
Scarring: From surgery, radiation therapy, or injury to the esophagus.
Esophageal cancer: A malignant tumor causing narrowing.
Swallowing caustic substances: Accidental or intentional ingestion of harmful chemicals.
Esophageal webs or rings (Schatzki ring): Thin membranes that partially obstruct the esophagus.
Medicine Used
Proton Pump Inhibitors (PPIs): To reduce stomach acid production (e.g., omeprazole, lansoprazole).
H2 Blockers: To reduce stomach acid production (e.g., ranitidine, famotidine – although some have been recalled).
Steroids: To reduce inflammation, particularly in cases of eosinophilic esophagitis (e.g., swallowed fluticasone).
Pain relievers: To manage discomfort.
Antibiotics/Antifungals: If infection is the cause of esophagitis.
Muscle relaxants: to help relax the esophagus.
Note: Medical treatments are often adjunct to procedures like esophageal dilation.
Is Communicable
No, esophageal strictures are not communicable or contagious. They are not caused by infectious agents that can be spread from person to person.
Precautions
Manage GERD: Follow dietary and lifestyle recommendations to minimize acid reflux.
Avoid caustic substances: Keep household chemicals out of reach of children and handle them with care.
Chew food thoroughly: This helps prevent large pieces of food from getting stuck.
Eat slowly: Take your time during meals.
Stay upright after eating: Avoid lying down for at least 2-3 hours after meals.
Follow-up with your doctor: Regular check-ups are important, especially if you have a history of GERD or other risk factors.
Medication Adherence: Take medications as prescribed for underlying conditions.
Avoid smoking and alcohol: Both can worsen GERD and esophageal inflammation.
How long does an outbreak last?
Esophageal strictures do not have "outbreaks" in the traditional sense of an infectious disease. The duration of symptoms and the overall "course" of the condition depend on the underlying cause and the effectiveness of treatment. Without treatment or with ongoing causative factors (like uncontrolled GERD), the stricture can persist and worsen over months or years. With effective treatment (dilation, acid suppression), symptoms can be significantly improved or resolved.
How is it diagnosed?
Upper Endoscopy: A thin, flexible tube with a camera is inserted into the esophagus to visualize the lining and identify any narrowing or abnormalities. Biopsies can be taken.
Barium Swallow (Esophagram): The patient drinks a barium solution, which coats the esophagus, and X-rays are taken to visualize the shape and function of the esophagus.
Esophageal Manometry: Measures the pressure and muscle contractions of the esophagus to assess its function. (Less common for stricture diagnosis, but helpful to rule out motility disorders).
Timeline of Symptoms
The timeline of symptoms can vary widely.
Gradual Onset: Symptoms may develop slowly over weeks, months, or even years, especially with GERD-related strictures. Initially, only certain foods (e.g., meat, bread) may cause difficulty swallowing.
Progressive Worsening: As the stricture narrows, the difficulty swallowing may progress to softer foods and eventually liquids.
Sudden Onset: In some cases, symptoms may appear more suddenly, such as after swallowing a caustic substance or if a bolus of food becomes impacted in a pre-existing, but previously unnoticed, stricture.
Important Considerations
Ruling out malignancy: It is crucial to determine whether a stricture is benign or malignant. Biopsies taken during endoscopy are essential for this.
Long-term management: Strictures often require ongoing management to prevent recurrence. This may include medications, lifestyle changes, and periodic esophageal dilations.
Nutritional support: Severe dysphagia can lead to malnutrition and dehydration. Addressing nutritional needs with dietary modifications or, in some cases, feeding tubes may be necessary.
Aspiration pneumonia: Difficulty swallowing increases the risk of aspiration (food or liquid entering the lungs), which can lead to pneumonia.
Patient education: Understanding the underlying cause, treatment options, and preventive measures is crucial for effective management.