| Esophageal stricture | |
|---|---|
| Other names | Peptic stricture |
 | |
| Endoscopic image of a benign peptic stricture | |
| Specialty | Gastroenterology General surgery |
Abenign esophageal stricture, orpeptic stricture,[1] is a narrowing or tightening of theesophagus that causesswallowing difficulties.
Symptoms of esophageal strictures includeheartburn, bitter or acid taste in the mouth, choking, coughing, shortness of breath, frequent burping or hiccups, pain or trouble swallowing,throwing up blood, or weight loss.[2]
It can be caused by or associated withgastroesophageal reflux disease,[1]esophagitis, a dysfunctionallower esophageal sphincter,disordered motility,lye ingestion, or ahiatal hernia. Strictures can form after esophageal surgery and other treatments such as laser therapy orphotodynamic therapy. While the area heals, a scar forms, causing the tissue to pull and tighten, leading to difficulty in swallowing.[3]
It can be diagnosed with an X-ray while the patient swallows barium (called abarium study of the esophagus), by acomputerized tomography scan, a biopsy,[4] or by anendoscopy.
If it is caused by esophagitis, in turn caused by an underlying infection, it is commonly treated by treating the infection (typically with antibiotics). In order to open the stricture, a surgeon can insert abougie – a weighted tube used to dilate the constricted areas in the esophagus.[3] It can sometimes be treated with other medications. For example, anH2 antagonist (e.g.ranitidine) or aproton-pump inhibitor (e.g.omeprazole) can treat underlying acid reflux disease.[citation needed]
Gastroesophageal reflux disease (GERD) affects approximately 40% of adults. Strictures occur in 7–23% of patients with GERD who are untreated.[5]
Chronic GERD is the most common etiology of benign esophageal strictures, referred to as peptic strictures.