Treatment of Esophageal Stenosis

About the disease

Esophageal Stenosis is a condition when esophagus becomes too narrow and tight. The esophagus is a tube, which is carrying the food and liquids to the stomach. Stenosis of the esophagus ranges from a mild form, when a person has troubles swallowing and chokes often, to a severe form, when food gets obstructed in the esophagus and can not reach stomach. Such condition is in most cases caused by stomach acids, which irritate the esophageal walls making them shrink. Tissues of the esophagus in this case become scarred. Most often stomach acids are caused by gastroesophageal reflux disease, which creates acid reflux. This disease accounts for 70% of all cases of such stenosis. Reflux disease attacks approximately 40% of adults in the matter of their lifetime, but it will not certainly result in stenosis. Narrowing can also be caused by enlarged veins in the esophagus and radiation therapy. Stenosis of the esophagus is benign, meaning that it is not a cancer, although these two diseases can have similar symptoms, that`s why a person needs to get proper diagnosis.

Symptoms 

• Pain during swallowing liquids
• Difficulty eating
• Weight loss
• Heartburn
• Burping
• Dehydration
• Choking
• Difficulty breathing
• Vomiting

If not treated on time, stenosis of the esophagus can result in inflammation of the lungs and pulmonary aspiration.

Diagnosis

• Swallow barium test is the most common diagnostic measure for this type of disease as it shows the image of the esophagus lining. Patient drinks special non-toxic drink, that coats the lining of esophagus and allows the doctor to create a series of X-Ray images. The extent of the narrowing is then determined.
• Endoscopy is used to examine the esophagus through a thin tube equipped with camera. It also allows the doctors to remove the tissue of esophagus and see if there are malignant cells or what was the reason for narrowing. 

Treatment

• Endoscope stretching is a procedure during which an esophagus is dilated. It is usually performed under the local anesthesia. Doctor inserts an endoscope equipped with a balloon at the end. This balloon stretches the esophagus.  
• Implantation of stents can keep the esophagus open to a normal extent permanently. Stents can be metal, plastic or made from a mesh material. They are also usually implanted during endoscopy and under local anesthesia.

After surgery, you will be able to eat and drink normally. You will also be prescribed certain medications to speed up your recovery and help esophagus heal faster. You will have to follow strict dietary restrictions for at least first months after the surgery. 

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed