Definition

Benign esophageal stricture is a narrowing of the esophagus (the tube from the mouth to the stomach). It causes swallowing difficulties.

Benign means that it is not caused by cancer of the esophagus.

Causes

Esophageal stricture can be caused by:

• Gastroesophageal reflux disease (GERD).
• Eosinophilic esophagitis.
• Injuries caused by an endoscope.
• Long-term use of a nasogastric (NG) tube (tube through the nose into the stomach).
• Swallowing substances that harm the lining of the esophagus. These may include household cleaners, lye, disc batteries, or battery acid.
• Treatment of esophageal varices.

Symptoms

Symptoms may include:

• Trouble swallowing
• Pain with swallowing
• Unintentional weight loss
• Regurgitation of food

Exams and Tests

You may need the following tests:

• Barium swallow to look for narrowing of the esophagus
• Endoscopy (EGD or esophagogastroduodenoscopy) to look for narrowing of the esophagus

Treatment

Dilation (stretching) of the esophagus using a thin cylinder or balloon that is inserted through an endoscope is the main treatment for acid reflux-related strictures. You may need to have this treatment repeated after a period of time to prevent the stricture from narrowing again.

Proton pump inhibitors (acid-blocking medicines) can keep an acid reflux-related stricture from returning. Surgery is rarely needed.

If you have eosinophilic esophagitis, you may need to take medicines or make changes to your diet to reduce the inflammation. In some cases, dilation is done.

Outlook (Prognosis)

The stricture may come back in the future. This may require a repeat dilation.

Possible Complications

Swallowing problems may keep you from getting enough fluids and nutrients. Solid food, especially meat, can get stuck above the stricture. If this happens, endoscopy would be needed to remove the lodged food.

There is also a higher risk of having food, fluid, or vomit enter the lungs with regurgitation. This can cause choking or aspiration pneumonia.

When to Contact a Medical Professional

Contact your health care provider if you have swallowing problems that do not go away.

Prevention

Use safety measures to avoid swallowing substances that can harm your esophagus. Keep dangerous chemicals out of the reach of children. See your provider if you have GERD.

References

Rej A, Chew TS, Sanders DS. Gastroenterology. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 21.

Rajala MW, Kochman ML. Benign esophageal strictures. In: Chandrasekhara V, Elmunzer J, Khashab MA, Muthusamy VR, eds. Clinical Gastrointestinal Endoscopy. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 21.

Richter JE, Vaezi MF. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 46.