Narrowing of the Esophagus

The esophagus links the throat to the stomach. Reflux of stomach acid, unwillingly swallowed chemicals, and other irritants may cause damage to the esophageal lining, producing signs of inflammation and the development of scar tissue. This may progressively lead to a narrowing esophagus, stopping food and fluids from getting into stomach.

Causes and Treatments of Narrowing of the Esophagus

If you are wondering why esophagus knowing happens and how to deal with it, here are the great answers for you.

1. Heartburn and GERD

Heartburn gives you a burning pain in the chest, which is just behind the breastbone and worsens when you try to bending over or lying down. Occasional heartburn is common and nothing to worry, but if it happens frequently and interferes with your daily life, then you are suffering from GERD or gastroesophageal reflux disease.

Symptoms may include:

  • Burning pain in the chest, just behind the breastbone, which worsens when you try to bending over or lying down and may radiate to the throat.
  • Swallow difficulty, dry cough, sore throat and even have sensation of having a lump in throat.

Treatments should include:

Heartburn and GERD, if left untreated, could damage and scar the esophageal lining, leading to narrowing of the esophagus.

  • Take OTC medications like antacids, H2RAs, proton pump inhibitors to reduce or prevent the excessive production of stomach acid.
  • You can also turn to a doctor for prescription medications like strength H-2-receptor blockers, strength proton pump inhibitors or baclofen to decrease the frequency of gastroesophageal reflux.
  • If your GERD is severe, surgery may be needed to reinforce or strengthen the lower esophageal sphincter.

2. Benign Esophageal Stricture

Benign esophageal stricture is defined as narrowing or contraction of the esophagus. Benign means that it is localized and has not spread into distant areas.

Causes: Benign esophageal stricture characteristically occurs when stomach acid refluxes and causes deterioration of the lining of the esophagus over a period of time. This can possibly lead to inflammation and scar tissue formation which will ultimately lead to narrowing of the esophagus.

Symptoms of benign esophageal stricture

It may include pain and difficulty on swallowing, heartburn, weight loss and regurgitation of food or liquids.

Treatment:

  • A diet of liquids or soft foods until solid foods can be swallowed without trouble.
  • Mechanical dilatation of the esophagus via an endoscope with a small balloon attached to the end of it, via a dilator which is a long thin tube, or via inserting an esophageal stent to open the blocked esophagus.
  • Proton pump inhibitors, a group of anti-blocking drugs, are the most effective medication to prevent recurrence of GERD. Other medications like antacids, sucralfate or antihistamines will also be used.
  • In severe cases, a surgery will be used to repair your blocked esophagus. In non-functioning esophagus cases, the affected segment of the esophagus may be removed and replaced with a portion of the large intestine.
  • In a few cases patients unfit for surgery may have a feeding tube inserted via stricture.

3. Esophagitis

Esophagitis is inflammation of the esophagus that may impair tissues of the esophagus. As the disorder progresses, the inflammation may lead to fibrosis and stricture.

Common signs and symptoms of esophagitis include:

  • Painful, difficult swallowing
  • Chest pain
  • Food impaction in the esophagus
  • Acid regurgitation
  • Heartburn

Treatment for Esophagitis may include:

  • Take medication. Choose antibiotics, corticosteroids, pain medications, antacids, drugs that reduce or block acid production like H-2-receptor blockers and proton pump inhibitors, etc. Do ask for your doctor's advice before taking any medication.
  • Change diet habits. Eat frequent small meals. Do not eat 2-3 hours before going to bed. Avoid GERD-causing foods like chocolate, mint, alcohol, spicy foods, etc.
  • Surgery is used if there is a tear in the esophagus or if there is something blocking the esophagus like a tumor.

4. Dysphagia

This condition means you have difficulty in swallowing which consumes a lot more effort and time to move solid or liquid from your mouth to the stomach. It can be caused by many achalasia, esophageal stricture, diffuse spasm, esophageal tumors, esophageal ring, etc. Many of them cause narrowing of the esophagus and makes swallow difficult.

Signs and symptoms associated with dysphagia may include:

  • Unable to swallow
  • Pain while swallowing
  • Drooling
  • Hoarseness
  • Regurgitation of food and acid
  • Heartburn
  • Weight loss
  • Coughing or gagging on swallowing

Treatment approaches for esophageal dysphagia may include:

  • Try esophageal dilation with an endoscope with a special balloon attached to expand your esophagus, or use a tube to give your esophagus a stretch.
  • Use surgery to remove a tumor, pharyngeal diverticula or other things that block the esophagus.
  • Take medications. Difficulty swallowing associated with GERD can be treated with oral medications to decrease stomach acid.

5. Esophageal Cancer

Esophageal cancer is defined as the disease where cells that line the esophagus change, mutate and become malignant cells. These cells multiply uncontrollably and form a tumor causing narrowing of the esophagus. There are two main types of esophageal cancer:

  • Squamous cell carcinoma affects the middle third of the esophageal tube;
  • Adenocarcinoma of the esophagus affects the lower third part of the esophageal tube.

Symptoms of esophageal cancer may include:

  • The first sign to manifest is usually dysphagia. Initially there may be difficulty swallowing solid foods followed by liquids.
  • Patients with esophageal cancer also can present with weight loss and hoarseness of voice.

Treatment:

  • Chemotherapy and radiation therapy may be recommended and done prior to surgery to help reduce the size of the tumor.
  • Endoscopy: If the esophageal cancer is restricted within the walls of the esophagus and has not metastasized to other areas in the body, doctors may use endoscopic procedure to surgically remove the tumor.
  • Surgery: For stage II or III cancer, esophagectomy is usually recommended and can be done to remove the affected segment of esophagus.

6. Other Causes for Narrowing of the Esophagus

  • Skin disorders like pemphigus vulgaris
  • AIDS-related diseases
  • Crohn's disease and other intestinal disorders
  • Trauma to head or neck
  • Foreign bodies getting lodged in esophagus
  • Autoimmune syndromes like SLE (systemic lupus erythematosus)
  • Scarring following surgical procedures like esophageal resection, after radiotherapy or nasogastric intubation (long term)
 
 
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