Esophageal Stricture

WHAT YOU SHOULD KNOW:

• Esophageal (e-sofah-JE-al) stricture (STRIK-chur) is a condition where there is a narrowing of the esophagus. The esophagus is the tube that carries food and liquid from the throat to the stomach. With an esophageal stricture, an abnormal change or injury may have caused inflammation (swelling) and damage to the esophagus. When the damaged areas heal, scar tissue forms and make the affected area of the esophagus hard. This narrows the esophagus and causes problems for foods and liquids to pass through. An esophageal stricture may be benign (not cancer) or malignant (cancer). This is based on the presence of abnormal cells in the esophageal stricture.
  
  
• The most common symptom is heartburn, which is a burning pain in the chest. This usually occurs after meals and may spread to your neck, jaw, or shoulder. You may also have pain when swallowing, frequent choking or coughing, vomiting (throwing up), or weight loss. Esophageal stricture is diagnosed by having an endoscopy or barium swallow. Treatment may include medicines, endoscopic therapies, or surgery. With early diagnosis and treatment, symptoms may be relieved and other serious health problems prevented.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Treatment for esophageal stricture carries certain risks. Your esophagus, stomach, blood vessels, or nerves may get injured while having surgery or other treatments. You may have trouble breathing, an infection, or bleeding after surgery. You may also feel bloated (too full) after meals. Even after having surgery or other treatment, scars may form again and cause further narrowing of the esophagus.
  
  
• If left untreated, you may continue to have problems swallowing. You may not be able to get the nutrition needed by your body. There is also an increased risk that food, liquids, or vomit (throw up) may get in your lungs. This may cause choking, infection of the lungs, or trouble breathing. Your chances of treating esophageal stricture are better if you are diagnosed and treated as soon as you have symptoms. Call your caregiver if you are worried or have questions about your condition, care, or medicines.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Soft food diet:

You may be allowed to eat soft foods. Some examples are applesauce, baby food, bananas, cooked cereal, cottage cheese, eggs, gelatin, pudding, and yogurt.

An IV (intravenous)

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may need any of the following:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Other medicines: Your caregiver may give you other medicines to treat the condition that may have caused your esophageal stricture. Anti-reflux medicines help decrease the stomach acid that can irritate your esophagus and stomach. You may also be given medicines to treat scleroderma or cancer.

Tests:

You may have any of the following:

• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Imaging tests: You may be given dye before the pictures are taken for some of these tests. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions. You may have one or more of the following tests:
  
  
  • Barium swallow: This test is an x-ray of your throat and esophagus, the tube connecting your throat to your stomach. This test may also be called a barium esophagram. You will drink a thick liquid called barium. Barium helps your esophagus and stomach show up better on x-rays. Follow the instructions of your caregiver before and after the test.
    
    
  • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
    
    
  • Computerized tomography scan: This test is also called a CT scan. A special x-ray machine uses a computer to take pictures of your esophagus and other organs. The thickness of the stricture may also be measured using a CT scan.
    
    
  • Endoscopy: This test uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. During an endoscopy, caregivers may find problems with how your digestive tract is working. Samples may be taken from your digestive tract and sent to a lab for tests. Small tumors may be removed, and bleeding may be treated during an endoscopy.

Treatment options:

You may have any of the following:

• Surgery: Your caregiver may suggest surgery depending on the type of esophageal stricture that you have.
  
  
  • Anti-reflux surgery: This surgery is done by strengthening the lower muscles of the esophagus to help prevent acid reflux.
    
    
  • Resection or esophagectomy: Your caregiver may remove a part of or the entire esophagus.
  
  
• Other treatments: Ask your caregiver about the following treatment options for esophageal stricture.
  
  
  • Dilatation: A dilator, balloon device, or stent may be placed in your esophagus to dilate (widen) it.
    
    
  • Endoscopic therapies: The esophagus may also be made wider by using any of the following therapies:
    
    
    • Ablation: Esophageal stricture may be treated by using a special gas, such as argon, or thermal (heat) energy.
      
      
    • Cautery: A small metal rod that uses electric current is used to burn away abnormal cells.
      
      
    • Injection therapy: Special chemicals, such as alcohol, may be injected into the esophagus to relieve your symptoms.
      
      
    • Laser or photodynamic therapy: Lasers, in combination with medicines that become active when exposed to light, are used to destroy abnormal cells.

Learn more about Esophageal Stricture (Inpatient Care)