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Esophageal Stricture
(narrowing)
  Esophageal Stricture
 Signs, symptoms, indicators
 Contributing risk factors
 


Esophageal stricture, also called benign stricture of the esophagus, is a narrowing of the esophagus, causing swallowing difficulties. Incidence; Causes & Development; Risk Factors


The overall incidence is about 1 in 500 people.

Causes include:
  • Reflux esophagitis (which causes constant irritation from gastric secretions)
  • Prolonged use of a nasogastric tube
  • Ingestion of corrosive substances
  • Viral or bacterial infections
  • Treatment of esophageal varices
  • Injuries caused by endoscopes.
Risk factors are related to the causes.

Diagnosis & Tests
Diagnosis involves using a barium swallow and/or endoscopy to show narrowing of the esophagus.

Treatment & Prevention
Dilation of the esophagus is the preferred treatment. Repeated dilation may be necessary to prevent the recurrence of the narrowing. If dilation is unsuccessful, surgical replacement of the esophagus with a segment of the stomach or large intestine may be attempted.

Prognosis; Complications
Recurrence of the stricture is possible.

Swallowing difficulties may lead to inadequate intake of fluids and nutrients. There is also an increased risk (with regurgitation) of having food, fluid, or vomitus enter the lungs and cause aspiration pneumonia.





Signs, symptoms & indicators of Esophageal Stricture (narrowing):
Symptoms - Gas-Int - General  Difficulty swallowing
 Difficulty swallowing, pain with swallowing, weight loss and regurgitation of food are the main symptoms.

Symptoms - Metabolic

  Very great/moderate/major unexplained weight loss

Risk factors for Esophageal Stricture (narrowing):
Digestion  Gastric/Peptic/Duodenal Ulcers
 A chronic ulcer causes swelling and inflammation of the gastric and duodenal tissues. Over time, scarring may close the pylorus, the lower end of the esophagus, thus preventing the passage of food and causing vomiting and weight loss.


KEY
Weak or unproven link
Strong or generally accepted link


GLOSSARY

Aspiration
Inhalation, or removal of fluids or gases from a cavity using suction.

Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous; they tend to grow slowly and don't spread (metastasize) like cancer tumors do.

Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.

Duodenum (Duodenal)
First portion of the small intestine between the pylorus and jejunum, connecting to the stomach.

Endoscopy
A procedure that uses an Endoscope: Examination with a flexible viewing tube.

Esophagus (Esophageal)
Commonly called the "food pipe", it is a narrow muscular tube, about nine and a half inches long, that begins below the tongue and ends at the stomach. It consists of an outer layer of fibrous tissue, a middle layer containing smoother muscle, and an inner membrane, which contains numerous tiny glands. It has muscular sphincters at both its upper and lower ends. The upper sphincter relaxes to allow passage of swallowed food that is then propelled down the esophagus into the stomach by the wave-like peristaltic contractions of the esophageal muscles. There is no protective mucosal layer, so problems can arise when digestive acids reflux into the esophagus from the stomach.

Gastric
Of, relating to, or associated with the stomach.

Lung (Lungs, Pulmonary)
Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.

Pneumonia (Pneumonitis)
Inflammation, usually infectious, of the lungs. Unless the result of only moderate chemical or smoke irritation, it is a potentially life-threatening condition. There are so many defenses against an infection this deep in the body that the very presence of pneumonia signals a pathogen of great virulence or impaired or exhausted immunity, or all three. Pneumonitis: Inflammation of the lungs, from whatever cause. It may be concurrent with pneumonia or pleurisy.

Pylorus
The sphincter muscle at the distal (lower) opening of the stomach. The pylorus only allows food to pass through after the digestive enzymes of the stomach have properly processed it. Once through the pylorus on its way to the duodenum, the food is still only partially digested.

Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

Stricture
An abnormal narrowing of a bodily passage caused by, for example, scar tissue.

Ulcer (Ulceration, Ulcers)
Lesion on the skin or mucous membrane.




Last updated: Sep 28, 2008


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