Esophageal stricture, or narrowing of the esophagus, results in a feeling of difficulty when swallowing. Causes, diagnosis, treatments… We take stock.
What is an esophageal stricture?
Esophageal stricture means narrowing of the esophagus (organ of the digestive system conveying food from the pharynx to the stomach). This phenomenon occurs during various pathologies such as esophageal cancer. This esophageal stricture results in difficulty swallowing (dysphagia) and in certain exceptional cases by hematemesis (discharge of blood from the mouth). Esophageal stricture can also be caused by gastroesophageal reflux which can cause a inflammation of the esophagus (oesophagitis), then a so-called peptic stenosis in connection with the healing phenomena.
What are the symptoms of an esophageal stricture?
The main symptom of a narrowing of the esophagus is difficulty swallowing (discomfort when passing food). It only affects solid foods at first but can get worse to the point that even liquids are difficult to pass. “Other symptoms that may occur are regurgitationthat is to say the rise of food or saliva contents from the esophagus to the mouth, and a weight loss. In all cases, dysphagia represents a warning sign that should lead to consulting a doctor quickly“, indicates Professor Maximilien Barret, gastroenterologist.
What causes an esophageal stricture?
Esophageal stricture may be benign, due to scarring of inflammation of the esophagus (esophagitis) caused by gastroesophageal reflux disease. “Of the inflammation of the esophagus can also cause esophageal stricture, for example following radiation therapy or surgery on the esophagus with a suture that has been made in the esophagus“, specifies the gastroenterologist. The esophageal stenosis can also be malignant, translating in particular esophageal cancer.
Is this a sign of cancer?
Esophageal stricture can be a sign of cancer. “In terms of symptoms, it is not different from other stenoses but the endoscopic appearance is very characteristic“, details the specialist.
In front of a dysphagiait is necessary to eliminate an esophageal stenosis by carrying out a oesogastro-duodenal endoscopy with a gastroenterologist. This examination makes it possible to look for a stenosis and to characterize it. THE biopsies will identify cancer cells.
What is the treatment for esophageal stricture?
Management of esophageal stricture is often endoscopic: the esophagus will be dilated to allow better passage of food. In practice, the gastroenterologist inflates, during a course of a oesogastro-duodenal endoscopy performed under anesthesia, a balloon in the esophagus, to increase its caliber. “If esophageal stricture is due to inflammationdrug treatment concomitant must be proposed, by proton pump inhibitors (PPIs) or topical corticosteroid therapy depending on the cause of the stenosis. This must be continued for life, in addition to local endoscopic treatment., adds the specialist. Esophageal cancer revealed by biopsies will be treated by surgery (esophagectomy), radiotherapy and/or chemotherapy.
Thanks to Pr Maximilien Barret, gastroenterologist at Cochin hospital.