Esophageal stenosis: causes, symptoms and effective treatments

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Are you constantly struggling to swallow food or liquids? It could be a symptom of esophageal stenosis. In this article, we will explore the causes, symptoms, and effective treatments for this condition.

Esophageal stenosis is characterized by narrowing in the esophagus, impairing the proper passage of food and liquids to the stomach. Keep reading and deepen your understanding of this problem and learn about the medical approaches that provide relief and better quality of life to affected patients.

The esophagus and its function

The esophagus is a muscular tube that plays a very important role in the digestion process and in conducting food from inside the mouth to the stomach.

Its primary function is to allow the efficient transport of chewed and liquefied food, along with saliva, through rhythmic contractions known as peristaltic movements.

This peristaltic action is responsible for propelling the food towards the stomach, even when the person is upside down.

However, this organ not only transports food but also participates in the initial phase of digestion.

The production of mucus in this structure lubricates the food bolus, making its displacement easier.

What causes esophageal stenosis?

This condition can be caused by a series of factors, with diverse origins and varying in severity. Below, see in more detail some of the most common causes of this narrowing of the esophagus.

Chronic Gastroesophageal Reflux (GERD)

Chronic acid reflux is one of the main causes of esophageal stenosis.

In this scenario, gastric acid flows back into the esophagus frequently, leading to irritation of the organ’s inner lining.

Over time, this irritation can cause inflammation and scarring, leading to narrowing of the organ.

Ingestion of caustic substances

The accidental or intentional ingestion of caustic chemicals, such as strong acids or caustic soda, can cause serious damage to the esophagus.

These substances corrode the inner lining of the organ and can lead to the formation of scars that result in stenosis.

Eosinophilic Esophagitis

This is a chronic inflammatory condition that involves an accumulation of immune system cells known as eosinophils in the esophageal lining.

Chronic inflammation can result in the formation of scars and, consequently, in a narrowing of the esophagus.

Ingesting foreign bodies

Swallowing foreign objects, such as fish bones, small parts of toys, or other solid objects, can cause injuries, which can lead to the formation of scars and stenosis.

Previous medical procedures or surgeries

Some medical procedures, especially surgeries on the esophagus or very close to it, can cause scarring and narrowing of the organ as a result of surgical interventions.

Autoimmune diseases

Autoimmune conditions, such as lupus or systemic sclerosis, can affect the health of the esophagus, causing chronic inflammation that, over time, can lead to the formation of scars and stenosis in the region.

Tumors

Tumors can also cause stenosis, as they grow and obstruct the passage (lumen) of the organ. The main causes of esophageal tumors are the ingestion of alcoholic beverages and smoking, and consequently changes in the lining of the esophagus, caused by chronic acid reflux.

Idiopathic causes

In some cases, the cause of esophageal stenosis may remain unknown, being classified as idiopathic, which means that there is no identifiable cause, which can be a challenge in medical diagnosis and treatment.

It is important to note that the causes of esophageal stenosis can vary in severity and if someone suspects the condition, medical consultation and follow-up are necessary.

Symptoms of esophageal stenosis

The symptoms of esophageal stenosis can be varied and significantly impact the quality of life of the affected individual.

This condition, characterized by abnormal narrowing of the esophagus, can manifest itself in various ways, and it is important to recognize them for proper diagnosis and treatment.

One of the most common symptoms is dysphagia, which is difficulty in swallowing solid and liquid foods. Dysphagia can range from mild to severe, and the sensation that food gets stuck in the esophagus is frequent.

In addition, many people who suffer from the problem may report pain or discomfort when swallowing, especially when ingesting solid foods. This is because the narrowed esophagus can cause friction and irritation during the swallowing movement.

Regurgitation is also a common symptom, where the ingested food may return to the mouth after the meal, causing discomfort and sometimes coughing or even choking.

Other possible symptoms include heartburn due to associated gastroesophageal reflux, unintentional weight loss due to difficulty eating normally, and in severe cases, recurrent vomiting.

It is essential to observe how these symptoms present themselves and know that they can vary from person to person, depending on the underlying cause and the degree of narrowing.

Regardless of the symptoms, esophageal stenosis requires medical evaluation to determine the cause and alleviate the symptoms correctly and effectively.

Diagnosis and medical exams for esophageal stenosis

The diagnosis of esophageal stenosis requires a broad medical evaluation, which usually begins with a thorough review of the patient’s symptoms and medical history.

To confirm the presence of the condition and determine its causes, several medical exams may be necessary.

One of the most common exams is the upper digestive endoscopy, in which a flexible tube with a camera at the tip is inserted through the patient’s mouth to examine the inside of the esophagus and identify possible narrowings, inflammations, or other abnormalities.

In addition, esophageal manometry can be performed to assess the muscular function of the esophagus and the pressure in different parts of the organ.

Imaging exams, such as contrasted radiographs or computed tomography, are also normally used to obtain additional information about the anatomy of the esophagus.

Accurate diagnosis is essential to determine the most appropriate treatment to relieve symptoms and improve the patient’s quality of life.

Treatments for esophageal stenosis

Some of the most common treatment options include:

Esophageal dilation

This is a procedure often used to treat the condition and involves the use of a balloon or a thin tube (probe) to gently widen the narrowed area of the esophagus.

Dilation is performed during an upper digestive endoscopy and can be repeated, if necessary, to keep the organ open.

Medications

Depending on the cause of the stenosis, medications may be prescribed to treat underlying conditions.

For example, medications to reduce acid reflux, such as proton pump inhibitors, can be used to control chronic gastroesophageal reflux.

Surgical treatment

In severe cases or when other treatments are not effective, surgery may be necessary.

There are different surgical procedures that can be performed, such as the removal of scar tissue or the lengthening of the esophagus.

The appropriate treatment depends on the specific cause of the stenosis and should be determined by a doctor after a complete evaluation of the patient.

Dietary recommendations for esophageal stenosis

Dietary recommendations aim to facilitate the passage of food through the narrowed esophagus, minimizing discomfort during feeding.

Here are some general guidelines:

Food texture

Opt for foods with soft and consistent textures, including well-cooked foods, purees, creamy soups, porridges, and processed foods, such as natural yogurt.

If possible, cut the food into small pieces to facilitate swallowing. Avoid large or hard foods that can get stuck in the esophagus.

Chew well

Even with softer foods, chew them carefully to facilitate the digestion process and minimize the risk of blockages.

Liquid foods

Drinks, such as water, juices, and milk, may be easier to swallow than solid foods.

Drink slowly to avoid choking.

Avoid dry foods

Avoid dry foods, such as cookies or toast, which can be difficult to swallow without an adequate amount of liquid.

Smaller and more frequent meals

Have smaller and more frequent meals throughout the day, instead of large meals. This helps to reduce pressure on the esophagus and facilitates digestion.

Avoid eating before bed

Avoid eating at least 2-3 hours before lying down. This helps to reduce the risk of acid reflux during sleep.

Moderately seasoned foods

Avoid excessively spicy, acidic, or seasoned foods, as they can aggravate discomfort in the esophagus.

Complications and long-term effects of untreated esophageal stenosis

Untreated stenosis can result in complications and long-term effects that adversely impact the health and well-being of the affected person.

Among these consequences, malnutrition and involuntary weight loss stand out, resulting from the difficulty in ingesting food due to the narrowing of the esophagus.

Dehydration is another concern, as inadequate intake of liquids can lead to broader health problems.

Pulmonary aspiration is a significant risk, as food or liquids can inadvertently enter the respiratory tract during swallowing, increasing susceptibility to lung infections, such as aspiration pneumonia.

Besides, it can result in progressive damage to the esophagus itself, including ulcers, erosions, and chronic inflammation.

Other serious complications include chronic respiratory problems, such as asthma or bronchitis, due to the continuous irritation of the airways by gastroesophageal reflux.

Quality of life is significantly impaired due to the constant difficulty of feeding and ingesting liquids, causing physical and emotional discomfort.

Therefore, it is always advisable to seek medical evaluation and appropriate treatment at the first sign, in order to avoid these complications and improve quality of life.

Esophageal stenosis can be triggered by various causes and frequent symptoms include various difficulties, causing a narrowing in the esophagus.

Effective treatment depends on the severity of the cause and can involve various methods. Therefore, it is always essential to seek medical guidance for accurate diagnosis and an appropriate treatment plan.

Image by Drazen Zigic on Freepik