Conditions

Oesophageal strictures (narrowing of the oesophagus)

Medical conditions, such as chronic acid reflux, can result in other health issues. This is due to the damage inflicted on the lining of the oesophagus by stomach acid over time, as well as the rise of stomach acid and bile up the food pipe.

Medical conditions such as chronic acid reflux, where stomach acid and bile frequently rise up into the food pipe (oesophagus), can lead to other health issues. Over time, stomach acid can damage the inner lining of the oesophagus, causing inflammation that may lead to scarring.

Repeated inflammation of the tissue can lead to a continuous process of healing followed by chronic inflammation and re-healing, ultimately resulting in scarring. If scar tissue accumulates, the oesophagus may develop narrow areas known as strictures. These strictures cause dysphagia, making it difficult to swallow food and, in severe cases, liquids, which can lead to dehydration and weight loss.

Oesophageal strictures are likely to occur in around 10% of patients with gastro-oesophageal reflux disease (GORD), where the symptoms of narrowness in the oesophagus are combined with symptoms of GORD such as heartburn, vomiting, sore throat or a cough. Strictures may also occur in the oesophagus due to viral or bacterial infections, certain medications, the ingestion of corrosive substances or as a result of diseases such as eosinophilic oesophagitis (EoE) and cancer.

Diagnosis of oesophageal strictures may involve swallowing barium while an x-ray is taken of the chest to observe any strictures, or an endoscopy examination where a narrow tube (endoscope) containing a light and a camera is inserted into the oesophagus so that doctors can see inside the food pipe.

The most common treatment for oesophageal strictures is endoscopic dilation, where an endoscope is used to move a tiny balloon or another dilation device into the oesophagus to gently stretch it. Proton pump inhibitors (PPIs) may also be prescribed. However, strictures can still return after a year or so, even with treatment, and multiple dilation sessions may be necessary. In severe cases, surgery may be recommended.

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