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> Disorders > Disease or Syndrome > Esophageal Stricture

Esophageal Stricture

Esophageal Stricture refers to a narrowing or constriction of the esophagus, the muscular tube that connects the throat to the stomach.
This condition can be caused by various factors, such as acid reflux, radiation therapy, or the presence of scar tissue.
Esophageal strictures can make it difficult to swallow food and may lead to symptoms like dysphagia, chest pain, and weight loss.
Early detection and appropriate treatment, such as dilation or stent placement, are crucial to managing this condition and improving the patient's quality of life.
This MeSH term provides a comprehensive overview of the key aspects of Esophageal Stricture, including its causes, symptoms, and management options.

Most cited protocols related to «Esophageal Stricture»

1
Preoperative Hand Grip Strength and Outcomes
From January 1st, 2007 to December 31th, 2008, there were 68 patients included in the study. This is a prospective study. The study was approved by the institution review board of Mackay Memorial Hospital. 7 patients were excluded due to loss of follow-up, could not adequately perform the tests due to stroke or due to incomplete data, Patients with other cancer history were also excluded. There were 61 patients have complete records for analysis. Patients were tested at least 3 times several days prior to operation. Low hand-grip strength here was defined as grip strength lower than 25 kg in the dominant hand. Other laboratory data, history of other co-morbidities and risk factors were also recorded for risk analysis. The standard position for testing hand-grip strength is standing position with upper limb relaxed down to the sides of the body and palm towards the torso. The elbow is extended without any flexion. The handedness is also recorded for comparison. Co-morbidities included diabetes, poor renal function, hypertension, ischemic heart disease, liver cirrhosis or other disease considered to have great influence on patients' outcome. Complications included postoperative acute respiratory failure, anastomotic leakage, wound infection, early esophageal stricture requiring endoscopic dilatation, and pleural effusion requiring tube drainage. Surgical mortality was defined as either patients died within 30 days after operation or in-hospital death without discharge. Mortality was defined to any patients died less than 6 months after operation during follow-up. Pathology stage was based on resected specimens. Early stage was defined as patients having stage 1 and stage 2. Advanced stage was defined as patients having stage 3 and 4. All patients included were followed for at least 6 months in the outpatient department.
SPSS (version 13.0) was used to help analyze the correlation of each risk factors with morbidity, mortality and hospital stay. Chi square test, Student t-test and Pearson correlation test were used to compare the influences of each factor. Receiver operating curve analysis was used to determine the most appropriate cut-off value of the tests. Regression analysis was used to evaluate the influence of each factor on outcome.
Chen C.H., H.o.-.C.h.a.n.g., Huang Y.Z, & Hung T.T. (2011). Hand-grip strength is a simple and effective outcome predictor in esophageal cancer following esophagectomy with reconstruction: a prospective study. Journal of Cardiothoracic Surgery, 6, 98.
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Publication 2011
Anastomotic Leak Arecaceae Cerebrovascular Accident Diabetes Mellitus Dilatation Drainage Elbow Endoscopy Esophageal Stricture Ethics Committees, Research High Blood Pressures Human Body Kidney Liver Cirrhosis Malignant Neoplasms Myocardial Ischemia Outpatients Patient Discharge Patients Pleural Effusion Respiratory Failure Student Surgery, Day Torso Upper Extremity Wound Infection
2
High-Resolution Manometry in Dysphagic Patients
HRIM studies were carried out in 18 control subjects, but owing to technical failures, data were available in only 16 (7 males, mean age 33 years, range 20–50). High-resolution manometry (HRM) studies were carried out in 75 asymptomatic subjects (40 males, mean age 27 years, range 19–48 years). Volunteers were recruited by advertisement or word of mouth and had no history of gastro-intestinal symptoms or surgery. The study protocol was approved by the Northwestern University Institutional Review Board and informed consent was obtained from each subject. Dysphagic patients were selected from a consecutive series of 2,000 patients after excluding individuals with major motility disorders by the Chicago Classification criteria (11 (link)) (achalasia, absent peristalsis, diffuse esophageal spasm, spastic nutcracker, functional obstruction defined by an elevated integrated relaxation pressure (IRP) with some preserved peristalsis), hiatus hernia (≥2 cm separation between the lower esophageal sphincter and crural diaphragm), esophageal stricture, or eosino philic esophagitis (endoscopic or histopathological evidence). In all, 113 patients (37 males, mean age 46 years, range 21–76) met these criteria of unexplained dysphagia.
Manometric studies were carried out with the patients in supine position after at least a 6-h fast. Both the HRIM and HRM catheters were 4.2 mm outer diameter solid-state assemblies with 36 circumferential sensors at 1-cm intervals (Sierra Scientific Instruments, Los Angeles, CA). The HRIM catheter also incorporated 18 impedance segments at 2-cm intervals. Transducers were calibrated at 0 and 300 mm Hg using externally applied pressure. The manometry assemblies were placed transnasally and positioned to record from the hypopharynx to the stomach with about three intragastric sensors. The manometric protocol included a 5-min baseline recording and ten 5-ml swallows. The study protocol for all HRM and HRIM studies was identical with the caveat that saline, not water, was used for test swallows in HRIM studies.
Roman S., Lin Z., Kwiatek M.A., Pandolfino J.E, & Kahrilas P.J. (2010). Weak Peristalsis in Esophageal Pressure Topography: Classification and Association With Dysphagia. The American journal of gastroenterology, 106(2), 349-356.
Publication 2010
Catheters Deglutition Disorders Endoscopy Esophageal Achalasia Esophageal Stricture Esophagitis Ethics Committees, Research Gastroesophageal Sphincters Hiatal Hernia Hypopharynx Intestines Leg Males Manometry MM 36 Motor Disorders Operative Surgical Procedures Oral Cavity Outpatients Patients Peristalsis Pressure Respiratory Diaphragm Saline Solution Spasm, Esophageal Spastic Stomach Swallows Transducers Voluntary Workers
3
Esophageal Motility Evaluation Protocol
Adult patients (age 18–89) presenting to the Esophageal Center of Northwestern for evaluation of esophageal symptoms between November 2012 and December 2019 who completed FLIP during upper endoscopy and HRM were prospectively evaluated and data maintained in an esophageal motility registry. Consecutive patients evaluated for primary esophageal motility disorders that completed FLIP during sedated endoscopy and a corresponding HRM were included. FLIP was commonly included with the endoscopic evaluation when patients were also being considered for manometry, thus as part of a comprehensive esophageal motility evaluation and/or when there was suspicion for an esophageal motility disorder. Additional clinical evaluation with timed barium esophagram (TBE) was obtained at the discretion of the primary treating gastroenterologist. No endoscopic or surgical treatment transpired between FLIP, HRM, or TBE. Patients with technically limited FLIP or HRM studies were excluded. Patients with previous foregut surgery (including previous pneumatic dilation) or esophageal mechanical obstructions including esophageal stricture, eosinophilic esophagitis, severe reflux esophagitis (Los Angeles-classification C or D), hiatal hernia > 3cm were excluded as these are potential causes of secondary esophageal motor abnormalities (Figure S1). Patients with inconclusive esophageal motility diagnoses based on HRM +/− TBE per CCv4.0 (Table S1) were excluded from the primary analysis (but are described separately) due to the associated clinical uncertainty that limited objective comparison with FLIP Panometry, as were patients with known systemic sclerosis.
Additionally, a cohort of healthy, asymptomatic adult volunteers (“controls”) were included. Informed consent was obtained for subject participation; control subjects were paid for their participation. The study protocol was approved by the Northwestern University Institutional Review Board. This cohort of patients and controls has been previously described.13 , 14
Carlson D.A., Gyawali C.P., Khan A., Yadlapati R., Chen J., Chokshi R.V., Clarke J.O., Garza J.M., Jain A.S., Katz P., Konda V., Lynch K., Schnoll-Sussman F.H., Spechler S.J., Vela M.F., Prescott J.E., Baumann A.J., Donnan E.N., Kou W., Kahrilas P.J, & Pandolfino J.E. (2021). Classifying esophageal motility by FLIP Panometry: A study of 722 subjects with manometry. The American journal of gastroenterology, 116(12), 2357-2366.
Publication 2021
Adult Barium Congenital Abnormality Diagnosis Endoscopy Endoscopy, Gastrointestinal Eosinophilic Esophagitis Esophageal Stricture Ethics Committees, Research Gastroenterologist Healthy Volunteers Hiatal Hernia Manometry Motility, Cell Motility Disorders, Esophageal Operative Surgical Procedures Pathological Dilatation Patients Peptic Esophagitis Symptom Evaluation Systemic Scleroderma
4
Pediatric Esophageal Eosinophilia and Inflammatory Markers
Subjects between the ages of 7 and 20 years who were undergoing an endoscopy with biopsy at either the Children's Hospital Colorado, Aurora, Colorado, USA or Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA to determine the causes of abdominal pain, vomiting, growth failure, dysphagia or histological efficacy of EoE treatment were enrolled in this study. Exclusion criteria included a history of oesophageal stenosis (stricture or narrowing), gelatin allergy or other causes that put subjects at increased risk (bleeding diatheses, connective tissue diseases) of endoscopic complications. Histories were taken to record symptoms, allergic history, family history and medications. Review of endoscopic and pathology records were performed to assure diagnostic accuracy and determine clinical features.
Subject diagnoses were assigned according to the following criteria based on published consensus recommendations:1 (link)
2 (link) (1) EoE-active: children with symptoms of oesophageal dysfunction and oesophageal eosinophilia >15 eosinophils/HPF, in whom other causes of symptoms and oesophageal eosinophilia were ruled out; (2) EoE-remission: children with EoE as defined above who had undergone at least 8 weeks of treatment (topical steroids or dietary elimination) and who, at the time of their endoscopy, were asymptomatic; (3) GORD: children with symptoms of vomiting or heartburn who had responded to proton pump inhibitor treatment and/or had an abnormal pH impedance monitor of the distal oesophagus. Subjects were on proton pump treatment at the time of the endoscopy; and (4) Normal: children with symptoms that lead to endoscopic testing who were found to have histologically normal oesophageal, gastric and duodenal mucosae.
The night before endoscopic procedures, subjects swallowed the Enterotest (online supplementary figure S1). Subjects could drink liquids until 3 h before their endoscopic procedure. If families or subjects desired, the subject was admitted to the Research Center (Clinical and Translational Research Center) at the Children's Hospital Colorado or Ann and Robert H Lurie Children's Hospital of Chicago the night before the procedure.
The day after swallowing the Enterotests, subjects had upper endoscopy performed. After anaesthesia was administered, the Enterotest was removed, adherent secretions were eluted from the proximal oesophageal section of the Enterotest and the sample was immediately frozen for later batch analysis of the ESGPs and CLC/Gal-10. The oesophageal string location was determined as noted below (online supplementary figure S1F). Mucosal pinch biopsies were then taken from oesophageal mucosal surfaces and immediately snap frozen for eosinophil-derived protein extraction and measurement. Diagnostic biopsies were placed in neutral buffered formalin for processing and routine H&E (eosinophil enumeration) and immunohistochemical (EPX Staining Index) staining.
This study was approved by the Colorado Multi-institutional IRB (COMIRB) and IRBs of the University of Illinois at Chicago and the Children's Memorial Hospital.
Furuta G.T., Kagalwalla A.F., Lee J.J., Alumkal P., Maybruck B.T., Fillon S., Masterson J.C., Ochkur S., Protheroe C., Moore W., Pan Z., Amsden K., Robinson Z., Capocelli K., Mukkada V., Atkins D., Fleischer D., Hosford L., Kwatia M.A., Schroeder S., Kelly C., Lovell M., Melin-Aldana H, & Ackerman S.J. (2012). The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis. Gut, 62(10), 1395-1405.
Publication 2012
Abdominal Pain Anesthesia Biopsy Blood Coagulation Disorders Child CLC protein, human Connective Tissue Diseases Deglutition Disorders Diagnosis Diet Duodenum Endoscopy Eosinophil Eosinophilia Esophageal Diseases Esophageal Mucosa Esophageal Stricture Esophagus Ethics Committees, Research Failure to Thrive Formalin Freezing Gastroesophageal Reflux Disease Gelatins Heartburn Hypersensitivity Mucous Membrane Pharmaceutical Preparations Proteins Proton Pump Proton Pump Inhibitors Secretions, Bodily Stenosis Steroids Stomach Surgical Endoscopy Vomiting
5
Systematic Review of Eosinophilic Esophagitis

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Publication 2012
Adult Child Cytoplasmic Granules Eligibility Determination Endoscopy Endoscopy, Gastrointestinal Eosin Eosinophil Erythema Esophageal Mucosa Esophageal Stenosis Esophageal Stricture Esophagitis Esophagogastric Junction Esophagus Exudate Hemorrhage Patients Senile Plaques Stenosis

Most recents protocols related to «Esophageal Stricture»

1
Refractory Esophageal Strictures Treated with RIC
Fifty-seven patients were treated with first RIC for stricture after treatment for esophageal cancer between April 2008 and September 2019 at our institution. The indications for the first RIC were when all of the following were met: (1) presence of refractory esophageal stricture or close to its condition with patient’s request; and (2) confirmation of cure after esophageal cancer treatments such as CRT, ESD, surgery, or any combinations of these modalities. A stricture was defined as refractory when an ordinary-sized endoscope could not pass through the esophagus despite repeated EBD on more than six occasions within 6 months. RIC was not indicated for refractory long esophageal stricture (≥ 5 cm) after nonsurgical treatments due to the technical difficulty. The following were excluded from the study: (1) patients who were treated with RIC in order to perform endoscopic resection for other esophageal cancer on the anal side of the stricture; and (2) patients who could not be followed up for more than 6 months.
Kano Y., Kadota T., Inaba A., Sunakawa H., Takashima K., Nakajo K., Murano T., Shinmura K., Yoda Y., Ikematsu H., Akimoto T, & Yano T. (2023). Efficacy and safety of repeated endoscopic radial incision and cutting procedure for benign esophageal stricture. Endoscopy International Open, 11(3), E230-E236.
Publication 2023
Aftercare Anus Endoscopes Endoscopy Esophageal Neoplasms Esophageal Stricture Esophagus Operative Surgical Procedures Patients Stenosis Therapeutics
2
Evaluating and Managing Esophageal Strictures
We performed endoscopic examination to evaluate for stricture within 2 to 4 weeks after the first RIC. EBD was performed when patients had recurrent symptoms of dysphagia or presence of esophageal stricture, and repeated approximately every 2 to 4 weeks according to the effect of the EBD and patient’s symptoms until the symptoms disappeared or stricture improved. However, we did not perform with EBD and postponed if the ulcer after RIC remained. We also performed a repeated RIC when refractory stricture occurred after the first RIC or when patients had close to its condition and strongly requested for further improvement of discomfort during food intake, and we regarded the both conditions as re-refractory stricture.
Kano Y., Kadota T., Inaba A., Sunakawa H., Takashima K., Nakajo K., Murano T., Shinmura K., Yoda Y., Ikematsu H., Akimoto T, & Yano T. (2023). Efficacy and safety of repeated endoscopic radial incision and cutting procedure for benign esophageal stricture. Endoscopy International Open, 11(3), E230-E236.
Publication 2023
Deglutition Disorders Eating Endoscopy Esophageal Stricture Patients Stenosis Ulcer
3
Diagnosis of Gastroesophageal Reflux Disease
According to the Lyon consensus published in 2018, typical symptoms and response to therapy alone are not sufficient to diagnose GERD. Endoscopy results and pH or pH impedance measurement are required for a definitive diagnosis (Gyawali et al., 2018 (link)).
In accordance with the Lyon consensus, conclusive evidence for pathologic reflux are advanced erosive esophagitis (Los-Angeles grades C/D esophagitis), long segment Barrett‘s mucosa, peptic esophageal strictures or an acid exposure time (AET) >6% in the distal esophagus on pH or pH-impedance monitoring. In contrast, an acid exposure time <4% and <40 reflux episodes on pH-impedance measurement argue against pathologic reflux. According to the Lyon criteria, every conclusive finding is strong evidence for the presence of GERD. If the results are inconclusive or borderline, further findings from esophageal examinations (e.g., biopsy and motor evaluation) can support the diagnosis (Gyawali et al., 2018 (link)).
In our study, the diagnosis of GERD was defined according to the criteria of the Lyon consensus (16) mentioned before. In the synopsis of the results collected from the diagnostic measurement, the patients were divided into those with GERD on the one hand and those without GERD on the other hand. GERD was diagnosed in the presence of erosive esophagitis Los Angeles C&D, an acid exposure time (AET) ≥ 6%, peptic esophageal strictures and/or long-segment Barrett‘s esophagus, whereas an AET <4% was considered as an exclusion criterion for GERD. In case of inconclusive or borderline results, such as an AET between 4–6% or erosive esophagitis Los Angeles A&B, the diagnosis was made by a synopsis of all findings in addition to expert opinion (interdisciplinary reflux board consisting of three experienced gastroenterologists and two visceral surgeons with a special focus on upper GI diseases).
Labenz J., Menzel M., Hirsch O., Müller M., Labenz C, & Adarkwah C.C. (2023). Symptoms, the GerdQ score and patients’ characteristics do not predict gastroesophageal reflux disease in patients with proton-pump-inhibitor-refractory reflux symptoms—results from a large prospective database. PeerJ, 11, e14802.
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Publication 2023
Acids Barrett Esophagus Biopsy Diagnosis Digestion Endoscopy, Gastrointestinal Esophageal Stricture Esophagitis Esophagus Gastroenterologist Gastroesophageal Reflux Disease Gastrointestinal Diseases Mucous Membrane Patients Physical Examination Surgeons Therapeutics
4
Randomized trial of EUS-guided CYA injection for high-risk gastric varices

This was a single-center randomized controlled trial performed at the endoscopy unit of Mansoura Specialized Medical Hospital, Mansoura University, Egypt, between February 2019 and February 2022. The Study population included 52 patients with high-risk GVs classified according to the Sarin and Kumar classification
3 (link)
into GOV2 or IGV1. The inclusion criteria were as follows: age > 18 years, primary prophylaxis for high risk GVs varices (> 20 mm) on initial standard diagnostic upper endoscopy, and patients unable or unwilling to undergo alternative therapies for GVs such as transjugular intrahepatic portosystemic shunts (TIPS) or surgery. Patients were excluded if unable to give informed consent for the procedure, concurrent hepatorenal syndrome and/or multiorgan failure, previous endoscopic treatment for GVs, hepatocellular carcinoma or portal and splenic vein thrombosis, esophageal stricture, pregnant, platelets count less than 50,000 /mL and International Normalized Rate (INR) > 2.
Eligible patients were randomized in two groups using computer-generated random number sequences using excel software in concealed envelopes with block randomization design. Group A underwent EUS-guided injection of 1 ml CYA into the perforator vein and Group B underwent DEI of 1 mL CYA into the varix. Informed written consent was obtained from each participant in the study after assuring confidentiality. The study protocol and consent form were approved by the Institutional Review Board of Mansoura faculty of medicine, Mansoura University. The study was conducted in accordance with the Declaration of Helsinki and registered at ClinicalTrials.gov under the code NCT04222127.
Sabry F., Seif S., Eldesoky A., Hakim H, & Altonbary A.Y. (2023). EUS-guided cyanoacrylate injection into the perforating vein versus direct endoscopic injection in the treatment of gastric varices. Endoscopy International Open, 11(2), E202-E210.
Publication 2023
Alternative Therapies Blood Platelets Diagnosis Endoscopy Endoscopy, Gastrointestinal Esophageal Stricture Ethics Committees, Research Faculty Hepatocellular Carcinomas Hepatorenal Syndrome Multiple Organ Failure Operative Surgical Procedures Patients Pharmaceutical Preparations Primary Prevention Sarin Shunt, Transjugular Intrahepatic Portosystemic Spleen Thrombosis Varices Veins Veins, Splenic Venous Thrombosis
5
Self-Expandable Metal Stent Placement in Malignant Strictures
The procedure was defined as technical success when SEMS covered the stricture fully and opened. The procedure was defined as clinical success when the patient tolerated enteral feeding after SEMS placement in patients with a malignant oesophageal stricture.
In patients with malignant colorectal stricture, the procedure was defined as technical success when SEMS covered the stricture fully and opened. Gas and stool discharge after procedure was defined as clinical success.
Assessment of adverse events: After SEMS placement, patients went through endoscopic inspection in case of suspicion of bleeding, persistent pain and/or obstruction. Direct radiography was performed to check for migration, and revision was conducted through endoscopic intervention. Patients went through endoscopic inspection to evaluate ingrowth and overgrowth over suspicion of reobstruction in the GIS during prolonged follow-ups. Routine control imaging or endoscopic control was not performed when patients presented no complaints during follow-up. The surveys of the patients were calculated at time the SEMS is active and the time of death.
Informed consent was obtained from all patients for the procedure and anaesthesia. The procedures were performed under sedation administered by an anaesthesiologist. Patients who underwent only biliary stenting due to malignant biliary obstruction, patients without pathological diagnosis of malignancy or benign aetiology and patients with missing data records were excluded from the study. All consecutive patients except these patients were included in the study.
The study was approved by the Ethics Committee of Health Sciences University Umraniye Training and Research Hospital (Date: 8 April 2021&No: B.10.1.TKH.4.34.H.GP.0.01/99).
Çağatay A.K., Sayar S., Kılıç E.T., Kahraman R., Öztürk O, & Özdil K. (2023). The Role of Self-Expandable Metallic Stents in the Treatment of Malignant Strictures in all Segments of the Gastrointestinal Tract. Indian Journal of Palliative Care, 29(1), 64-69.
Publication 2023
Anesthesia Anesthesiologist Cholestasis Diagnosis Endoscopy Esophageal Stricture Ethics Committees Feces Malignant Neoplasms Pain Patient Discharge Patients Sedatives Stenosis X-Rays, Diagnostic

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1
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2
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More about "Esophageal Stricture"

Esophageal Stricture, also known as Esophageal Stenosis or Esophageal Narrowing, is a medical condition characterized by a constriction or narrowing of the esophagus, the muscular tube that connects the throat to the stomach.
This condition can have various underlying causes, including gastroesophageal reflux disease (GERD), also called acid reflux, radiation therapy, or the formation of scar tissue.
Esophageal Stricture can lead to difficulties in swallowing (dysphagia), chest pain, and unintentional weight loss.
Early detection and appropriate treatment are crucial to managing this condition and improving the patient's quality of life.
Treatment options may include dilation procedures, such as endoscopic balloon dilation or bougienage, or the placement of a stent to keep the esophagus open.
Patients with Esophageal Stricture may also experience other related symptoms, such as heartburn, regurgitation, and difficulty with swallowing solids or liquids.
In some cases, the stricture may be due to the presence of scar tissue, which can develop after injury, surgery, or radiation therapy to the esophagus.
To diagnose Esophageal Stricture, healthcare providers may utilize various diagnostic tools, such as endoscopy (GIF-Q260), barium swallow studies, or imaging tests like computed tomography (CT) or magnetic resonance imaging (MRI).
Treatments may involve the use of medications like Kenacort (a corticosteroid) or Primperan (a prokinetic agent), as well as mechanical interventions like CRE Fixed Wire, LSM 710, IT Knife 2, or Axio 200 devices.
In managing Esophageal Stricture, healthcare providers may also recommend lifestyle modifications, such as dietary changes, to help alleviate symptoms and prevent further complications.
Patients may be advised to avoid certain foods or beverages that can exacerbate acid reflux, such as those containing caffeine or alcohol.
For data analysis and reporting, researchers may utilize statistical software like SPSS version 22.0 or SPSS version 25.0 to analyze data related to Esophageal Stricture and evaluate the effectiveness of various treatment approaches.
Zantac, a histamine-2 receptor antagonist, may also be prescribed to help reduce acid production and promote esophageal healing.
By understanding the nuances of Esophageal Stricture, healthcare professionals can provide comprehensive and personalized care to patients, ultimately improving their overall quality of life.