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Gastroenterology Blog

What is Esophageal Stricture and How is it Treated?

Posted by Gastroenterology Associates on Thu, May 23, 2019 @ 10:12 AM


esophageal strictureTightness in the throat is a familiar sensation for some.  It can be an uncomfortable, painful, and even frightening feeling.  Sometimes, the tightness is short-lived and may be attributed to anxiety or an allergic reaction.  However, persistent tightness that worsens over time may be the result of esophageal stricture.   Conditions such as gastroesophageal reflux (GERD) may cause damage to the esophageal tissue over time, resulting in a buildup of scar tissue that makes swallowing progressively more difficult.

Even in the case of benign esophageal stricture, treatment should still be sought.  Not only will the tightness worsen over time, but the underlying issue that is leading to your throat tightness and pain should be addressed as well.  Here are some of the common tests used to diagnose esophageal stricture, as well as the most common and effective forms of treatment:

Diagnosing Esophageal Stricture

  • Barium Swallow – After swallowing barium, x-rays are taken to show the narrowing of the esophagus
  • Endoscopy – A thin scope with light and camera, known as an endoscope, is guided into the esophagus in order to visualize the narrowing.  This procedure is generally performed under a sedative and local anesthetic.

Treating Esophageal Stricture

  • Proton Pump Inhibitors (PPIs) – These medications are typically used to treat the most common cause of esophageal stricture:  GERD.   By alleviating the symptoms of GERD, they are thereby able to reduce the pain, inflammation, and irritation in the throat.
  • Dilation – In this procedure, the esophagus is dilated through one of many possible methods, such as using a weighted dilator passed through the mouth and into the esophagus.  This treatment is typically performed either with sedation or a local anesthetic.  Depending on the severity of the stricture, it may need to be performed multiple times.
  • Surgery – In rare cases in which the stricture cannot be adequately dilated or strictures continue to return after repeated dilations, surgical treatment may be necessary.

Once treated, the prognosis of esophageal strictures is quite good.  While some may return and require subsequent treatment, most patients may resume their normal diet and routine.  In order to prevent the initial development of esophageal strictures, there are some precautionary measures that you can take. Use caution to avoid accidental ingestion of corrosive substances, and if you suffer from frequent or prolonged heartburn, see your doctor for a diagnosis and treatment of GERD.  If the appropriate steps are taken to prevent esophageal stricture or to treat it once it occurs, the condition should have minimal impact.

If you experience difficulty swallowing and inflammation or irritation of the throat, it may be time to speak with a specialist about the possibility of esophageal stricture.  At Gastroenterology Associates, we have several gastroenterology physicians who are qualified in the identification and treatment of the condition.  Simply click here to request an appointment, or call our office directly at (225) 927-1190.

6 Reasons Not to Ignore GERD

Topics: Esophagus, Endoscopic Procedures

Esophageal Stricture: Explaining the Tightness in Your Throat

Posted by Gastroenterology Associates on Fri, Aug 31, 2018 @ 1:47 PM

esophageal strictureAn esophageal stricture is caused by damage to the esophagus that causes inflammation or swelling. When this occurs, the space in the esophagus becomes smaller, making it feel tighter and compromising function. Esophageal strictures cause symptoms such as hoarseness, difficulty swallowing, heartburn, regurgitation of food, feeling of tightness in the chest after a meal, and frequent burping or hiccupps.

While tightness in the throat can be a result of other conditions like strep throat, sinus infections, or allergic reactions, an esophageal stricture is usually caused by chemicals such as stomach acid burning the esophagus. GERD and acid reflux diseases are the most common culprit for esophageal strictures.

Diagnosis of Esophageal Stricture

The biggest risk involved with esophageal stricture is pulmonary aspiration. This can occur if food or liquid enters the lungs. There is also an increased risk of choking, while some experience a loss of appetite due to discomfort that can lead to malnutrition or dehydration.

There are a few different ways which a doctor can diagnose a case of esophageal stricture. Barium swallow tests are common, which involves swallowing a barium dye and taking x-ray images of the esophagus. This is typically a first step and preferred method as it is a non-invasive procedure.

Endoscopy is another option for diagnostic purposes.  This technique involves a camera entering through the throat to obtain images of the upper GI tract. There is also pH testing that can be performed, where a tube is entered through the mouth into the stomach to measure the amount of stomach acid that enters the esophagus.

Treatment of Esophageal Stricture

Once testing has determined the cause of stricture, your doctor will recommend a treatment plan. The solution often involves stents or dilations, which means the esophagus is opened or stretched to alleviate the tightness.  If GERD is the cause of the stricture, your doctor may recommend medication or changes in diet that will help to alleviate symptoms.

Although tightness in the throat may appear to be nothing, chronic cases should be investigated by a gastroenterologist. If you are exhibiting signs of esophageal stricture or are concerned with symptoms of GERD or acid reflux, it is important to seek out medical help. Gastroenterology Associates can help. Contact us today or visit our website for more information.

 6 Reasons Not to Ignore GERD

 

Topics: Esophagus

Acid Reflux and Eosinophillic Esophagitis

Posted by Gastroenterology Associates on Mon, Aug 03, 2015 @ 1:16 PM

GERD_esop_and_stomAcid reflux and eosinophillic esophagitis (EE or EoE) are medical problems that affect a large number of Americans. Both children and adults suffer from these ailments, which can cause a large amount of discomfort when it comes time to eat and digest.  Acid Reflux, or GERD, and eosinophilic esophagitis have similar symptoms and are EoE is commonly mistaken for GERD.

What is Eosinophilic Esophagitis?

Your esophagus is the large tube that connects your mouth to your stomach. Those who suffer from eosinophilic esophagitis experience an inflammation of the esophagus, which can result in a problem with swallowing. The reason for this inflammation is large numbers of white blood cells, specifically ones called eosinophils, being congregated within the esophagus.

Symptoms of eosiniophilic esophagitis typically include:

  • Poor weight gain also called “failure to thrive”
  • Refusal to eat (in children)
  • Vomiting following meals
  • Heartburn
  • Difficulty swallowing , called dysphagia
  • Pain or discomfort with swallowing,  referred to as odynophagia
  • Food impaction (lodged in the esophagus)
  • Coughing
  • Chest, throat, or abdominal pain

Interestingly, although all people can develop this condition, it is most commonly found in adult men and young boys. There has been rising incidence of EoE over the past few years, and more pediatricians, internists, and primary care physicians are becoming aware of and recognizing the disease.  It is often at that point that the patient is referred to a gastroenterologist for an endoscopic exam or biopsy. 

 What Causes Eosinophilic Esophagitis? 

There are many reasons why an individual might develop eosinophilic esophagitis. Several studies point to allergens in food for the development of eosinophilic esophagitis. The main reason for associating EoE with allergies is that eosinophils are found in high numbers in a large amount of other allergy-related conditions such as hay fever, asthma, and atopic dermatitis. 

Many believe that the most common reason for one to develop this condition is due to acid reflux. This assumption is incorrect, and EoE stands as a distinct disease whereby an allergic reaction in the esophageal lining occurs when exposed to allergens like food or pollen.

What is Acid Reflux?

Acid reflux is another common problem affecting 1 in 5 Americans. Acid reflux occurs when the lower esophageal sphincter allows stomach acids to escape back into the esophagus.  Acid reflux could be a persistent problem, or one that only occurs when the wrong foods or substances are ingested.

GERD-burn-smAcid reflux is caused when foods, drinks, or medications are ingested. If foods have a low pH balance, meaning they are acidic, then acid reflux can take hold. Other risk factors for acid reflux or GERD are being overweight or obese, smoking, lying down soon after eating, pregnancy, and taking aspirin, Ibuprofen, muscle relaxers or blood pressure medications.

Those who suffer from acid reflux often experience heartburn, a burning in their chest, rising up through their esophagus. The most common symptoms of acid reflux (GERD) are:

  • Heartburn
  • Regurgitation (the feeling of vomit or acid in the back of the mouth/throat)
  • Cough
  • Feeling a lump in the throat
  • Increased production of saliva
  • Laryngitis and hoarseness
  • Bad Breath

Treatment of acid reflux/GERD can be accomplished a number of ways. The first one typically recommended are lifestyle changes- get to a healthy weight, reduce consumption of foods and drinks that aggravate the condition, and stop smoking.  Beyond these, acid reflux treatments are available over the counter for infrequent issues, but for ongoing (chronic) sufferers, a physician will usually prescribe a proton pump inhibitor (PPI) to curb the amount of acid produced and escaping the stomach.

Sometimes, a family history of swallowing problems or history of other allergic conditions in the patient, such as asthma, may also prompt consideration of eosinophilic esophagitis.

Is There Anything to do to Treat Eosinophilic Esophagitis? 

Fortunately, there are number of great ways to treat this condition. The most common practice for treating patients with eosinophilic esophagitis is through a process of dilating the esophagus and administering medicine. 

The process of gentle esophageal dilation moves or fractures the strictures of the esophagus, allowing for an easier passage for food. This can make patients who have had trouble swallowing feel much better, and allow them to eat without fear of discomfort or pain. The esophageal dilation needs to be done very carefully in patients with eosinophilic esophagitis, as opposed to other patients with swallowing problems.

What Else Can Be Done to Prevent Eosinophilic Esophagitis? 

There are many ways that an individual can try to prevent eosinophilic esophagitis from persisting or popping up again after being eliminated. An easy way to go about this is through the process of an elimination diet.

An elimination diet is a common practice with those who might be developing an allergic reaction to certain kinds of foods. A great way to begin is by going to see an allergist and have them analyze your blood. They will administer a series of tests over the course of time to see if there is one specific thing that is causing your reaction.

Another way to take part in an elimination diet is by paying attention to what you eat. Slowly weed out items from your daily diet that are large problems in the world of allergies. This includes dairy, soy, peanuts or tree nuts, shellfish, eggs and wheat.

The difference between acid reflux and eosinophilic esophagitis is noted at microscopic examination of the tissue specimens obtained from the esophagus at endoscopy. Sometimes this is suspected, especially when a patient has had intermittent (sometimes infrequent) episodes of food getting stuck in the esophagus requiring ER visits for removal. Although some patients with eosinophilic esophagitis may improve with medication given for controlling acid, an accurate diagnosis may help in preventing future complications. 

Gastroenterologists Are the Experts

When it comes to anything related to your digestive tract (which includes the stomach and esophagus), the physicians specializing in this field are gastroenterologists. They are specially trained and educated in assessing, diagnosing, and treating conditions of the gastrointestinal (GI) system. If you have been experiencing symptoms of EoE or GERD, schedule a consult with one of the 17 board certified gastroenterologists at Gastroenterology Associates. It can mean the difference between a course of action leading to resolution of the symptoms or just masking symptoms!

 6 Reasons Not to Ignore GERD

Disclaimer: All information provided in this article is for informational purposes only and should not replace the consultative advice and experienced feedback from your physician.    Always consult with your physicians on any of your questions and concerns.

 

Topics: GERD, Acid Reflux, Esophagus