Oesophageal Strictures

What are Oesophageal Strictures?

Oesophageal strictures are when there is an abnormal tightening, narrowing or constriction in the food pipe (the oesophagus) which creates swallowing difficulties.

A patient may experience pain or pressure in the chest after eating (as food and liquid may struggle to pass the stricture), a ‘lump in the throat’ sensation after swallowing or even recurrent episodes of choking and/or regurgitation/vomiting of food.

Oesophageal strictures are not common and are usually a complication of a different condition of the digestive tract:

  • Gastro-oesophageal reflux disease (GORD) is the most common cause of strictures, as acid damages the lining of the food pipe, and this type of stricture is called a peptic stricture.
  • People who have or have had Oesophageal Cancer may find that the cancer itself, cancer treatments or surgery cause a stricture
  • Having previous surgery of the oesophagus – as every surgery carries a low risk of inflammation/scarring (which could cause a stricture)

Oesophageal strictures can occur at any age but usually affect people older than 40 years.

Diagnosing Oesophageal Strictures

Often patients who are affected by oesophageal strictures are already under the care of a gastroenterologist, but anyone affecting by chronic swallowing issues should ask to be referred to a specialist for further investigation.

The doctor will take a few medical history and will then conduct all or some of the following tests to confirm if the cause is oesophageal strictures:

  • The gold standard test would be an endoscopy to visualize the stricture and asses how tight it is but also take biopsies to exclude any abnormal cells.
  • Barium swallow – during this procedure X-rays of the neck and chest are taken after the patient swallows a barium milkshake to follow the route the liquid takes
  • Endoflip – during this procedure, a small catheter tube measures the muscle and valve function of the food pipe. This can be conducted at the same time as a routine endoscopy and is very useful in conditions such as achalasia.

Treating Oesophageal Strictures

Oesophageal strictures will be treated differently depending on if they are non-cancerous (benign) or cancerous (malignant)

  • Benign oesophageal strictures are usually treated through dilation (or stretching) of the food pipe. A dilation procedure can widen the oesophagus and reduce symptoms. This is usually done with balloon dilation, a non-invasive procedure conducted via an upper endoscopy. This treatment involves passing a thin flexible tube (catheter) with a camera attached and a device where the balloon is inflated. This opens up the space to quickly and effectively relieve the patient’s symptoms.
  • Malignant oesophageal strictures will be treated differently dependent on the patient’s whole cancer treatment plan. It may or may not be recommended to treat the stricture. They may be surgically repaired, perhaps alongside other treatments including chemotherapy, oesophageal stents and laser treatments.

Patients affected by oesophageal stricture often worry that this means they have cancer. While cancer can cause a stricture in the oesophagus, there are many other swallowing conditions and gastrointestinal diseases that may cause a non-cancerous stricture.

Appointments for Oesophageal Strictures

Dr Rehan Haidry is an experienced consultant gastroenterologist and endoscopist helping many patients with oesophageal strictures, click here to book an appointment.

Get In Touch

For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:

Tel: 0203 423 7609  |  Email: rhaidrymedsec@ccf.org