What is Esophageal stricture and how is it treated?

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What is esophageal stricture? 

Esophageal stricture is the abnormal tightening or narrowing of the esophagus, making it difficult for children to swallow foods and liquids — a problem called dysphagia.

Many times, esophageal strictures occur in children that underwent surgery for esophageal atresia, when a baby is born without a part of their esophagus. As the area heals, the tissues develop scarring that causes them to contract and narrow the esophageal lumen. 

Other less common causes: 

Chronic gastroesophageal reflux disease (GERD) — Over time, chronic reflux causes stomach acid to rise into a child’s esophagus and damages the sensitive tissues lining the esophageal wall and develop scar tissue.

Eosinophilic esophagitis — Similar to chronic reflux, this condition is caused through an allergic reaction, typically a food allergy.

Caustic injuries to the esophagus — Caustic substances, such as lye, bleach and acid damage the esophagus and cause scarring. 

Congenital esophageal stricture – Some esophageal strictures are present at birth.

What are the symptoms of esophageal stricture? 

Dysphagia or difficulty swallowing is typically the most common symptom. Others include: 

• Difficultly managing secretions
• Coughing 
• Retching 
• Chest pain 
• Regurgitation 
• Weight loss 
• Sore throat 

Other signs may be related to the condition your child is experiencing. 

How is esophageal stricture diagnosed and treated? 

A comprehensive diagnosis looks at all of the types of strictures possible, symptoms and medical history. Common tests used to examine the stricture are: 

• Esophagram or barium swallow — A special liquid that allows a radiologist to see the esophagus.

• Endoscopy — A thin tube with a camera at the end is guided through the mouth and into the esophagus, allowing the physician to examine the esophageal lumen and narrowing directly.

The diagnosis will provide guidance on how to best treat the stricture. Typically for children with esophageal atresia, balloon dilation is used to expand the scar tissue causing the stricture. Balloon dilation uses an endoscopic tube that is inserted through the mouth and into the esophagus, then filled to expand and stretch the scar tissue.

Sometimes, steroids or other medications are injected into the area to prevent scar tissue from forming. Incisional therapy is an advanced and innovative option to cut scar tissue in a way to open the stricture. Children may develop a condition called refractory esophageal stricture when they are not responsive to dilation procedures. When this occurs, our team of specialists will decide the best course of treatment, which may include surgery. 

Follow-up care 

Your child’s condition will continue to be monitored as needed, depending on their individual needs. Esophageal stricture, often associated with esophageal atresia, requires a team of specialists that examine and monitor your child’s overall health.

Learn more about treatment and follow-up care for esophageal atresia.