Esophageal strictures are commonly used to widen a narrow bowel segment. These strictures are dilated during a series of procedures to achieve the desired size opening.
Diseases causing esophageal strictures
Many diseases cause esophageal strictures. These include medication or radiation-induced diseases, infectious diseases, congenital and autoimmune diseases, corrosive ingestion among others.
Esophageal strictures are treated with endoscopic dilators followed by disease-specific treatment. Two main types of techniques are used in clinical practice:
Mechanical (Bougie or Push-type) – These are available in a variety of sizes and are made of different materials such as rubber etc.(SG Dilatation,
Balloon – A balloon dilator is passed through the scope and the lumen is dilated by the expansion of the balloon. These also come in different sizes.
Dilation of strictures is an outpatient procedure. The appropriate technique is determined based on the site, size and complexity of the stricture. A lower esophageal stricture is treated using a mechanical dilator as they are generally small in size while complex strictures need to be managed using balloon dilators.
Untreated esophageal strictures may result in complications such as:
- Severe chest pain
- Fistula formation
- Asthma due to aspiration
- Food particle aspiration
- Food impaction, and
- Dysphagia, weight loss
Esophageal strictures require prompt recognition and management to avoid complications. Besides early treatment, it requires long-term clinical observation to prevent a recurrence.