ENT Specialist Doctor In Mumbai OESOPHAGEAL STRICTURES

OESOPHAGEAL STRICTURES

Oesophageal strictures can be divided into:

I) Caustic strictures.

II) Strictures secondary to esophagitis and reflux.

I) Caustic strictures

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Aetiology: Ingestion of caustic agents such as dye, drain openers, acids.

Diagnosis:

a) History of ingestion.

b) Symptoms: Shock, burning sensation.

c) Endoscopy to determine the damage.

Treatment:

Medical:

a) Neutralizing agent.

b) Corticosteroids and broad-spectrum antibiotics for 3-6 weeks.

c) Barium swallow of the oesophagus performed after 10-14 days to determine development of stricture.

Surgical:

a) Dilatation of stricture if present.

b) Oesophageal replacement surgery with colon or stomach may be necessary.

II. Secondary strictures to esophagitis and reflux:
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Pathophysiology:
a) Usually at gastro-oesophageal junction.

b) In severe cases long stricture may result.

Diagnosis:

a) History of reflux symptoms and dysphagia is suggestive of strictures.

b) Barium swallow of the oesophagus confirms the diagnosis.

c) Fibre-optic upper GI endoscopy done to locate the site of the stricture and take a biopsy if required.

d) Rigid oesophagoscopy is important to determine the extent of disease,rule out malignancy and take a biopsy if required.

Treatment:

a) Dilatation of the oesophagus by fibre optic oesophagoscopy is attempted first and anti-reflux operation is performed.

b) Reconstructive surgery using stomach or colon.

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