What Is Benign Esophageal Stricture?
Benign esophageal stricture describes a narrowing or tightening
of the esophagus. The esophagus is the tube that brings food and liquids from
your mouth to your stomach. “Benign” means esophageal cancer isn’t causing the
Benign esophageal stricture typically occurs when stomach acid and
other irritants damage the lining of the esophagus over time. This leads to
inflammation (esophagitis) and scar tissue, which causes the esophagus to
Although benign esophageal stricture isn’t a sign of cancer, the
condition can cause several problems. Narrowing of the esophagus may make it
difficult to swallow. This increases the risk of choking. It can also lead to complete
obstruction of the esophagus. This can prevent food and fluids from reaching
What Causes Benign Esophageal Stricture?
Benign esophageal stricture can happen when scar tissue forms in
the esophagus. This is often the result of damage to the esophagus. The most
common cause of damage is gastroesophageal
reflux disease (GERD), also known as acid reflux.
GERD occurs when the lower esophageal sphincter (LES) doesn’t
close or tighten properly. The LES is the muscle between the esophagus and the
stomach. It normally opens for a short amount of time when you swallow. Stomach
acid can flow back up into the esophagus when it doesn’t close completely. This
creates a burning sensation in the lower chest known as heartburn.
Frequent exposure to harmful stomach acid can cause scar tissue to
form. Eventually, the esophagus will narrow.
Other causes of benign esophageal stricture include:
- radiation therapy to the chest or neck
- accidental swallowing an acidic or corrosive
substance (such as batteries or household cleaners)
- extended use of a nasogastric tube (a special tube that carries food and
medicine to the stomach through the nose)
- esophageal damage caused by an endoscope (a
thin, flexible tube used to look inside a body cavity or organ)
- treatment of esophageal varices (enlarged veins
in the esophagus that can rupture and cause severe bleeding)
Symptoms of Benign Esophageal Stricture
Typical symptoms of benign esophageal stricture include:
- difficult or painful swallowing
- unintended weight loss
- regurgitation of food or liquids
- frequent burping or hiccups
Potential Complications of Benign Esophageal
Dense and solid foods can lodge in the esophagus when it narrows.
This may cause choking or difficulty breathing.
Problems swallowing can prevent you from getting enough food and liquid.
This may lead to dehydration and malnutrition.
There’s also a risk of getting pulmonary aspiration, which occurs
when vomit, food, or fluids enter your lungs. This could result in aspiration
pneumonia, a condition in which the lungs and the airways leading into the
lungs become inflamed.
Diagnosing Benign Esophageal Stricture
Your doctor may use the following tests to diagnose the condition.
Barium Swallow Test
A barium swallow test includes a series of X-rays of the
esophagus. These X-rays are taken after you drink a special liquid containing
the element barium. Barium isn’t toxic or dangerous. This contrast material
temporarily coats the lining of your esophagus. This allows your doctor to see
your throat more clearly.
Upper GI Endoscopy
In an upper gastrointestinal (upper GI) endoscopy, your doctor will
place an endoscope through your mouth and into your esophagus. An endoscope is
a thin, flexible tube with an attached camera. It allows your doctor to examine
your esophagus and upper intestinal tract.
Your doctor can use forceps (tongs) and scissors attached to the
endoscope to remove tissue from the esophagus. They’ll then analyze this sample
of tissue to find the underlying cause of your benign esophageal stricture.
Esophageal pH Monitoring
This test measures the amount of stomach acid that enters your
esophagus. Your doctor will insert a tube through your mouth into your
esophagus. The tube is usually left in your esophagus for at least 24 hours.
Treating Benign Esophageal Stricture
Treatment for benign esophageal stricture will vary depending on
the severity and underlying cause of the condition.
Esophageal dilation, or stretching, is the preferred option in
most cases. Esophageal dilation can cause some discomfort, so you’ll be under
general or local anesthesia during the procedure.
Your doctor will insert an endoscope through your mouth into your
esophagus, stomach, and small intestine. Then, they’ll inflate a small balloon
on the end of the endoscope to stretch your esophagus.
In some cases, your doctor may use a dilator instead of an
endoscope during the procedure. A dilator is also a long, thin tube that can
expand the esophagus.
Your doctor may need to repeat this procedure in the future to
prevent your esophagus from narrowing again.
Esophageal Stent Placement
The insertion of esophageal stents can provide relief from esophageal
stricture. A stent is a thin tube made of plastic, expandable metal, or a flexible
mesh material. Esophageal stents can help keep a blocked esophagus open so you
can swallow food and liquids.
During the procedure, your doctor will give you a local
anesthetic to numb your throat and esophagus. They’ll use an endoscope to guide
the stent into place.
Diet & Lifestyle
Making certain adjustments to your diet and lifestyle can effectively
manage GERD, which is the primary cause of benign esophageal stricture. These
changes can include:
- elevating your pillow to prevent stomach acid
from flowing back up into your esophagus
- losing weight
- eating smaller meals
- not eating for three hours before bedtime
- quitting smoking
- avoiding alcohol
You should also avoid foods that cause acid reflux, such as:
- spicy foods
- fatty foods
- carbonated beverages
- coffee and caffeinated products
- tomato-based foods
- citrus products
Medications also can be an important part of your treatment plan.
A group of acid-blocking drugs, known as proton pump inhibitors (PPIs),
are the most effective medications for managing the effects of GERD. These
drugs act by blocking the proton pump, a special type of protein, which helps
reduce the amount of acid in the stomach.
Your doctor may prescribe these medications for short-term relief
to allow your stricture to heal. They may also recommend them for long-term treatment
to prevent recurrence.
The PPIs used to control GERD include:
Other medications may also be effective for treating GERD and
reducing your risk of esophageal stricture. They are:
- antacids: provide short-term relief by
neutralizing acids in the stomach
provides a barrier that lines the esophagus and stomach to protect them from
acidic stomach juices
- antihistamines (such as ranitidine
and famotidine): decrease the secretion of acid
Your doctor may recommend surgery if medication and esophageal
dilation are ineffective. A surgical procedure can repair your LES and help
prevent GERD symptoms.
Surgical treatment can be difficult in the rare cases where a
non-functioning esophagus causes the stricture. In these extreme cases, an
esophageal replacement may be the only effective option.
Long-Term Outlook for People with Benign
Treatment can correct benign esophageal stricture and help
relieve the associated symptoms, but the condition can occur again. Among the people
who undergo esophageal dilation, approximately 30
percent require another dilation within one year.
You may need to take medication throughout your lifetime to
control GERD and reduce your risk of developing another esophageal stricture.
Preventing Benign Esophageal Stricture
You can help prevent benign esophageal stricture by avoiding
substances that can damage your esophagus. Protect your children by keeping all
corrosive household substances out of their reach.
Managing symptoms of GERD can also greatly reduce your risk for esophageal
stricture. Follow your doctor’s instructions regarding dietary and lifestyle
choices that can minimize the backup of acid into your esophagus. It’s also
important to make sure you take all medications as prescribed to control
symptoms of GERD.