Upper Esophageal Strictures and Webs

Esophageal stricture refers to narrowing or tightness in the esophagus (swallowing tube) causing a decrease in its ability to open during swallowing. Esophageal narrowing can be caused both by benign and cancerous conditions, with benign being the most common reason.

Narrowing can occur both at the top and bottom part of the esophagus. The most common benign type of esophageal narrowing is called a peptic stricture due to acid reflux. These strictures occur in the lower part of the esophagus. Other common types of benign narrowing include esophageal webs or rings, which are thin bands of scar tissue within the lining of the esophagus. Webs are commonly seen in the upper part of the esophagus and rings are commonly seen in the lower part of the esophagus.

Symptoms of Upper Esophageal Strictures and Webs

Patients may experience difficulty swallowing solid food (breads, meats, etc) and pills. Swallowing difficulties may be long-standing and can progress slowly. Other symptoms may include chest pain and/or weight loss. Patients with narrowing of the esophagus are at risk for getting a food impaction which is food sticking in the narrowed area of the esophagus requiring surgical removal.

Diagnosis of Upper Esophageal Strictures and Webs

Diagnosis of esophageal strictures is made by several evaluations including modified barium swallow study, barium esophagram, and transnasal esophagoscopy.

Upper Esophageal Strictures and Webs Treatment

In patients with difficulty swallowing due to esophageal narrowing, an esophageal dilation (stretching of the narrowed esophageal segment) is the main treatment, especially in benign conditions. Different methods and instruments can be used for dilation including rigid cylindrical dilators versus balloon dilators.