![]() ![]() Over time, this leads to chronic inflammatory changes in the wall of the esophagus. The pathophysiology of stricture development differs based on the underlying etiology, but the basic pathological changes include damage to the mucosal lining. ![]() A stricture can narrow this down to 13 mm or less, causing dysphagia. The normal esophagus measures up to 30 mm in diameter. There is no clear association between sex genotype and esophageal stricture, but men are at higher risk than women for erosive esophagitis. Peptic strictures are tenfold more common in Whites than Blacks or Asians. Malignant strictures are found in older people, as cancer prevalence is higher in older populations. Strictures related to acid reflux, iatrogenic or drug-induced esophagitis, on the other hand, are more common in adults. ![]() Strictures due to caustic esophagitis or eosinophilic esophagitis, however, are more common in children and young patients. History of GERD, hiatal hernia, prior dysphagia, peptic ulcer disease, and use of alcohol are known risk factors for peptic stricture formation.Įsophageal strictures can occur in any age group or population when one considers all the different possible etiologies. Peptic strictures, being the most common among them, have decreased in incidence from 1994 to 2000 along with a substantial increase in PPI use during this time. One study reported an incidence rate of 1.0 person-years, which also increases with age. There is an overall low disease prevalence for the condition. New technological advancements in endoscopic therapy and different stent products have shown promising results with notable improvement in stricture management with low recurrence rates and fewer complications.Įsophageal stricture formation is not common. Regardless of etiology, stricture disease is best managed promptly and aggressively to restore luminal patency this is done for symptomatic improvement and/or palliative management in cases of cancer. Generally, the term esophageal stricture is reserved for intraluminal esophageal disorders resulting in narrowing, although extrinsic esophageal compression and luminal compromise can sometimes occur by direct invasion of malignancy or lymph node enlargement, for example, and therefore result in esophageal stricture as well. Recent advancement in the use of endoscopic procedures for diagnostic as well as therapeutic purposes has increased the occurrence of iatrogenic post-procedural esophageal stricture formation resulting from the mucosal injury. The luminal stricture itself may have abrupt or tapered margins. The esophagus loses distensibility with stricture formation, and this may be localized or diffuse throughout the length of the esophagus. Stricture formation can be due to inflammation, fibrosis, or neoplasia involving the esophagus and often posing damage to the mucosa and/or submucosa. Its recognition and management should be prompt. It is a serious sequela to many different disease processes and underlying etiologies. An esophageal stricture refers to the abnormal narrowing of the esophageal lumen it often presents as dysphagia, commonly described by patients as difficulty swallowing. ![]()
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