Stenosis of the esophagus: causes, symptoms, treatment

Esophageal Stenosis — the state, which is accompanied by a pathological narrowing of the esophageal tube. This anomaly may be congenital, or to appear more adult. The disease can lead to weight complications. Moreover, problems with swallowing and passing food into the stomach negatively affect the well-being of the patient and the whole organism. So why is there this pathology and can prevent its development? What signs should pay attention to? Are there any really effective treatments?

Stenosis of the esophagus: what is it?

As is known, the oesophagus is the hollow tube that connects the throat and stomach. The average length of it is 25 cm. of Course, the tube diameter is not the same — the esophagus has three physiological narrowing which is located in the region of the cricoid cartilage, and bifurcation of the trachea and the openings of the diaphragm.

In modern gastroenterology often occurs pathology, called stenosis of the esophagus. What is it? This pathology is accompanied by unusual narrowing of the esophageal tube. Since there is a close relationship between this part of the digestive tract and other organs (in particular, trachea, aorta, pericardium, the left bronchus, the trunk of the vagus nerve, thoracic lymphatic duct, part of the pleura), and the disruption of its work associated with a lot of complications.

Main causes of disease

Are There any risk factors that trigger such a condition? Stenosis of the esophagus may have different causes. If we are talking about congenital forms of the disease, they are associated with impaired embryonic development, resulting in hypertrophy of the muscular wall of the esophagus, the appearance of fibrous or cartilaginous rings.

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As regards acquired stenoses, the reasons for their much more diverse:

• For Example, the mucosa can be damaged by constant contact with the acidic contents of the stomach. This occurs when reflux esophagitis, peptic ulcers, chronic gastritis, hernia hiatal or even severe toxemia of pregnancy, if accompanied by frequent vomiting.
• It is Worth mentioning the injuries. The most severe stenoses of the esophagus are observed at burns chemically aggressive media, and as a result of damage to the wall of the foreign body. Injury is possible during various diagnostic procedures, including intubation of the stomach.
• Narrowing or even complete closure of the lumen appears as a result of cancer of the esophagus or the appearance of benign tumors.
• Esophageal Stenosis may be associated with infectious diseases including fungal infections, scarlet fever, syphilis, tuberculosis, diphtheria.
• In some cases, the narrowing of the tube and is associated with abnormalities of others organs. For example, the esophagus can be compressed abnormally located vessels, or enlarged lymph nodes. The causes include tumors of the mediastinum and aortic aneurysm.

Forms of stenoses and their features

There are many classification systems of this disease. For example, stenosis of the esophagus may be congenital or acquired. By the way, in 90% of cases of common congenital form of the disease.

Depending on the number of affected areas isolated single stenosis (narrowed lumen of the esophagus in only one place) and multiple (there are several foci of pathological changes). Take into account the localization of the constriction, dividing the pathology into the high stenosis (localized in the cervical), middle (narrowed area is located at the level of the bifurcation of trachea and aortic arch), low (the nidus located in the cardiac Department) and combined.

There is a split on the causes of the disease. For example, cicatricial stenosis of the esophagus is characterized by damage to the mucous membranes and sometimes of the muscular layer of the tube. Damaged tissue gradually appears connective tissue — so the scar is formed. The reason usually is a chronic gastro-esophageal reflux. Sometimes the narrowing is due to the formation and growth of tumors, which can be both good and malignant. There are the traumatic form of the disease. In any case, to accurately determine the kind and characteristics of the disease is possible only after a thorough diagnosis.

Stage of development of disease

In modern medicine it is accepted to distinguish four degrees of stenosis of the esophagus:

• In the first stage the disease is accompanied by a narrowing of the lumen prior to 9-11 mm in diameter. Through him it is possible to enter the endoscope of medium size.
• On the second stage say if the diameter of the lumen of the esophagus at the site of stenosis is reduced to 6-8 mm., However, it is still possible to enter fibrobronchoscopy.
• In the third stage, the esophageal tube is tapered and its diameter does not exceed 3-5 mm. Through this area the doctor may only enter a special, ultra-thin fiberscope.
• The Fourth stage of the disease is characterized by severe narrowing of the lumen, its diameter is of 1-2 mm. in some patients there is complete blockage of the esophagus, which is very dangerous.

Stenosis of the esophagus: symptoms

The sooner the disorder is diagnosed, the faster the patient will receive necessary treatment. So what signs accompanied by stenosis of the esophagus? The symptoms largely depend on the form and stage of development of the disease.

If we are talking about congenital abnormalities, the first “bump”, you notice almost immediately. After feeding the baby often spits up Nestorianism milk. You can also notice heavy discharge of mucus from the nasal passages and profuse salivation.

In that case, if the child has a moderate form of congenital stenosis, the problems begin with the introduction in the diet of first feeding or solid food.

Acquired pathology develops gradually. Typically, patients manifest difficulties with swallowing. For example, possible pain in passing food through the esophagus and the appearance of pain behind the breastbone. In the initial stages, dysphagia is observed in the use of solid food, but as narrowing of the esophageal tube, man becomes difficult to swallow even liquid food. Sometimes the disease becomes so severe that the patient is not able to swallow water or even saliva.

If the stenosis is in the cervical region, but the liquid drunk, or even pieces of food can enter the trachea, resulting in severe cough, laryngospasm, dyspnea. In the most severe cases, the stenosis leads to the development of aspiration pneumonia.

Often the hard and large pieces of food begin to accumulate in the region of the narrowing, which leads to frequent nausea and vomiting, the appearance of severe pain. To dangerous consequences of the stenosis can be attributed to a spontaneous tearing of the wall of the esophagus.

Modern methods of diagnosis

After a conversation with the patient, the doctor may make allegations about the presence of stenosis. Of course, in the future, more research is needed. First of all you need to conduct an esophagoscopy, which can be used to detect narrowing of the esophagus and measure its diameter, and inspect the mucosa. In the presence of tumors or ulcers can be conducted endoscopic biopsy for the presence of malignant cells.

An equally important method of diagnosis is radiography using contrast substance (usually used barium salt). This procedure helps to explore the terrain and contours of the esophagus, and to study its motility.

What treatments offers the modern medicine?

Schema therapy depends on many factors, including the form of disease, the stage of its development, the patient's condition and the causes of stenosis. First we need to change the diet-the diet should consist of semiliquid and liquid food, which can pass through the area of narrowing of the esophagus. If we are talking about severe dysphagia the fourth degree when the patient is unable even to take a SIP of water, the meals is carried out intravenously.

There are several techniques to eliminate the constriction. In milder cases is balloon dilatation using bougies. But if the stenosis is not amenable to similar methods of the extension is endoscopic incision of the stricture. In that case, if there is compression of the esophagus (e.g., narrowing it near a growing tumor), the inside of the lumen can insert a special stent that will maintain the required dimensions of the esophagus.

Sometimes, the above methods do not give the desired result, the stenosis continues to progress. Your doctor may decide on a more radical solution-removing the affected part of the esophagus, with subsequent reduction.

Is it Possible to cure with traditional methods?

Traditional medicine — an industry that offers a huge amount of alternative therapies. Is there a way to get rid of using them from such diseases as stenosis of the esophagus? Treatment of folk remedies in this case is unacceptable. It is possible that the doctor will recommend the correct diet or give any other instruction. Home therapy in this case is absolutely contraindicated.

Are There any effective preventive measures?

Unfortunately, a truly effective means of prevention does not exist. With regard to the congenital forms, for mothers it is important to monitor the condition. In the presence of risk factors (moved during pregnancy, infection, etc.) the survey has to be conducted in the first days after birth, to be able to adjust the diet and time to take security measures.

In adulthood, the patient is recommended to follow the diet and treat diseases of the digestive tract, preventing their transition to more severe or chronic form.

The Prognosis for patients with stenosis of the esophagus

In the absence of timely treatment of stenosis of the esophagus may lead to many complications. However, surgery allows to eliminate the violation. Of course, the presence of comorbidities required additional therapy. However, the prognosis is quite favorable. A relapse is possible, but, according to the statistics, such cases are the exception and are recorded extremelyrare.