Esophageal stricture history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Overview

The hallmark of esophageal stricture is dysphagia. A positive history of heartburn is suggestive of esophageal stricture. The most common symptoms of esophageal stricture include dysphagia, odynophagia, and heartburn. Less common symptoms of esophageal stricture include chronic cough and wheezing.

History and Symptoms

The hallmark of esophageal stricture is dysphagia. Various history findings and symptoms associated with esophageal stricture are discussed below.

History

Patients with esophageal stricture due to different causes may have a positive history of:^[1]^[2]^[3]^[4]^[5]^[6]^[7]

Difficulty in swallowing
Pain in swallowing
Heartburn
Caustic ingestion
Radiation therapy
Esophageal cancer
Allergy history in eosinophilic esophagitis
Bullous skin eruptions in epidermolysis bullosa dystrophica
Hoarse voice
Hematemesis
Regurgitation of food
Anemia
Anorexia
Gastrointestinal bleeding

Common Symptoms

Common symptoms of esophageal stricture include:^[8]^[9]^[10]

Dysphagia ^[11]
- Benign and malignant strictures can be differentiated based on duration of dysphagia
- Long-standing, intermittent, nonprogressive dysphagia in benign strictures
- Weight loss, rapidly progressive dysphagia in malignant stricture
- Grades of dysphagia

Grade	Manifestations
I	Able to eat everything but with difficulty
II	Dysphagia to solids
III	Dysphagia to semi-solids
IV	Dysphagia to liquids
IV	Complete dysphagia

Odynophagia
Weight loss
Cough while swallowing
Heartburn
Stomach or chest pain
Acid taste in the mouth
Drooling
Trouble speaking

Less Common Symptoms

Less common symptoms of esophageal stricture can be related to aspiration pneumonia and include^[8]

Chronic cough
Wheezing
Shortness of breath
Asthma due to aspiration of acids

References

↑ Csendes A, Braghetto I (1992). “Surgical management of esophageal strictures”. Hepatogastroenterology. 39 (6): 502–10. PMID 1483661.
↑ Marks RD, Richter JE (1993). “Peptic strictures of the esophagus”. Am. J. Gastroenterol. 88 (8): 1160–73. PMID 8338082.
↑ Wasserman RL, Ginsburg CM (1985). “Caustic substance injuries”. J. Pediatr. 107 (2): 169–74. PMID 4020540.
↑ Coia LR, Myerson RJ, Tepper JE (1995). “Late effects of radiation therapy on the gastrointestinal tract”. Int. J. Radiat. Oncol. Biol. Phys. 31 (5): 1213–36. doi:10.1016/0360-3016(94)00419-L. PMID 7713784.
↑ Khanna N (2006). “How do I dilate a benign esophageal stricture?”. Can J Gastroenterol. 20 (3): 153–5. PMC 2582967. PMID 16550258.
↑ Luedtke P, Levine MS, Rubesin SE, Weinstein DS, Laufer I (2003). “Radiologic diagnosis of benign esophageal strictures: a pattern approach”. Radiographics. 23 (4): 897–909. doi:10.1148/rg.234025717. PMID 12853664.
↑ Ruigómez, Ana; Alberto García Rodríguez, Luis; Wallander, Mari-Ann; Johansson, Saga; Eklund, Stefan (2006). “Esophageal Stricture: Incidence, Treatment Patterns, and Recurrence Rate”. The American Journal of Gastroenterology. 101 (12): 2685–2692. doi:10.1111/j.1572-0241.2006.00828.x. ISSN 0002-9270.
↑ ^8.0 ^8.1 Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML (2016). “Natural history and management of refractory benign esophageal strictures”. Gastrointest. Endosc. 84 (2): 222–8. doi:10.1016/j.gie.2016.01.053. PMID 26828759.
↑ Siersema PD (2008). “Treatment options for esophageal strictures”. Nat Clin Pract Gastroenterol Hepatol. 5 (3): 142–52. doi:10.1038/ncpgasthep1053. PMID 18250638.
↑ Luedtke P, Levine MS, Rubesin SE, Weinstein DS, Laufer I (2003). “Radiologic diagnosis of benign esophageal strictures: a pattern approach”. Radiographics. 23 (4): 897–909. doi:10.1148/rg.234025717. PMID 12853664.
↑ Earlam R, Cunha-Melo JR (1981). “Benign oesophageal strictures: historical and technical aspects of dilatation”. Br J Surg. 68 (12): 829–36. PMID 7032643.

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[pmid1483661-1] Csendes A, Braghetto I (1992). “Surgical management of esophageal strictures”. Hepatogastroenterology. 39 (6): 502–10. PMID 1483661.

[pmid8338082-2] Marks RD, Richter JE (1993). “Peptic strictures of the esophagus”. Am. J. Gastroenterol. 88 (8): 1160–73. PMID 8338082.

[pmid4020540-3] Wasserman RL, Ginsburg CM (1985). “Caustic substance injuries”. J. Pediatr. 107 (2): 169–74. PMID 4020540.

[pmid7713784-4] Coia LR, Myerson RJ, Tepper JE (1995). “Late effects of radiation therapy on the gastrointestinal tract”. Int. J. Radiat. Oncol. Biol. Phys. 31 (5): 1213–36. doi:10.1016/0360-3016(94)00419-L. PMID 7713784.

[pmid16550258-5] Khanna N (2006). “How do I dilate a benign esophageal stricture?”. Can J Gastroenterol. 20 (3): 153–5. PMC 2582967. PMID 16550258.

[pmid12853664-6] Luedtke P, Levine MS, Rubesin SE, Weinstein DS, Laufer I (2003). “Radiologic diagnosis of benign esophageal strictures: a pattern approach”. Radiographics. 23 (4): 897–909. doi:10.1148/rg.234025717. PMID 12853664.

[RuigómezAlberto_García_Rodríguez2006-7] Ruigómez, Ana; Alberto García Rodríguez, Luis; Wallander, Mari-Ann; Johansson, Saga; Eklund, Stefan (2006). “Esophageal Stricture: Incidence, Treatment Patterns, and Recurrence Rate”. The American Journal of Gastroenterology. 101 (12): 2685–2692. doi:10.1111/j.1572-0241.2006.00828.x. ISSN 0002-9270.

[pmid26828759-8] 8.0 ^8.1 Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML (2016). “Natural history and management of refractory benign esophageal strictures”. Gastrointest. Endosc. 84 (2): 222–8. doi:10.1016/j.gie.2016.01.053. PMID 26828759.

[pmid18250638-9] Siersema PD (2008). “Treatment options for esophageal strictures”. Nat Clin Pract Gastroenterol Hepatol. 5 (3): 142–52. doi:10.1038/ncpgasthep1053. PMID 18250638.

[pmid128536642-10] Luedtke P, Levine MS, Rubesin SE, Weinstein DS, Laufer I (2003). “Radiologic diagnosis of benign esophageal strictures: a pattern approach”. Radiographics. 23 (4): 897–909. doi:10.1148/rg.234025717. PMID 12853664.

[pmid7032643-11] Earlam R, Cunha-Melo JR (1981). “Benign oesophageal strictures: historical and technical aspects of dilatation”. Br J Surg. 68 (12): 829–36. PMID 7032643.

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