Esophageal stricture natural history, complications and prognosis

If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration. Common complications of esophageal stricture include perforation, bleeding, pneumonia, bacteremia. Prognosis is generally good but recurrence of symptoms after dilation are prevalent and usually recurrent dilation is necessary.

• The natural history of benign esophageal strictures starts with gradual dysphagia to solid food and heartburn.^[1]
• In some cases of esophageal stricture, symptoms of heartburn disappear when fibrosis is established.^[2]
• If left untreated, patients with esophageal stricture may progress to develop:^[3]
  • Pulmonary aspiration
  • Weight loss
  • Dehydration

• Common complications of esophageal stricture include:^[4][5]
  • Perforation
  • Bleeding
  • Pneumonia
  • Bacteremia

• Prognosis is generally good and depends on the cause of esophageal stricture. More than 80-90% of esophageal strictures respond well to endoscopic dilation but one third of patients have recurrent symptoms after one year.^[4][6]
• Weight loss is associated with poor prognosis among patients with esophageal stricture.^[7]
• Progressive gastroesophageal reflux may lead to extended esophageal stricture which prevent gastric acid to flow back in the esophagus. Loss of previous heartburn is related to more esophageal stricture.^[2]

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