Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is suspected, further diagnostic investigations are warranted. The primary diagnostic and therapeutic intervention is an upper GI endoscopy. It is crucial to biopsy any identified strictures to rule out malignancy.
A barium swallow involving chest X-rays may be necessary depending on the severity of dysphagia and clinical symptoms. This imaging test helps evaluate conditions like foreign body impaction, diaphragmatic hernia, and certain pulmonary conditions. It also provides insights into strictures' level, size, extent, and severity, which is particularly useful when standard endoscopes cannot pass the stricture.
Endoscopic ultrasound (EUS) can offer high-resolution images of the esophageal wall and detailed information on the extent of esophageal injury, especially in benign stricture causes.
Treatment Options for Esophageal Strictures:
Lifestyle Modifications:
These strategies are crucial for managing GERD and preventing or delaying the development of esophageal strictures.
From Chapter 9:
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