Esophageal Stenosis FYI

Esophageal Condition, Narrowing

Esophageal stenosis is a narrowing of the esophagus caused by the buildup of scar tissue or by a congenital defect.

Esophageal Stenosis Causes, Incidence, and Risk Factors

In adults, the causes of esophageal stenosis are generally acid reflux disease and other digestive troubles.  In children the condition is usually a form of congenital birth defect known as esophageal atresia.  In most types of esophageal atresia the esophagus ends before reaching the stomach or connects to the windpipe.  In esophageal stenosis, the esophagus itself gradually narrows.

  • Some form of atresia occurs in about one out of every four hundred births with many of these falling into the category of stenosis.
  • It is usually accompanied by other birth defects.
  • It occurs during the fourth week of development.
  • It can go undiagnosed until adulthood, depending upon the severity of the narrowing.

Exact causes of congenital birth defects are usually unknown, but some risk factors could increase the chances of developing esophageal stenosis.

  • Use of illegal drugs, alcohol, or cigarettes while pregnant could increase the chances of this condition occurring.
  • Some prescription medications have been linked to esophageal stenosis.
  • Hereditary and genetic factors could also play a role in the development of the condition.

Esophageal Stenosis Symptoms

There are several symptoms that could point towards a diagnosis of esophageal stenosis.

  • Feeding troubles including coughing, choking, or gagging during feeding.
  • Poor feeding habits.
  • Bluish tint to the skin or mucus membranes during feeding.
  • Drooling.

Esophageal Stenosis Diagnosis

In most cases this condition is noticed shortly after birth when feeding difficulties present themselves.  Tests can confirm the presence of esophageal stenosis.

  • An X-ray can reveal the structure of the esophagus and tell doctors the nature of the problem.
  • Attempts to insert feeding tubes could also lead to blockages, and an inability to insert the tube completely is often a strong sign of esophageal stenosis.
  • An upper GI endoscopy is usually the easiest way to diagnose esophageal stenosis, and a camera inserted down the esophagus will be able to determine the severity of the condition.

Esophageal Stenosis Treatment

Esophageal atresia surgeries will be performed as soon as possible after a diagnosis, and are treated as an emergency.  Steps will be taken to properly connect the esophagus to the stomach and in the case of esophageal stenosis, the procedure will focus on widening the esophagus to proper levels.  In some cases an endoscopy might be performed to widen the opening.

Esophageal Stenosis Prognosis

The sooner the condition can be corrected, the better the outlook will be.  Most surgeries will correct the condition and the child can live a long, healthy life afterwards.

Esophageal Stenosis Complications

Various complications could arise from this condition including:

  • Reflux
  • Feeding difficulties
  • Fluid in the lungs
  • Pneumonia
  • Choking
  • Death

Calling your Health Provider about Esophageal Stenosis

If your child vomits, gags, or chokes during feeding or has breathing difficulties then you should immediately contact your health care professional.

Esophageal Stenosis Prevention

In adults, treating and monitoring acid reflux is the easiest method of prevention.  For expectant mothers, avoiding high risk activities during pregnancy is the best prevention.  Since the exact causes of congenital esophageal stenosis aren’t known, these are the only real measures available.

Esophageal Stenosis References

Orenstein S, Peters J, Khan S, Youssef N, Hussain SZ. Congenital anomalies: esophageal atresia and tracheoesophageal fistula. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 316.

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