Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in strictures.
Ingestion of household cleaning products, accidental or deliberate, can cause esophageal injury ranging from minor to severe, often resulting in strictures due to full-thickness necrosis.
Radiation therapy, a standard treatment for head, neck, and lung cancers, can lead to radiation-induced esophageal strictures as a long-term complication. The targeted radiation in cervical or thoracic regions can damage surrounding soft tissues, including the esophagus, with strictures typically developing within a median of 6 months post-treatment.
Malignant tumors in the esophagus can infiltrate its layers – the mucosa, submucosa, muscularis propria, and adventitia. Tumor growth within these layers leads to scarring, fibrosis, and subsequent narrowing of the esophagus. Additionally, tumors in adjacent organs or lymph nodes can exert external pressure, causing further constriction.
Eosinophilic esophagitis is another cause, where eosinophils accumulate in the esophagus, causing inflammation, constriction, and strictures due to an allergic response.
Risk factors
Other potential causes of esophageal strictures include congenital abnormalities, prolonged nasogastric tube use, long-term NSAID medication use, and post-surgical complications such as those following fundoplication for GERD.
Esophageal strictures refer to the abnormal narrowing or tightening of the esophageal lumen, ranging from a mild constriction to a complete obstruction.
The most common cause of esophageal strictures is chronic acid reflux, which triggers inflammation, damages, and scars the esophageal lining, leading to strictures.
Accidental or intentional ingestion of acids or alkalis damages the esophagus, with acids causing coagulative necrosis and alkalis causing liquefactive necrosis; both can result in stricture formation.
Furthermore, radiation therapy to the cervical or thoracic regions for cancer treatment can harm the esophagus, causing radiation-induced esophageal stricture.
Next is eosinophilic esophagitis, an allergic condition where the esophagus fills with eosinophils, causing swelling, narrowing, and esophageal stricture.
Lastly, damage caused by endoscopic procedures can cause physical trauma to the esophageal lining, leading to esophageal strictures.
Other causes of esophageal strictures include tumors, congenital esophageal strictures, prolonged NSAID use, extended nasogastric tube use, GERD Nissen fundoplication surgery, and the presence of foreign objects in the esophagus.
繁體中文
