Esophagus, narrowing of the esophagus: causes, symptoms and treatment

Stenosis, or narrowing of the esophagus, is a reduction in its diameter. It can be of different etymologies. Stenosis, it is called the obstruction of the esophagus, is divided into several groups, which depend on the causes of the onset of the disease. This disease can develop as a result of a trauma to the gastrointestinal tract. The pathology may be based on the tumor of the esophagus (benign or malignant). To provoke the development of the disease, surgical interventions are possible, after which scars remain. Both in adults and in children, the esophagus can suffer. The narrowing of the esophagus often causes a violation of the swallowing function (dysphagia).

What is the narrowing of the esophagus?

To understand what a pathology is, an anatomical structure should be considered. What is a normal esophagus? Is the constriction of the esophagus always a pathology? Let's understand.

Esophagus is part of the digestive system. He performs in the human body the function of promoting food from the mouth to the stomach. A healthy esophagus also necessarily has contractions that do not interfere with the progress of food.

Anatomical constrictions are isolated 3:

• Pharyngeal;
• Diaphragmatic;
• Bronchial.

In addition, physiological narrowing of the esophagus is observed. They are caused by the tone of the muscle tissue. With relaxation, the narrowing disappears.

They are located:

• In the junction zone of the esophagus and stomach;
• In the area of the aorta and esophagus.

Pathology - these are excessive constrictions, which make it difficult for the food masses to pass.

Causes of the disease

Stenosis can be of two types:

• acquired;
• congenital.

In 90% of all cases, the acquired pathology of various etymologies is diagnosed.

Sources of congenital disease

In such patients, the esophagus suffers from birth. The narrowing of the esophagus is diagnosed, as a rule, in early childhood. Congenital stenosis occurs even during the development of the fetus, before the birth of the child.

The main reasons for this pathology are:

1. The effect of harmful substances on the organism of the future mother. Household chemicals, gasoline, dyes, getting into the body of a woman, affect the development of the fetus and can cause deviations.
2. Irradiation with X-rays. The effect of radiation also causes mutational abnormalities in the body. That is why pregnant women are categorically contraindicated in radiology.
3. To the deviations can also lead to various infections. These are viruses (for example, rubella), bacteria and protozoan microorganisms.

Causes of acquired disease

Pathology can develop in childhood, and in quite an adult age. Acquired stenosis can be due to a number of reasons. It is able to manifest itself in the most minor pathologies affecting the esophagus.

The narrowing of the esophagus often occurs as a result of ulcers. Later, these erosions begin to heal. The areas on which scars form are significantly reduced, and as a result food can not move freely. Such a process can underlie pathology. In this case, cicatricial narrowing of the esophagus is diagnosed.

Ulcers can occur due to the following factors:

• Axial hernia of the esophagus ;
• Chronic gastritis and stomach ulcer;
• Toxicosis during pregnancy, which is accompanied by vomiting reflexes;
• Gastroesophageal reflux disease ;
• The formation of scars on the walls of the esophagus after surgery;
• Mucosal dysfunction.

Stenosis can provoke an inflammation of the esophagus, caused by infection. Pathology can develop against the background of syphilis, scarlet fever, tuberculosis and diphtheria.

Injuries, such as chemical or thermal burn of the esophagus, damage to the walls by tools or other objects, can also cause the disease. Disturbances can occur even if the gastrointestinal tract is not correctly probed. Esophageal burn requires adequate and timely treatment. Otherwise, it can lead to a narrowing.

Much less common factors affecting the narrowing of the esophagus are:

• mycosis;
• radiation therapy;
• Collagenosis;
• Sclerotherapy of varicose veins.

Narrowing can be dictated by the appearance of tumors. Unfortunately, esophageal cancer is a fairly common pathology. However, it is extremely difficult to treat.

Pathologies also occur due to lesions and diseases that do not affect the esophagus. This is an aortic aneurysm, an increase in lymph nodes, a mediastinal tumor, an improper arrangement of blood vessels.

Degrees of development

There are four stages in the development of this disease:

1. The first degree of stenosis. Easily cured with timely advice from a gastroenterologist. At this stage, the diameter of the esophagus decreases to 9 mm. Food masses pass, but with difficulty.
2. The second degree - the esophagus narrows to 6 mm.
3. At the third degree, the esophagus narrows down to 3 mm.
4. The fourth degree - the narrowing of the esophagus to 1 mm makes the disease critical. At this stage of the disease, the food consumed is not digested by the body and stagnates in the intestine, as a result, stools accumulate, from which toxins that damage the human body are formed. Even with the ingestion of saliva, a person suffocates from spasms, suffocation and coughing attacks.

Characteristic symptomatology

A sign of the occurrence of stenosis is, first of all, a violation of the swallowing process.

Other indirect symptoms indicating a narrowing of the esophagus:

1. Regurgitation of newborn unallocated milk. If the milk did not curdle, then it could not get into the stomach. Congenital narrowing of the esophagus may appear even during the introduction of complementary foods containing solid particles. In this case, the baby refuses food, often regurgitates, he has a vomiting reflex.
2. In the more adult, there is chest pain, which arises from the strain of the muscles of the esophagus when trying to push food through the place of narrowing, further into the stomach.
3. Increased salivation (hypersalivation) is a reaction to food masses that accumulate in the esophagus, not being able to go further into the stomach.
4. Nausea and vomiting.
5. Isolation of a large amount of mucus from the nose.
6. Sudden weight loss caused by a violation in digestion, the inability to pass food through the esophagus and getting it into the stomach. With this condition, avitaminosis develops. With severe disease, cachexia may develop (body exhaustion).

Stenosis can be complicated by pneumonia. Often, for this pathology, food pieces enter the respiratory tract. As a result of this disease, serious inflammation of the esophagus may develop and even its rupture with bleeding may occur. Such complications require urgent medical intervention.

Methods of diagnosis

To establish the narrowing of the esophagus, two methods are used:

1. Endoscopy. The study sets the diameter of the constriction. If a stricture of the esophagus is formed (cicatricial changes), then this survey is quite informative. It allows you to visually check the mucosa. In addition, a biopsy is done.
2. X-ray. Produced with the participation of barium. Detects defects in filling, traces the contrasting body.

Dietary food

At any stage of stenosis, you should always follow a diet. Eat little, often and in small portions. From the diet to exclude all foods that can create difficulties in swallowing and thereby cause choking.

You can not eat hot food, it should be warm. The consistency of the dishes is liquid, semi-liquid or soft. In this case, the body must receive with food all the necessary vitamins and minerals.

Treatment of pathology

What methods of therapy are recommended for patients who are diagnosed with esophageal narrowing? Treatment of pathology is the extension of the damaged area.

It is important not to forget about the diet. Until recovery comes, only liquid and semi-liquid food should be fed.

If peptic stricture of the esophagus is observed, the patient is shown antacid and astringent drugs.

However, conservative therapy rarely leads to complete recovery. Most often it is prescribed to prepare the patient for surgical intervention.

Buzhirovanie (artificial expansion with the help of special devices) is used in the event that a benign tumor of the esophagus is found. In the process of treatment, the size of bougie is gradually changed to a larger one.

If complications arise, gastrostomy is applied to provide patients with the opportunity of normal nutrition.

Esophagoplasty is the transplantation of a portion of the intestine or stomach into the esophagus.

In severe cases, when the body is very depleted, or an operation is not possible, gastrostomy is performed. In this case, the body gets the opportunity to eat enterally.

Prevention of disease

The effect of treating the narrowing of the esophagus depends on therapeutic techniques. Esophageal resection and endoprosthetics are considered to be the best methods of treating this disease.

After bougie and endoscopy, relapses may occur.

Prevention of stenosis involves timely treatment when the first symptoms of the disease occur.

It is necessary to fight against diseases that can cause narrowing of the esophagus. Carefully avoid exposure to the esophagus of chemicals and other harmful substances. Prevent the esophagus from getting into it foreign objects.