Esophageal stricture and it’s treatment

Throat tightness is very much familiar for many people which causes uncomfortable, pain and even frightening feeling. Sometimes this tightness is for short time and hence may be recognized as anxiety or an allergic reaction. But persistent tightness which get worsen with time may be due to esophageal stricture. Not only tightness but person may feel pain in underlying tissue also. Gastroesophageal reflux or GERD can harm to esophageal tissue over time which can result in a scar and person may feel difficulty in swallowing.

Let’s take a look at common tests that are used to diagnose esophageal stricture :

Diagnosing Esophageal Stricture

  • Barium Swallow – After swallowing barium, x-rays are taken to show the narrowing of the esophagus
  • Endoscopy – A thin scope with light and camera, known as an endoscope, is guided into the esophagus in order to visualize the narrowing.  This procedure is generally performed under a sedative and local anesthetic.

Treating Esophageal Stricture

  • Proton Pump Inhibitors (PPIs) – PPI is used to treat GERD. By alleviating the symptoms of GERD, they are thereby able to reduce the pain, inflammation, and irritation in the throat.
  • Dilation – In this procedure, the esophagus is dilated through weighted dilator that is passed through the mouth and into the esophagus.  This treatment is typically performed by giving local anesthetic.  If stricture pain is severe then it is performed for multiple times.
  • Surgery – Surgery may be recommended by the gastroenterologist. In rare cases in which the stricture cannot be adequately dilated or strictures continue to return after repeated dilations, surgical treatment may be necessary.

Prognosis is very important after treatment. Some patients may require subsequent treatment, but most patients can resume to their normal diet and routine.

It is possible to prevent the initial development of esophageal strictures by using caution to avoid the accidental ingestion of corrosive substances. If you suffer from frequent or prolonged heartburn, see a gastroenterologist doctor for diagnosis and treatment of GERD.  If the appropriate steps are taken to prevent esophageal stricture or to treat it once it occurs, the condition should have minimal impact.

If you feel difficulty swallowing and inflammation or irritation of the throat, it may be time to speak with a gastroenterology specialist about the possibility of esophageal stricture.


All you need to know about ERCP procedure

What is ECRP?

ERCP is procedure that allow gastroenterologist doctors to examine pancreatic and bile ducts. ERCP is a flexible, lightweight tube (endoscope) having thickness of index finger which can be inserted through mouth and into your stomach and first part of the small intestine (duodenum). In the small intestine there are 2 small openings ampulla and cannula through which tube is inserted. Then dye (contrast material) is injected into the area and X-rays are taken in order to study the ducts of the pancreas and liver.

Why is an ERCP performed?

ERCP is very useful to examine and treat the conditions of pancreas or bile ducts. It is very useful to diagnose symptoms of diseases and abnormalities in these organs that includes abdominal pain, weight loss, jaundice (yellowing of the skin), or an ultrasound or CT scan that shows stones or a mass in these organs.

ERCP is also useful the post-operative performance of gallbladder surgery, diagnose and remove bile duct stones, diagnose and treat cancerous and noncancerous tumours.

ECRP is also used to determine, whether surgery is required aor not for suspected or known pancreatic disease and pancreatic stones can also be removed by it.

What precaution is required before ERCP?

  • Person should not eat anything apprx. 8 hours before the examination.
  • Person should discuss with doctor about his/her current medication.
  • Also discuss about allergies if any.
  • Also, inform about diseases like heart or lung disease as it may require special care while performing procedure.

What can be expected during the ERCP?

Local anaesthetia is used before procedure to numb your throat and prevent gagging. Doctor also give some medications to feel relax during procedure. Then person is allowed to lying down in comfortable position an X-ray table and endoscope is passed through mouth down to esophagus, and into stomach and duodenum.

Usually the procedure lasts for 1 hour but time may vary depending on planned intervention. Note that endoscope does not interfere with breathing. Person may feel temporarily bloated during and after the procedure due to the air used to inflate the duodenum.

What happens after ERCP?

Once the process is done, physician will inform about test results on the same day. Biopsy results may take few days. Person is kept under observation for 1-2 hours

You will be monitored in the endoscopy area for 1-2 hours until the effects of the sedatives have worn off. Person may feel sore for 1-2 day in throat area. He/she can resume diet and take routine medication after you leave the endoscopy area, unless otherwise instructed.

What complications can occur?

ERCP is absolutely safe if performed by well experienced and trained endoscopic physician. Usually there are no complications, however, they can occur like pancreatitis due to irritation of the pancreatic duct by the X-ray contrast material or cannula. A reaction due to the sedatives may occur. Irritation in vein in which medications were given. Slight bleeding may occur during surgery.


Get answered to all your questions about acid reflux

Acid reflux and heartburn are the most common complaints that people are facing these days.  Most people understand that the burning sensation of reflux directly results result into acid.  However, there are many other questions about acid reflux which are still not clear. Here is the list of common questions and their answers about acid reflux, that you should know: 

What is the difference between heartburn and acid reflux disease?

Heartburn is very common and is experienced by most of the people. If a person has acid reflux or heartburn more than twice a week it is called as acid reflux disease, which is also known as gastroesophageal disease or GERD.

What causes acid reflux disease?

Acid reflux occurs due to improper functioning of sphincter at the bottom of the esophagus like failing to close properly, opening at the wrong time. It may be due to LES is weaker than it should be. The disease can also be caused due to hiatal hernia. In this type of hernia, part of the stomach moves so that it is above the diaphragm. Obesity or overweight increases the risk of hiatal hernia and GERD.

How does diet affect acid reflux disease?

Acid reflux is often made worse by the following types of food.

  • Foods that are high in fat
  • Acidic foods like tomatoes and citrus fruits
  • Spicy foods
  • Peppermint (mint relaxes the LES)
  • Alcohol
  • Caffeine
  • Chocolate

Avoid above foods to reduce the risk of acid reflux. Eat small, frequent meals, and do not eat 3 hours before you go to bed. Lying down after eating makes it easier for digestive juices to escape the stomach.

What medications can I use to treat acid reflux disease?

Antacids like calcium carbonate tablets (Tums) is recommended to reduce risk of acid reflux. Antacids helps to neutralize the acid level so it is less irritating to the esophagus. However, this is a temporary solution.

Proton pump inhibitors (PPIs) medicine reduces the acid level produced by stomach. You can take small dosages of some PPIs without any prescription. Gastroenterologist often prescribe a higher dosage and may tell you to take the tablets on a regular basis.

Is there any side effects of medications for acid reflux?

Antacids contains either calcium or magnesium salts. Calcium can cause constipation and magnesium can cause diarrhoea. Therefore, taking an antacid containing both calcium and magnesium can help to prevent these side effects. Usually there are no side effect but people may feel nausea, headaches, constipation or diarrhoea.

If you are suffering from acid reflux, visit Gadhikar Clinic. The skilled  gastroenterologist, Dr. Harshal Gadhikar provides effective treatment for acid reflux.