𝑶𝒆𝒔𝒐𝒑𝒉𝒂𝒈𝒆𝒂𝒍 𝑺𝒕𝒓𝒊𝒄𝒕𝒖𝒓𝒆𝒔 Flashcards
What is an esophageal stricture?
An abnormal narrowing of the esophageal lumen.
What are the major etiologies of esophageal strictures?
Persistent reflux of gastric acid, systemic sclerosis, swallowing corrosive chemicals, esophageal surgery, esophageal cancer, traumatic endoscopic procedures, and frequent exposure to harmful stomach acid.
How does persistent acid reflux contribute to esophageal strictures?
It damages the esophageal lining, leading to inflammation, scarring, and narrowing over time.
What is the role of systemic sclerosis in esophageal stricture formation?
It causes fibrosis and stiffening of the esophagus, leading to narrowing.
Why can esophageal surgery lead to strictures?
Surgical trauma can cause scarring, which results in narrowing of the esophagus.
What is the pathophysiology of esophageal strictures?
Damage to the esophageal lining → inflammation (esophagitis) → scarring → stiffening → progressive narrowing → swallowing difficulties.
What is the most common symptom of esophageal strictures?
Dysphagia (difficulty swallowing).
What symptom is commonly experienced after meals in esophageal strictures?
Chest pain after eating.
What are the complications of regurgitation in esophageal strictures?
Aspiration into the lungs, leading to cough, wheezing, and shortness of breath (S.O.B).
What are some systemic symptoms of esophageal strictures?
Weight loss and dehydration.
Why do patients with esophageal strictures often have heartburn?
Reflux of stomach acid irritates the esophageal lining.
What diagnostic tests are commonly used for esophageal strictures?
History, physical examination, barium swallow test, esophageal pH monitoring, and upper GI endoscopy.
What is the purpose of the barium swallow test in diagnosing esophageal strictures?
It coats the esophageal lining, allowing better visualization of narrowing on X-ray.
How does esophageal pH monitoring help in diagnosing esophageal strictures?
It measures stomach acid entering the esophagus over 24 hours.
What is the first-line treatment for esophageal strictures?
A diet of liquids or soft foods.
What procedure is used to mechanically widen an esophageal stricture?
Mechanical dilation (esophageal bougienage).
Which medications are commonly used in the treatment of esophageal strictures?
Proton pump inhibitors (omeprazole, esomeprazole) and antacids.
When is surgical intervention considered in esophageal strictures?
In severe cases, the esophagus may be removed and replaced with a segment of the large intestine.
What is the purpose of a gastrostomy tube in esophageal strictures?
To bypass the esophagus completely for food intake.
Which foods should be avoided to prevent worsening of esophageal strictures?
Spicy foods, coffee, caffeinated products, fatty foods, and carbonated beverages.
