Overview
Esophageal stricture is a narrowing of the esophageal lumen that causes progressive difficulty swallowing (dysphagia). It is classified as benign — most commonly caused by chronic GERD (peptic stricture), eosinophilic esophagitis, or surgical scarring — or malignant (esophageal cancer), which must always be urgently excluded. Most benign strictures are effectively managed by endoscopic dilation (balloon or bougie), often combined with treatment of the underlying cause. Inadequate treatment of the root cause invariably leads to stricture recurrence.
Symptoms
Progressive difficulty swallowing — initially with solid foods (meat, bread, dry foods), later with soft foods, eventually with liquids
Sensation of food sticking in the chest or throat after swallowing
Regurgitation of unchewed or poorly chewed food
Excessive salivation or drooling with severe stricture
Unintentional weight loss due to reduced oral intake
Common Causes
Chronic GERD — peptic (acid-induced) stricture; usually in the lower esophagus at the gastro-esophageal junction
Eosinophilic esophagitis — often produces multiple rings or fibrotic strictures; more common in younger patients
Surgical anastomosis — scarring after esophageal or gastric surgery
Radiation therapy to the chest, neck, or head region
Esophageal cancer — always excluded first with endoscopic biopsy; malignant dysphagia is typically rapidly progressive
Self-Care Tips
Take prescribed acid-suppression medication (PPI) daily without gaps — this is essential to prevent peptic stricture from recurring after dilation
Eat slowly, chew food extremely thoroughly, and cut all food into small pieces before swallowing
Avoid notoriously difficult foods: dry crusty bread, large pieces of meat, raw apple, or dry rice
Drink water with each mouthful to help wash food through
Remain upright for at least 2–3 hours after meals to minimise acid reflux
Attend all follow-up endoscopies for repeat dilation as scheduled — most peptic strictures require 1–3 sessions to maintain an adequate lumen
When to See a Doctor
Progressive difficulty swallowing is always an alarm symptom that requires endoscopy within 1–2 weeks to exclude malignancy. Seek emergency evaluation for complete food impaction (inability to swallow even your own saliva). Do not delay investigation by attributing dysphagia to anxiety, stress, or simple heartburn.
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