Stenosis, or narrowing of the esophagus, is a reduction in its diameter. It can be of various etymologies. Stenosis, it is also called obstruction of the esophagus, is divided into several groups, which depend on the causes of the disease. This disease can develop as a result of an injury to the gastrointestinal tract. The pathology may be based on a tumor of the esophagus (benign or malignant). Surgical interventions are possible to provoke the development of the disease, after which scars remain. In both adults and children, the esophagus may be affected. The narrowing of the esophagus often causes a violation of swallowing function (dysphagia).
What is a narrowing of the esophagus
To understand what constitutes a pathology, it is necessary to consider the anatomical structure. What is a normal esophagus? Is narrowing of the esophagus always a pathology? Let's get it right.
The esophagus is part of the digestive system. It performs in the human body the function of promoting food from the mouth to the stomach. A healthy esophagus also necessarily has constrictions that do not interfere with the advancement of food.
Anatomical constrictions distinguish 3:
- pharyngeal;
- diaphragmatic;
- bronchial.
In addition, physiological narrowing of the esophagus is observed. They are caused by muscle tone. With relaxation, the constrictions disappear.
They are located:
- in the area of the junction of the esophagus and stomach;
- at the intersection of the aorta and esophagus.
Pathology is an excessive narrowing that impedes the passage of food masses.
Causes of the disease
Stenosis is of two types:
In 90% of all cases, acquired pathology of various etymologies is diagnosed.
Sources of Congenital Disease
In such patients, the esophagus suffers from birth. Esophageal narrowing is usually diagnosed in early childhood. Congenital stenosis occurs already during the development of the fetus, until the birth of the baby.
The main causes of this pathology are:
- The impact of harmful substances on the body of the expectant mother. Household chemicals, gasoline, dyes, getting into the body of a woman, affect the development of the fetus and can cause abnormalities.
- X-ray irradiation. Exposure to radiation also causes mutational abnormalities in the body. That is why x-ray studies are strictly contraindicated for pregnant women .
- Various infections can also lead to deviations. These are viruses (for example, rubella), bacteria and simple microorganisms.
Causes of Acquired Disease
Pathology can develop in childhood and in adulthood. Acquired stenosis can be due to a number of reasons. It is able to manifest itself with the most minor pathologies affecting the esophagus.
The narrowing of the esophagus often occurs as a result of ulcers. Subsequently, these erosions begin to heal. The areas in which scars form are much worse reduced, as a result, food can not move freely. Such a process may underlie the 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 ;
- scarring on the walls of the esophagus after surgery;
- violation of the mucosa.
Stenosis can provoke inflammation of the esophagus caused by infection. Pathology can develop on the background of syphilis, scarlet fever, tuberculosis and diphtheria.
Injuries, such as a chemical or thermal burn of the esophagus, damage to the walls with tools or other objects, can also cause illness. Violations can occur even with improper probe of the gastrointestinal tract. A burn of the esophagus requires adequate and timely treatment. Otherwise, it can lead to a narrowing.
Much less often, factors affecting the narrowing of the esophagus are:
- mycosis;
- radiation therapy;
- collagenosis;
- sclerotherapy of varicose veins.
The narrowing can be dictated by the appearance of tumors. Unfortunately, cancer of the esophagus is a fairly common pathology. However, it is extremely difficult to treat.
Pathologies also arise due to causes of lesions and diseases that do not affect the esophagus. This is an aortic aneurysm, enlarged lymph nodes, mediastinal tumors, improper arrangement of blood vessels.
Degrees of development
There are four stages of the development of this disease:
- The first degree of stenosis. Easily cured, subject to timely consultation with a gastroenterologist. At this stage, the diameter of the esophagus decreases to 9 mm. Food masses pass, but with difficulty.
- The second degree - the esophagus narrows to 6 mm.
- On the third degree, the esophagus is narrowed to 3 mm.
- The fourth degree - 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 intestines, as a result, feces accumulate, from which toxins are formed that affect the human body. Even when swallowing saliva, a person suffocates from spasms, suffocation and coughing attacks.
Characteristic symptoms
A sign of stenosis is primarily a violation of the swallowing process.
Other indirect symptoms indicating a narrowing of the esophagus:
- Spitting of newborn milk with uncovered milk. If the milk has not curled, then it could not get into the stomach. Congenital narrowing of the esophagus can occur even during the introduction of complementary foods containing solid particles. In this case, the baby refuses food, often spits up, he has a gag reflex.
- In older adults, chest pain occurs due to tension in the muscles of the esophagus when trying to push food through the site of narrowing, further into the stomach.
- Increased salivation (hypersalivation) is a reaction to food masses that accumulate in the esophagus, not being able to go further into the stomach.
- Nausea and vomiting.
- Isolation of a large volume of mucus from the nose.
- Sudden weight loss caused by a violation in digestion, the inability to pass food through the esophagus and into the stomach. In this condition, vitamin deficiency develops. In severe cases of the disease, cachexia (depletion of the body) may develop.
Stenosis can be complicated by pneumonia. Often with this pathology, pieces of food fall into the respiratory tract. As a result of this disease, serious inflammation of the esophagus can develop and even rupture with bleeding can occur. Such complications require urgent medical attention.
Diagnostic Methods
Two methods are used to establish narrowing of the esophagus:
- Endoscopy The study establishes the diameter of the narrowing. If a stricture of the esophagus has formed (cicatricial changes), then this examination is quite informative. It allows you to visually check the mucous membrane. In addition, a biopsy is done.
- X-ray It is produced with the participation of barium. Detects filling defects, traces a contrasting body.
Diet food
At any stage of stenosis, you should always follow a diet. It is necessary to eat fractionally, often in small portions. Exclude from the diet all foods that may create difficulty in swallowing and thereby cause suffocation.
You can’t eat hot food, it must be warm. The consistency of the dishes is liquid, semi-liquid or soft. In this case, the body should receive with nutrition all the necessary vitamins and minerals.
Pathology treatment
What treatment methods are recommended for patients who are diagnosed with narrowing of the esophagus? Treatment of pathology is the expansion of the damaged area.
It is important not to forget about the diet. Until recovery comes, you need to eat only liquid and semi-liquid foods.
If peptic stricture of the esophagus is observed, then the patient is shown antacid and astringent drugs.
However, conservative therapy rarely leads to a complete recovery. Most often, it is prescribed to prepare the patient for surgery.
Bougienage (artificial expansion using special devices) is used if a benign tumor of the esophagus is detected. During treatment, the size of the bougie is gradually changed to a larger one.
If complications occur, a gastrostomy is applied to provide patients with the possibility of a normal diet.
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 it is not possible to carry out the operation, a gastrostomy is performed. In this case, the body gets the opportunity to eat enterally.
Disease prevention
The effect of treating narrowing of the esophagus depends on therapeutic techniques. Esophageal resection and endoprosthetics are considered the best methods of treating this disease.
After bougieurage and endoscopy, relapses may occur.
Prevention of stenosis involves timely treatment when the first symptoms of the disease occur.
It is imperative to fight diseases that can cause narrowing of the esophagus. Avoid exposing your esophagus to chemicals and other harmful substances. Prevent the esophagus from getting foreign objects into it.