Esophageal obstruction (Esophageal stricture) – What is this disease? Obstruction (stricture) the esophagus is a narrowing of the esophagus traumatic, tumor or cicatricial Genesis, inconsistent with the passage of food in the digestive tube, that leads to a number of problems in the gastrointestinal tract.
The prevalence of this disease is about 30-50 accidents 100 th. the population.
Esophageal obstruction – The cause of the
Causes of obstruction (stricture) esophagus varied. One of the most common causes is erosivno-yazate reflux esophagitis and peptic rubcujushhiesja ulcer of oesophagus. Erosivno-azwenne processes in the esophagus can occur when diseases such, as gastroesophageal reflux disease, sliding (axial) hiatal hernia, stomach ulcer, chronic gastritis giperatidnyi, gestational toxicosis (with constant vomiting) and etc..
Often the cause of the development of esophageal strictures become mechanical, chemical and thermal injury of esophagus (foreign bodies, chemical burns acids, thermal burns, etc.), as well as iatrogenic causes (damage to the walls of the esophagus during soundings, conducting esophagogastroduodenoscopy, buzhirovanii, and also against the background of the prolonged reception high dosages of non-steroidal anti-inflammatory drugs).
More rare causes of narrow clearance of the esophagus become radiation therapy (Esophageal tumors, mediastinum, sclerotherapy varikozno expanded veins oesophagus, etc.), Esophageal tumors themselves and mediastinum, infectious diseases of the esophagus (When tuberculosis, scarlet fever, sifilise, diphtheria, etc.), fungal infections, aneurysm aortы, enlarged sredostennye lymph nodes and systemic connective tissue lesions (dermatomiozity, scleroderma, Systemic Lupus Erythematosus, etc.).
Symptoms of obstruction (stricture) esophagus
The main clinical symptom of this disease is a violation of the Act of swallowing (dysphagia). Develops dysphagia gradually, passing successive 4 severity (1 -periodic difficulty swallowing solid food, 2 -food is possible only semi food, 3 -permeability is retained only for liquid ingredients nutrition, 4 -difficulty even when trying to swallow water or saliva). It can be accompanied by a feeling of discomfort in the chest, pain, srygivaniem and vomiting, gipersalivaciej, acidic or bitter belch, loss of body mass index. At high location of the stricture food and water can get into the upper airway, causing cough, suffocation, laringospazm.
Esophageal obstruction – Diagnostics
The main methods of diagnosis of esophageal strictures are x-ray and endoscopy. When conducting x-rays apply water-soluble contrast or barium suspension (Depending on the degree of narrowing of the esophagus). Endoscopic examination allows evaluating the State of esophageal mucosa, as well as to visualize the nature of narrowing, take material for cytological and histological study (If you suspect the presence of a tumor process).
Esophageal obstruction – Classification
Depending on the location of the stricture distinguish high contraction (at the level of the cervical esophagus), average (in place of the Carina, at the level of the aorta), low contraction (kardial'noe, jepifrenal'noe), as well as combined (and esophagus, and stomach).
Depending on endoscopic pictures exists 4 the degree of narrowing of the esophagus:
· I ст. -permeability of the esophagus to medium-endoscope, the diameter of the esophagus in the most narrowly- 9-11 mm;
· II ст. -the smallest diameter clearance- 6-8 mm, go to fibrobronhoskopa;
· III ст. -the smallest diameter clearance (in the field of urethral stricture) is 3-5 mm, esophagus pass only for ultra thin fibroskopa;
· IV ст. -diameter of the lumen of the esophagus does not exceed 2 mm (can be fully obliterirovan, somknut), do not go for endoscopy studies.
Longest strictures are divided into short (less 5 cm), Electron (exceeding 5 cm), Subtotal (a small section of the oesophagus remains normal) and total stricture.
Esophageal obstruction – Actions of the patient
In case of difficulty in swallowing should immediately pass inspection and consult a specialist for timely treatment of the detected pathology.
Treatment of impassability (stricture) esophagus
Usually, in benign processes eliminating narrow esophagus stricture level exercise by balloon diljatacii and/or reconstricton. However, when the chemical and thermal burns should withstand exposure before reconstricton (minimum 2 of the week), because early intervention can lead to perforacijam and bleeding from esophageal. The ineffectiveness reconstricton (When high density scar) spend endoscopic dissection stricture. When squeezing the esophagus from the outside or tumor processes apply methodology endoprothesis of the esophagus. In severe cases, resorted to jezofagoplastike and gastrostomii. When the development strictures against the backdrop of erosive and ulcerative esophagitis, In addition to the above mentioned treatment methods, appoint cementing and antacid drugs.
Esophageal obstruction – Complications
This pathology can worsen digestive problems, metabolism, rupture of the esophagus, aspiration-etc.
Prevention of obstruction (stricture) esophagus
As a precaution, it is recommended to avoid injury to the esophagus, as well as the timely treatment of diseases, leading to the outbreak of esophageal strictures.