Esophagus is the food pipe that connects the mouth to the stomach. It carries food we eat from mouth to stomach. This esophageal pipe may become narrowed creating difficulty and pain in swallowing the food we eat due to various reasons. Some of the reasons are given below.
1) Reflux of stomach acids: Acids produced in the stomach may be refluxed into esophageal tube. These refluxed acids produce strictures in the lower part of the esophageal tract which cause the narrowing of the esophageal tube and hindrance to the passage of food.
2) Schatzki ring: In about 6 % of the population it is seen that a circular band of tissues called the schatzki’s ring is the cause for the narrowing of the esophageal tube. Medical science has not found an answer to the question how or why these rings are forming.
3) Web in esophagus: In some people a layer of normal tissue grows inside the esophageal tract. The growth of these tissues can decrease the width of the tube.
4) Eosinophilic esophagitis: This is an allergic disorder found commonly in man than women which also can cause the shrinkage of esophageal passage.
5) Tumors/cancers in esophageal tract: Formation of tumors or cancerous cells is another cause that can narrow the esophageal pipe.
Narrowing of the food pipe is usually diagnosed by conducting a barium test. In this test the patient is given some liquid containing barium for drinking. X-ray pictures are taken several times to clearly show the passage of the liquid through the esophageal tract. With the help of this X-rays your surgeon will be able to find out the exact location and the extend of the narrowing
The narrowing caused by the reflux of acids from the stomach can be treated by medications. Use of esophageal stent and esophageal dilation are the other two options.
Esophageal dilation: In this procedure a specially designed guide wire is introduced into the food pipe. With the help of this a semi-rigid dilator is introduced into the stomach and it is allowed to pass through the stricture thereby widening it. This process is repeated with dilators with increased diameter so that the width of the esophageal passage increases slowly. This procedure can be done with the help of an endoscope where the surgeon will be able to view the actions in the video screen. In some cases this is done without the help of an endoscope also.
Esophageal stenting: Stents are tubes made of plastic, mesh, or metal. By inserting a stent in the area where the narrowing of the food pipe has occurred, its width can be restored and the pain and the problems in swallowing can be overcome. Insertion of the stent is done through an endoscopic procedure. Endoscope is an instrument which has a camera and a light source on one side of it and the videos taken by the camera are allowed to be displayed in the monitor placed before the surgeon. With the help of this instrument the stent is inserted to the food pipe and it is release when it reaches the appropriate location.
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