What are the symptoms of esophageal strictures?

The most typical clinical symptom of esophageal stricture is dysphagia. If the stricture is caused by esophageal cancer, most of the strictures are progressive. In the early stages of this condition, the stenosis is usually not obvious, and in the middle and late stages, the stenosis is very severe.

Therefore, in the early stage, you can eat semi-liquid or ordinary food, and gradually you can only eat liquid and semi-liquid food, and finally you can only drink boiled water. Progressive dysphagia like this is often considered to be a case of esophageal cancer. Other benign lesions of esophageal strictures, such as esophageal leiomyomas, esophageal stromal tumors, or achalasia, may be characterized by esophageal strictures.

Most of these conditions do not show gradual dysphagia, but only sudden poor eating. Esophageal compression caused by lung mass is similar to the appearance of esophageal cancer, which needs to be ruled out in conjunction with chest CT examination. Therefore, the main symptom of esophageal stricture is dysphagia, which can also be accompanied by other manifestations such as nausea, vomiting, bloating, indigestion, and severe vomiting after swallowing.

The esophagus is a flat and narrow muscular duct, the upper end of which continues to the pharynx at the plane of the lower edge of the body of the 6th cervical vertebra, passes through the esophageal hiatus of the neck, thoracic cavity, and perforator of the diaphragm, and is about 25 cm long to the left side of the 11th thoracic vertebra. The esophagus varies in length and thickness, and there are three strictures: the first is equivalent to the beginning of the esophagus, the lower border of the 6th cervical vertebra, and about 15 cm from the central incisor.

The second is at the intersection with the left main answer or bronchi, corresponding to the plane of the sternal angle or between the 4 5 thoracic vertebrae, about 25 cm from the central incisor. The third is located at the hiatal foramen, equivalent to the plane of the 10th thoracic vertebra, about 40 cm from the central incisor. The above stenosis is the site where foreign bodies are easily retained, and it is also a common site for tumors.

Pay attention to these strictures during esophagoscopy or gastroscopy.

Answer]: The first stricture corresponds to the beginning of the esophagus; The second stenosis is at the intersection with the left main bronchus; The third stricture is located at the hiatus of the esophagus, and the anterior closure of the above stricture is the site where the foreign body is easy to retain, and it is also the site of the tumor, and these strictures should be paid attention to when intubating the gastric tube, esophagoscopy or gastroscopy for the first fissure.

Esophageal stricture is a relatively common disease, people of all ages may be formed, the patient's normal eating will be affected, and then the supply of nutrients in the body will also be limited, so it is easy to malnutrition, growth and development restriction and other abnormal conditions, so how to know whether it is suffering from esophageal stricture, which is the symptoms of tube stricture?

Clause. 1. Dysphagia.

If the esophageal stricture is caused by esophagitis or esophageal cancer. In the early stage of the disease, the stenosis is not very obvious, so the patient does not have typical manifestations, and with the gradual progression of the disease, generally in the middle and late stages, the degree of stenosis will become more severe, there will be progressive dysphagia, at first able to eat ordinary food or semi-liquid food, and then can only eat liquid food, or drink water. Progressive dysphagia is closely related to esophageal cancer, and esophageal strictures can also occur if you have esophageal leiomyomas, esophageal stromal tumors, and achalasia.

Clause. 2. Nausea and vomiting.

Some patients with esophageal stricture will be affected by their usual eating, and in life, especially when eating, they are more likely to have nausea and vomiting, which will cause retching even if they can't vomit sometimes. Some patients may experience sudden, very violent vomiting after a difficult swallow.

Clause. 3. Bloating, indigestion, etc.

Although patients with esophageal stricture eat more delicately, after the food enters the gastrointestinal tract through the esophagus, there may be digestive manifestations such as abdominal distension and indigestion, which brings greater pain to the patient.

Esophageal stricture is a progressive disease, many patients do not have obvious manifestations at the beginning, but may suddenly have poor eating, and then nausea, vomiting, stomach distention, indigestion and other conditions, we should pay great attention to esophageal stricture, especially esophageal stricture caused by esophageal cancer, not to mention it.

This disease is the result of excessive proliferation of the trachea, the base of the esophageal diaphragm, or the mesodermal components of the esophageal lateral crest during the development of the esophageal embryo, and usually occurs below the tracheal bifurcation.

Common causes of acquired stenosis:

1.The esophageal mucosal epithelium is damaged by inflammation or corroded by chemicals, and a scarring stricture is formed after repair;

2.Esophageal tumors, such as esophageal cancer, obstruct the lumen of the esophagus to varying degrees;

3.Periesophageal tissue lesions are caused by external compression of the esophagus, such as lung and mediastinal tumors, aneurysms, goiters, etc.

The diameter of the esophagus is not uniform up and down, and due to the structural characteristics of the esophagus itself and the influence of adjacent organs, the esophagus presents three strictures.

The first stenosis is located at the junction of the pharynx and esophagus, 15 cm from the central incisor;

The second stenosis is located at the level of the tracheal branch, and the left main bronchus spans its anterior position, corresponding to the sternal angle or the level of the 4th and 5th thoracic discs, 25 cm from the central incisors;

The third stricture is where the esophagus passes through the diaphragmatic esophageal hiatus, which corresponds to the level of the 10th thoracic vertebra and is 37 40 cm from the central incisor.

The two ends of the esophagus, the first and third strictures, are often closed, with the former preventing air from entering the esophagus from the pharynx during inspiration, and the third stricture, which prevents the reflux of gastric contents into the esophagus. The second stricture is caused by compression of the adjacent aortic arch and left main bronchus, and this stenosis does not affect the passage of food and has no physiological significance, but the second stricture is often a common site for foreign body incarceration and esophageal cancer.

X-rays are the main basis for diagnosing the disease, and imaging should be used to distinguish the following conditions:

1.Achalasia narrows are located in the cardia and open intermittently, and barium can be sprayed into the stomach. Congenital esophageal strictures are persistent strictures with no signs of open ejection, but barium can continue to pass. Esophageal dilation above strictures is usually less pronounced than in achalasia.

2.Acquired reflux esophagitis has narrowed esophagus that is not smooth, uneven, mucosal destruction or niches, and sometimes hiatal hernia. During follow-up observations, the stenosis may worsen or lengthen. Clinical symptoms are also worsening.