A lot of people have heartburn once in a while, maybe after a heavy or fatty meal. But gastroesophageal reflux disease (GERD) is more than just occasional heartburn.
With GERD, you have heartburn symptoms repeatedly. That can be dangerous because when you have heartburn, stomach acid goes into your esophagus. Unlike your stomach, your esophagus doesn’t have a lining that helps protect it from stomach acid. So over time, that acid can cause damage.
One of the problems untreated GERD can cause is esophageal strictures. “They develop when stomach acid damages the lining of the esophagus and causes inflammation, irritation and scar tissue,” said Wahid Wassef, MD, a gastroenterologist with Banner – University Medicine.
Scar tissue is stiffer and less flexible than the normal tissue in your esophagus. “Over time, the scar tissue can make your esophagus narrower, so it’s harder to swallow and more likely that food could become stuck or aspirated,” Dr. Wassef said. The longer GERD is untreated, the higher the chance of developing esophageal strictures.
Watch for these symptoms
You may have an esophageal stricture if you notice:
- Difficulty swallowing (dysphagia), especially with solid foods.
- A feeling that food is sticking in your throat or chest during or after meals.
- Regurgitation of food or liquids back into your throat or mouth.
- Unintentional weight loss due to trouble eating.
“In order to swallow normally, the space inside your esophagus needs to be about a half-inch wide,” Dr. Wassef said. “If the scarring causes the space to shrink down to less than that, food can get stuck.”
If you have symptoms of esophageal strictures, talk to a health care provider. They can evaluate them and recommend a treatment plan. When you address symptoms of GERD and esophageal strictures as soon as you notice them, you’re more likely to be able to treat them.
“You’ll also want to see a provider to make sure that it’s GERD and not something else that’s causing your symptoms,” Dr. Wassef said. You could have other conditions, such as eosinophilic esophagitis or Barrett’s esophagus, which may need different treatments.
Why treatment is important
Esophageal strictures can cause complications that may impact your health and your daily life:
- You may have discomfort or pain, especially when you’re swallowing.
- Food can get stuck in your esophagus and cause choking. “At times, it can go down by drinking water. But if it doesn’t, you may need to go to the emergency room to have the food removed,” Dr. Wassef said.
- Saliva that can’t be swallowed may get into your lungs and cause aspirational pneumonia.
- You may avoid certain foods or not eat enough, so you may not get the nutrients you need.
Preventing and diagnosing esophageal strictures
If you have symptoms of GERD like frequent heartburn, regurgitation or trouble swallowing, you’ll want to see a health care provider. They may recommend tests to diagnose GERD, such as:
- Endoscopy: A provider inserts a thin, flexible tube with a camera through the mouth and into the esophagus to look at the lining.
- Barium swallow: An X-ray test where you swallow liquid so it’s easier to see the esophagus and then swallow a tablet to see if it gets stuck. “If it doesn’t travel down, it confirms an esophageal stricture,” Dr. Wassef said.
- pH monitoring: A test that measures how often stomach acid enters your esophagus and how long it stays there.
How are esophageal strictures treated?
If you have esophageal strictures, your provider may recommend treatment options for GERD, such as lifestyle changes and medication.
They may also recommend an esophageal dilation procedure to widen the esophagus. It can be done in two ways:
- A specialized balloon is put through an endoscope to the area where the esophagus is narrower, then the balloon is inflated to stretch and widen the area.
- A wire is placed through an endoscope, and catheters of different sizes are inserted over the wire to open the area.
“In both cases, you need slow and gentle dilation to avoid damaging the esophagus,” Dr. Wassef said. Depending on how much of your esophagus is narrow and how narrow it is, you may need to have esophageal dilation several times.
Afterward, you’ll need to take a medication called a proton pump inhibitor (PPI) to lower the amount of acid your stomach makes so the stricture doesn’t come back.
Here’s how to reduce your risk
By managing GERD, you can keep stomach acid from reaching your esophagus and lower your risk of developing esophageal strictures. These lifestyle changes can help:
- Eat smaller, more frequent meals.
- Limit spicy foods, citrus fruits, chocolate and caffeinated drinks.
- Elevate the head of your bed to reduce nighttime acid reflux.
- Reduce stress.
- Maintain a healthy weight.
- Get regular moderate, low-impact physical activity.
Your health care provider may also recommend medications such as:
- Antacids
- H2 blockers
- Proton pump inhibitors (PPIs)
- Combinations of medications
Be sure to have regular follow-up appointments with your health care provider to discuss your symptoms and how well your treatment plan is working. The right treatment plan can improve your symptoms and your quality of life.
The bottom line
If you have GERD, it’s important to treat it. Otherwise, your stomach acid could cause scarring in your esophagus over time. That’s called an esophageal stricture and with it, food can get stuck in your esophagus and cause complications.
If you have symptoms of GERD or esophageal strictures like frequent heartburn, regurgitation or a sensation that food is stuck, reach out to your health care provider or an expert at Banner Health.
