Esophageal Stricture: Symptoms and Diagnosis Explained - Otolaryngology

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Esophageal stricture, or narrowing of the esophagus, can lead to various symptoms that significantly affect a person's quality of life. The symptoms you are experiencing, such as difficulty swallowing, a sensation of fullness or bloating after eating, and the need to expel air, could indeed be indicative of an esophageal stricture. This condition can arise from several underlying causes, including chronic gastroesophageal reflux disease (GERD), inflammation, or scarring from previous injuries or surgeries.

When food passes through a narrowed esophagus, it may cause discomfort, leading to the sensation of needing to regurgitate or expel air. This can be particularly pronounced when consuming larger or fibrous foods, such as apples or oranges, which may be more difficult to pass through a constricted area. The act of straining to expel air can also create pressure that may inadvertently push food back up, resulting in a feeling of nausea or the urge to vomit.

To diagnose esophageal stricture, a healthcare provider typically recommends an upper endoscopy (esophagogastroduodenoscopy, or EGD). During this procedure, a flexible tube with a camera is inserted through the mouth and into the esophagus, allowing the physician to visualize the esophagus and potentially identify any strictures or abnormalities. Biopsies may also be taken to rule out malignancy or other conditions.

Regarding your question about fasting before the examination, it is generally recommended to have an empty stomach for an upper endoscopy. This is to ensure that the physician has a clear view of the esophagus and stomach and to reduce the risk of aspiration during the procedure. Typically, patients are advised not to eat or drink anything for at least six to eight hours prior to the procedure.
As for scheduling the examination, it can often be performed on the same day as your initial consultation, depending on the availability of the endoscopy suite and the physician's assessment. However, in some cases, it may be necessary to schedule the procedure for another day, particularly if further evaluations or preparations are needed.

In addition to endoscopy, other diagnostic tests may be utilized to assess esophageal function, such as esophageal manometry, which measures the rhythmic muscle contractions in the esophagus when you swallow, and pH monitoring to assess acid exposure in the esophagus.

If an esophageal stricture is confirmed, treatment options may include dilation procedures to widen the narrowed area, medication to manage underlying conditions such as GERD, or, in more severe cases, surgical interventions. Lifestyle modifications, such as eating smaller meals, avoiding trigger foods, and maintaining an upright posture during and after meals, can also help manage symptoms.

In summary, your symptoms could indeed be related to esophageal stricture, and it is advisable to consult with a gastroenterologist for a thorough evaluation. An upper endoscopy is a key diagnostic tool that may require fasting beforehand, and it can often be scheduled on the same day as your consultation, depending on the circumstances. Early diagnosis and management are crucial in preventing complications and improving your quality of life.