Стеноз пищевода что это такое: Стеноз пищевода — причины, симптомы, диагностика и лечение

Стеноз пищевода — симптомы, диагностика, лечение, профилактика

Стеноз пищевода –уменьшения диаметра пищевода. Причиной этого заболевания могут быть рубцы, опухоли, травмы пищевода или любые другие факторы, способные нарушить его проходимость.

Как показывает лечебная практика, стеноз пищевода это очень коварное заболевание. Эта патология может возникнуть как у взрослых, так и у детей. Пищевод очень напоминает трубку, которая служит соединением между желудком и глоткой. При возникновении стеноза диаметр этой самой трубки уменьшается, происходить это может на отдельных участках.

Диагностика и симптомы

У грудных детей необходимо обратить особое внимание на их поведение после кормления. Если ребенок часто срыгивает не створоженным молоком, это может быть явным признаком заболевания. Наряду с частым срыгиванием, у грудничка наблюдается обильное слюноотделение. Также можно обнаружить слизистые выделения из носа. Если у ребенка были обнаружены эти симптомы, нужно срочно обратиться к специалисту. Как утверждают практики, развитие стеноза это процесс нарастающий.

Для взрослых людей основной причиной служит дисфагия. Дисфагия это нарушение функции глотания. Первым появляется, малоприятное ощущение во время проглатывания пищи. Реже больной может ощутить боль во время прохождения комка еды по трубке пищевода. Это довольно ясный сигнал о необходимости обратится к врачу. Если на этом этапе не обратились за помощью к специалисту, то на следующем этапе болезненные ощущения будут реакцией на жидкую пищу. Если и в этом случае не начать лечения, то в скором времени в желудок не будет попадать и жидкая пища. Во время этого снижается иммунитет, происходит потеря веса и физическая слабость. Еще одними признаками стеноза пищевода является частая отрыжка, рвота после еды и усиленное слюноотделение.

Причины возникновения

Диаметр трубки пищевода изначально не одинаковый по всей своей длине. Сужение может находиться на этих трех участках:

• в районе перстневидного хряща;
• в области диафрагмы;
• и на участке бифуркации трахеи.

Специалисты разделяют стеноз пищевода на два вида это врожденный и приобретенный. У маленьких детей это, как правило, врожденный синдром и причины его возникновения скрыты в тонкостях внутриутробного развития.

Для людей более старшего возраста характеры такие причины возникновения:

• Перенесенные травмы грудной клетки.
• Воспаления слизистой оболочки.
• Последствия перенесения инфекционных заболеваний в осложненной форме.

Лечение и профилактика

После того как поставлен окончательный диагноз лечение нужно начинать как можно скорее. При таком заболевании крайне важно соблюдать все назначенные предписания и рекомендации лечащего врача.

Стеноз пищевода часто устраняется терапевтическим методом.Важную роль в терапевтическом лечении отводят к качеству еды, которую будет употреблять пациент. Еда должна быть жидкой или полужидкой.

К хирургическому вмешательству прибегают в том случае, когда терапия не дает явных признаков выздоровления. При легких формах заболевания применяется бужирование. Это когда вводят специальную трубку для расширения пищевода. В случае, когда ряд процедур не приносит должного результата, лечение продолжается при помощи операции. Плотные рубцы, которые все это время мешали прохождению пищи, удаляются.

симптомы, лечение, степени и классификация

Стеноз пищевода – это патологическое состояние, при котором уменьшается просвет полого органа в одном или нескольких местах. Патологический процесс имеет код по МКБ-10 К22.2.

Нормальный пищевод обнаруживает физиологические сужения:

• на уровне начала трахеи;
• возле разделения трахеи на главные бронхи;
• при прохождении диафрагмы в нижней трети.

Но при необходимости эти отделы растягиваются и пропускают пищевой комок. При развитии стеноза пищевод теряет эластичность, и сужение становится постоянным. Протяженность суженного участка зависит от причины заболевания, может достигать ряда сантиметров либо до половины длины пищевода.

Классификация стенозов

По времени возникновения болезнь делят на 2 типа:

1. Врождённый – 10% клинических случаев. Диагностируется у новорождённых в первую неделю жизни. В зависимости от формы пищевода бывает:

• мембранозный – просвет перекрыт дупликатурой слизистой оболочки;
• сегментарный – множественные суженные участки чередуются с расширениями;
• тип песочных часов – одиночный.

2. Приобретённый – встречается у 90% всех больных. Регистрируются у взрослых и детей.

В зависимости от количества патологических сужений могут встречаться:

• одиночные;
• множественные.

Стеноз пищевода

По протяженности сужения классификация следующая:

• короткие – при поражении органа длиной менее 5 см.;
• протяжённые – всё, что больше 5 см.

Очаг поражения может находиться в любом отделе пищевода:

• шейном;
• в проекции дуги аорты или раздвоения трахеи;
• диафрагмальном;
• при протяженном виде способен занимать несколько участков и захватывать зону кардии.

К разновидностям протяженного стеноза относят субтотальные (сужение до 90% длины трубки) и тотальные поражения.

В зависимости от того, какое заболевание вызвало патологию, различают доброкачественный и злокачественный варианты течения. От фактора зависит тактика терапии и прогноз.

По степени тяжести

Первая – при диаметре просвета в самой узкой части 9-11 мм. Эндоскопическое исследование возможно.

Вторая – просвет составляет 6-8 мм. Пищевод проходим для фибробронхоскопа.

Третья – сужение от 3 до 5 мм. Для исследования требуется специализированный ультратонкий фиброскоп.

Четвёртая – уменьшение от 2 мм до тотальной обтурации пищеводной трубки. Эндоскопическое исследование нижележащих отделов пищеварительного тракта невозможно.

На первой стадии стеноз проявляется как компенсированный, больной может питаться, но с соблюдением ограничений в диете. На второй и далее может развиваться как субкомпенсированный, так и декомпенсированный клинический вариант, требующий экстренного оперативного лечения.

Причины развития заболевания

Врождённый тип патологии является следствием нарушений внутриутробного развития, и причина этого явления точно не выяснена.

При этом формируется мембрана, перекрывающая просвет, разрастание мышечного слоя или кольцо фиброзной или хрящевой ткани.

Приобретённый стеноз развивается:

• После химического ожога – при случайном или намеренном употреблении едких жидкостей (уксусная эссенция, бытовая химия). После заживления раневой поверхности формируется рубцовый стеноз, одиночный и протяжённый, часто субтотальный.
• После механической травмы – при проглатывании острого предмета, после выполнения врачебных манипуляций (зондового промывания желудка, бужирования). Также развивается рубцовое изменение стенки, одиночное или множественное, но короткое.
• На фоне хронических болезней пищевода – к ним относятся эзофагиты различной природы (инфекционный при дифтерии или туберкулезе, пептический).
• При новообразовании в области пищевода – полипы и рак с экзофитным типом роста. Также к стенозу может приводить крупная опухоль в области средостения, сдавливающая близлежащие органы.
• После лучевого лечения опухолей грудной клетки, склеротерапии.

Симптомы патологии

При врождённом декомпенсированном стенозе клиническая картина ярко проявляется у детей одновременно с началом кормлений.

У ребёнка происходит регулярное срыгивание во время каждого приёма пищи. От обычных срыгиваний симптом отличается тем, что молоко выходит нествороженным. Дополнительно появляется слюнотечение, обильное выделение носовой слизи.

При компенсированном врождённом сужении симптомы появляются при включении в прикорм пищи кусочками.

Проявления приобретённой болезни

Независимо от причины, приобретенная патология характеризуется неуклонным прогрессированием.

• Затруднённое проглатывание – дисфагия. Как и стеноз, делится на 4 степени тяжести:

1 – нарушение появляется время от времени, при проглатывании твердого пищевого комка. Может проявляться чувством растяжения или боли.

2 – по пищеводу проходит только полужидкая еда.

3 – пациент способен принимать только жидкость.

4 – в пищеводе задерживается всё, включая слюну и воду.

Похудение – прогрессирует одновременно с дисфагией, вплоть до кахексии. При декомпенсированном стенозе добавляется обезвоживание.

• Обильное слюноотделение.
• Болевые ощущения за грудиной при попытке проглатывания.
• Отрыгивание или рвота через несколько минут после еды. В рвотных массах может появляться примесь крови.

Диагностические мероприятия

При появлении жалоб и подозрении на эту патологию врачом обязательно изучается история болезни, чтобы понять, есть ли предрасполагающие факторы.

1. Проводятся стандартные анализы: крови, мочи. Как правило, регистрируется анемия, снижение уровня белка, глюкозы и других макроэлементов.
2. Делается рентген. Это один из основных методов диагностики. Пациенту дают выпить специальный раствор бария, непроницаемый для излучения. Визуализируются контуры пищевода. По форме сужения врач может предположить причину болезни. Также видна складчатость стенок, наличие дефектов заполнения. Так удаётся определить локализацию стеноза, его протяжённость и степень.
3. Проводится эзофагоскопия. Наиболее информативный метод. Позволяет непосредственно оценить состояние стенок, измерить просвет. При обнаружении новообразования хирург может одновременно делать биопсию для гистологического исследования. При стенозе 1-2 степени возможно осмотреть орган ниже уровня поражения.

Лечение

Клинические рекомендации при подтвержденном диагнозе предполагают комплексный подход к лечению.

1. Консервативная терапия. Показана при компенсированном стенозе 1 степени, чтобы предотвратить прогрессирование болезни, перед операцией и в послеоперационный период. Включает:

• Механически, химически и термически щадящую диету. Пациенту разрешено употребление протёртой умеренно-тёплой еды без едких приправ.
• Назначение противоязвенной терапии при наличии эзофагита или пептических язв пищевода.

2. Хирургическое лечение. При тяжёлом стенозе восстановить проходимость органа возможно только с помощью операции. Вид оперативного лечения определяет врач, ориентируясь на причину патологии, её тип и наличие сопутствующих заболеваний.

Виды операций:

• Бужирование пищевода – малоинвазивная операция, проводимая для лечения доброкачественного варианта сужения. При этом в просвет поочередно вводятся трубки – бужи, диаметр которых постепенно увеличивают.
• Баллонная дилатация – используется эндоскоп, способный расширяться и растягивать стенки пищевода. Может проводиться для профилактики рубцового стеноза после ожога или травмы.
• Эндоскопическое рассечение – показано при сформировавшемся плотном рубце. При этом не нарушается серозная оболочка органа.
• Эндопротезирование пищевода – выполняется при злокачественном стенозе, когда невозможно иссечение опухоли. Вводится специальное устройство – стент, которое расширяется и фиксируется в месте сужения. Таким образом, временно улучшается проходимость органа.
• Эзофагопластика – проводится при протяжённом стенозе или после иссечения опухоли. Удаляется поражённый отрезок, после чего замещается участком желудка, тонкого или толстого кишечника.
• Гастротомия – паллиативная операция. Формируется отверстие в стенке желудка, куда вставляется зонд для питания.

Терапия врождённой патологии

При сегментарной форме или деформации по типу песочных часов лечение начинают с бужирования или баллонного расширения.

При необходимости могут провести до трёх попыток. При отсутствии положительной динамики лечить пациента необходимо хирургически.

Если диагностирован мембранозный тип, проводится эндоскопическое удаление препятствия. После операции необходимо через несколько недель пройти повторное эндоскопическое исследование, чтобы предупредить развитие рубцового процесса и рецидива.

 

В послеоперационный период кормление больного зондовое или парентеральное. Энтеральное питание начинают через 5-6 дней с жидкостей, постепенно переходя на протёртую пищу. Постепенно включают в рацион протёртые блюда, позволенные диетой №1.

Соблюдение правил питания необходимо для полного восстановления и предотвращения рецидива болезни.

90000 Benign Esophageal Stricture: Causes, Symptoms & Diagnosis 90001 90002 Benign esophageal stricture describes a narrowing or tightening of the esophagus. The esophagus is the tube that brings food and liquids from your mouth to your stomach. «Benign» means it’s not cancerous. 90003 90002 Benign esophageal stricture typically occurs when stomach acid and other irritants damage the lining of the esophagus over time. This leads to inflammation (esophagitis) and scar tissue, which causes the esophagus to narrow.90003 90002 Although benign esophageal stricture is not a sign of cancer, the condition can cause several problems. Narrowing of the esophagus may make it difficult to swallow. This increases the risk of choking. It can also lead to complete obstruction of the esophagus. This can prevent food and fluids from reaching the stomach. 90003 90002 Benign esophageal stricture can happen when scar tissue forms in the esophagus. This is often the result of damage to the esophagus. The most common cause of damage is gastroesophageal reflux disease (GERD), also known as acid reflux.90003 90002 GERD occurs when the lower esophageal sphincter (LES) does not close or tighten properly. The LES is the muscle between the esophagus and the stomach. It normally opens for a short amount of time when you swallow. Stomach acid can flow back up into the esophagus when it does not close completely. This creates a burning sensation in the lower chest known as heartburn. 90003 90002 Frequent exposure to harmful stomach acid can cause scar tissue to form. Eventually, the esophagus will narrow.90003 90002 Other causes of benign esophageal stricture include: 90003 90016 90017 radiation therapy to the chest or neck 90018 90017 accidental swallowing of an acidic or corrosive substance (such as batteries or household cleaners) 90018 90017 extended use of a nasogastric tube (a special tube that carries food and medicine to the stomach through the nose) 90018 90017 esophageal damage caused by an endoscope (a thin, flexible tube used to look inside a body cavity or organ) 90018 90017 treatment of esophageal varices (enlarged veins in the esophagus that can rupture and cause severe bleeding) 90018 90027 90002 Typical symptoms of benign esophageal stricture include: 90003 90016 90017 difficult or painful swallowing 90018 90017 unintended weight loss 90018 90017 regurgitation of food or liquids 90018 90017 sensation of something stuck in the chest after you eat 90018 90017 frequent burping or hiccups 90018 90017 heartburn 90018 90027 90002 Dense and solid foods can lodge in the esophagus when it narrows.This may cause choking or difficulty breathing. 90003 90002 Problems swallowing can prevent you from getting enough food and liquid. This may lead to dehydration and malnutrition. 90003 90002 There’s also a risk of getting pulmonary aspiration, which occurs when vomit, food, or fluids enter your lungs. This could result in aspiration pneumonia, an infection caused by bacteria growing around the food, vomit or fluids in the lung. 90003 90002 90051 Learn more: Aspiration pneumonia: Symptoms, causes, and treatment »90052 90003 90002 Your doctor may use the following tests to diagnose the condition: 90003 90056 Barium swallow test 90057 90002 A barium swallow test includes a series of X-rays of the esophagus.These X-rays are taken after you drink a special liquid containing the element barium. Barium is not toxic or dangerous. This contrast material temporarily coats the lining of your esophagus. This allows your doctor to see your throat more clearly. 90003 90056 Upper GI endoscopy 90057 90002 In an upper gastrointestinal (upper GI) endoscopy, your doctor will place an endoscope through your mouth and into your esophagus. An endoscope is a thin, flexible tube with an attached camera. It allows your doctor to examine your esophagus and upper intestinal tract.90003 90002 90051 Learn more: Endoscopy »90052 90003 90002 Your doctor can use forceps (tongs) and scissors attached to the endoscope to remove tissue from the esophagus. They’ll then analyze this sample of tissue to find the underlying cause of your benign esophageal stricture. 90003 90056 Esophageal pH monitoring 90057 90002 This test measures the amount of stomach acid that enters your esophagus. Your doctor will insert a tube through your mouth into your esophagus. The tube is usually left in your esophagus for at least 24 hours.90003 90002 Treatment for benign esophageal stricture varies depending on the severity and underlying cause. 90003 90056 Esophageal dilation 90057 90002 Esophageal dilation, or stretching, is the preferred option in most cases. Esophageal dilation can cause some discomfort, so you’ll be under general or moderate sedation during the procedure. 90003 90002 Your doctor will insert an endoscope through your mouth into your esophagus, stomach, and small intestine. Once they see the strictured area, they’ll place a dilator into the esophagus.The dilator is a long, thin tube with a balloon at the tip. Once the balloon inflates, it will expand the narrowed area in the esophagus. 90003 90002 Your doctor may need to repeat this procedure in the future to prevent your esophagus from narrowing again. 90003 90056 Esophageal stent placement 90057 90002 The insertion of esophageal stents can provide relief from esophageal stricture. A stent is a thin tube made of plastic, expandable metal, or a flexible mesh material. Esophageal stents can help keep a blocked esophagus open so you can swallow food and liquids.90003 90002 You’ll be under general or moderate sedation for the procedure. Your doctor will use an endoscope to guide the stent into place. 90003 90056 Diet & lifestyle 90057 90002 Making certain adjustments to your diet and lifestyle can effectively manage GERD, which is the primary cause of benign esophageal stricture. These changes can include: 90003 90016 90017 elevating your pillow to prevent stomach acid from flowing back up into your esophagus 90018 90017 losing weight 90018 90017 eating smaller meals 90018 90017 not eating for three hours before bedtime 90018 90017 quitting smoking 90018 90017 avoiding alcohol 90018 90027 90002 You should also avoid foods that cause acid reflux, such as: 90003 90016 90017 spicy foods 90018 90017 fatty foods 90018 90017 carbonated beverages 90018 90017 chocolate 90018 90017 coffee and caffeinated products 90018 90017 tomato-based foods 90018 90017 citrus products 90018 90027 90056 Medication 90057 90002 Medications can also be an important part of your treatment plan.90003 90002 A group of acid-blocking drugs, known as proton pump inhibitors (PPIs), are the most effective medications for managing the effects of GERD. These drugs act by blocking the proton pump, a special type of protein, which helps reduce the amount of acid in the stomach. 90003 90002 Your doctor may prescribe these medications for short-term relief to allow your stricture to heal. They may also recommend them for long-term treatment to prevent recurrence. 90003 90002 The PPIs used to control GERD include: 90003 90002 Other medications may also be effective for treating GERD and reducing your risk of esophageal stricture.They are: 90003 90016 90017 antacids: provide short-term relief by neutralizing acids in the stomach 90018 90017 sucralfate (Carafate): provides a barrier that lines the esophagus and stomach to protect them from acidic stomach juices 90018 90017 antihistamines, such as famotidine ( Pepcid AC): decrease the secretion of acid 90018 90027 90002 Shop for antacids online at Amazon. 90003 90056 Surgery 90057 90002 Your doctor may recommend surgery if medication and esophageal dilation are ineffective.A surgical procedure can repair your LES and help prevent GERD symptoms. 90003 90002 Treatment can correct benign esophageal stricture and help relieve the associated symptoms. However, the condition can occur again. Among the people who undergo esophageal dilation, approximately 30 percent need another dilation within one year. 90003 90002 You may need to take medication throughout your lifetime to control GERD and reduce your risk of developing another esophageal stricture. 90003 90002 You can help prevent benign esophageal stricture by avoiding substances that can damage your esophagus.Protect your children by keeping all corrosive household substances out of their reach. 90003 90002 Managing symptoms of GERD can also greatly reduce your risk for esophageal stricture. Follow your doctor’s instructions regarding dietary and lifestyle choices that can minimize the backup of acid into your esophagus. It’s also important to make sure you take all medications as prescribed to control symptoms of GERD. 90003.90000 causes, symptoms, diagnosis and treatment 90001 90002 90003 What is meant by benign esophageal stricture? Benign esophageal stricture is narrowing or tightening of the esophagus. In other words, it is a condition in which the diameter of the esophagus becomes narrow. Esophagus is a muscular tube that connects the throat to the stomach and transports food to the stomach. It is about 8 inches long and is lined by pink moist tissue called mucosa. The word benign means that the condition is cancerous yet harmless and it can not spread to other parts of the body.90004 90003 Benign esophageal stricture causes difficulties in swallowing food, saliva or liquids and increases the risk of choking. It impairs the passage of food or liquid through the esophagus with a sensation of fullness or pressure in the chest. This condition lasts for a short time in most cases, but in rare conditions, it may be prolonged demanding emergency intervention. 90004 90007 What are the causes of benign esophageal stricture? 90008 90009 Gastroesophageal reflux disease 90010 90003 Gastroesophageal reflux disease (GERD) is a condition that affects the lower esophageal sphincter.Lower esophageal sphincter is a ring of muscle present between the esophagus and stomach. In normal digestion, it opens when food has to be passed from the esophagus to the stomach and after it has delivered the food it closes to prevent the back flow of the food particles and stomach acids from the stomach to the esophagus. 90004 90003 In GERD this sphincter is either weak or relaxes inappropriately due to which return of the stomach contents into the esophagus starts. GERD is the most common cause of esophageal strictures.It is the cause in 70-80% of the cases. This disease is more common in men above 40 years of age, but can occur in any sex or age group. 90004 90003 Excessive acid reflux from the stomach results in inflammation of the lower part of the esophagus, creating heartburn or a burning sensation in the chest. Repeated exposure to harmful stomach acid increases injury and inflammation. This ultimately leads to healing, but when this whole process continues for a long time it causes scarring of the esophagus.Eventually, a benign stricture develops that narrows the opening of the esophagus. 90004 90009 Ingestion of corrosives 90010 90003 Corrosives are another cause of the esophageal sphincter stricture. Corrosives are substances that can attack and destroy exposed body tissues. They can cause damage to the body tissues as soon as they come into contact with them. 90004 90003 Common corrosives are hydrochloric acid, nitric acid, sulfuric acid, chromic acid, hydrofluoric acid, acetic acid, ammonium hydroxide, potassium hydroxide and sodium hydroxide.When corrosives are swallowed, they cause damage to the lining of the esophagus, mouth, throat and stomach. Due to corrosive damage, scarring develops that cause stiffness of the esophageal lining. The result is narrowing of the esophageal sphincter and swallowing problems. 90004 90009 Extended use of a nasogastric tube 90010 90003 Extended use of nasogastric tube can lead toesophageal stricture. Nasogastric tube is a tube that carries food and other materials from the nose to the stomach. It is mainly used in patients that are usable to swallow food and liquids on their own.When this tube is passed again and again or used for a long time, it can cause inflammation of esophagus and scarring. This leads to constriction of the esophagus with symptoms of difficulty in swallowing and food regurgitation. 90004 90009 Esophageal rings 90010 90003 Esophageal rings can cause narrowing of the esophagus. A concentric, thin and smooth extension of normal esophageal tissue is called as an esophageal ring. It is usually 3-5mm in diameter. It consists of all 3 anatomic layers; mucosal, sub mucosal and muscle layer.This ring can be present anywhere along the esophagus, but usually it is present in the distal part of the esophagus. 90004 90003 Esophageal rings are of three types, classified as A, B, and C. Type A ring is uncommon. 90004 90003 This muscular ring is present 1.5 centimeters proximal to the squamocolumnar junction (the point where the epithelium of the esophagus changes from the squamous to columnar). This ring is not fixed and is rarely symptomatic. Type B ring is the most common in the esophagus also known as Schatzki ring.90004 90003 It is composed of mucosa and submucosa only. It is located at the junction between the esophagus and the stomach and can be present for years. It is non-progressive. Schatzki ring can be seen after swallowing of a solution of barium dye which is visible on X-rays and taking out X-rays of the esophagus. This non-cancerous ring causes swallowing problems (dysphagia). It can be easily treated with dilation of the esophageal stricture by the passage of a dilator. Type C ring is a rare.It can be found incidentally on X-ray and rarely causes symptoms. It is caused by the diaphragmatic crura. 90004 90009 Other causes 90010 90009 Damage caused by an endoscope 90010 90003 Endoscope is a lighted, thin tube that is used to see inside the body in the form of images for evaluation or diagnosis. This tube is passed through the mouth into internal body. Sometimes it may cause esophagitis (inflammation of the esophagus) leading to esophageal strictures. 90004 90009 Treatment of esophageal varices 90010 90003 Esophageal varices are enlarged veins in the esophagus usually in the lower part that can bleed.These are often treated with endoscope which can cause post operative esophageal constriction. 90004 90009 Hiatal hernia 90010 90003 Hiatal hernia is a condition in which stomach bulges up into the thorax through the diaphragm. It is strongly associated with a gastric esophageal reflux disease which then leads to scarring and narrowing of the esophagus. 90004 90009 Postoperative strictures 90010 90003 In about 10% of people esophageal stricture is a complication of the previous surgery. After surgical treatment of esophageal atresia (obliteration of lumen) or any other esophageal operation, esophageal constriction can occur.This is known as postoperative esophageal strictures. 90004 90009 Drug related stricture 90010 90003 Some studies have shown that drugs like non-steroidal anti inflammatory drugs or NSAIDs, iron and alendronate can cause esophageal strictures in some people. 90004 90009 Congenital esophageal stricture 90010 90003 Benign esophageal strictures can be congenital (existing at or dating from birth) in origin. Membranous diaphragm is a congenital problem that may lead to esophageal stricture. 90004 90009 Achalasia 90010 90003 Achalasia is a gradual thickening of the muscles present in the lower end of the esophagus.This thickening disturbs the normal functioning of the lower esophageal hisphincter, which in turn leads to constriction of the esophagus. 90004 90007 What are the risk factors of benign esophageal stricture? 90008 90009 Gastric esophageal reflux diseases 90010 90003 Presence of this disease increases the risk for the development of corrosive scarring and leads to stricture formation. 90004 90003 Swallowing of substances that damage the lining of the esophagus, such as lye, household cleaners, disc batteries, or battery acid can also lead to scarring and narrowing of esophagus.90004 90009 Esophageal diverticula 90010 90003 Diverticulum is a pouch or sac originating from a tube like organ, such as esophagus. It protrudes into the weak portion of the lining of the esophagus. Usually this condition is asymptomatic but it may become symptomatic. 90004 90003 Dysphagia (difficulty in swallowing), aspiration (collection of fluid) in the lungs and regurgitation (back flow) of food are the main symptoms. 90004 90009 Esophageal stenosis 90010 90003 Stenosis is one of the greatest risk factors for esophageal strictures.Narrowing of the esophagus occurs in this condition. When it persists for a long time it leads to inflammation. Long term inflammation may cause scarring and increases the likelihood of developing stricture. 90004 90009 NSAIDs 90010 90003 These drugs should be avoided in patients of GERD. When a patient with a disease is given these medicines chances of benign stricture formation increases many folds. 90004 90009 Surgery 90010 90003 Esophageal surgeries can cause weakness of the esophagus.Rarely, scar tissue can develop and disturb the functioning of sphincter muscles which then leads to contriction. 90004 90009 Other risk factors 90010 90003 Radiation therapy, sclerotherapy on the esophagus, antibiotics, scleroderma, esophagitis and infectious skin diseases are the other risk factors. 90004 90007 What are the signs and symptoms of benign esophageal stricture? 90008 90003 Signs and symptoms include: 90004 90101 90102 Heartburn 90103 90102 Bitter or acid taste in mouth 90103 90102 Choking 90103 90102 Cough 90103 90102 Shortness of breath 90103 90102 Frequent burping or hiccups 90103 90102 Pain or trouble with swallowing 90103 90102 Throwing up blood 90103 90102 Unintentional weight loss 90103 90102 Regurgitation of food or liquid: Regurgitation is backflow of substances from the stomach to esophagus or mouth.Sometimes, food may be aspirated into the lungs. Symptoms of aspiration are shortness of breath, cough and wheezing. 90103 90102 Dysphagia: It is defined as difficulty in swallowing food and liquids or feeling that food is not normally passing into the stomach. 90103 90102 Feeling of fullness in the chest 90103 90102 Pressure like sensations in the chest 90103 90102 Chest pain after meals 90103 90102 Shortness of breath 90103 90102 Increased salivation 90103 90102 Dehydration 90103 90136 90007 How to diagnose benign esophageal stricture 90008 90009 A medical history and physical examination 90010 90003 When you go to your doctor he will ask about all your symptoms and will take a detailed medical history.He will seek your permission for a physical exam. If he will suspect any serious problem, he will refer you to a specialist of the gastrointestinal tract (gastroenterologist) who will examine your gastrointestinal system. He will rule out any malignancy. Then he will ask for some special tests to confirm diagnosis. 90004 90009 Barium swallow 90010 90003 Barium swallow is an X-ray of throat and esophagus. It is also called as barium esophragm. Before starting this X-ray you will be given thick liquid called barium to drink.The barium will temporarily coat the linings of the throat and esophagus and it will help to show up sharp, clear and better images of the gastrointestinal track on the X-ray. In this test a series of esophageal X-rays are taken during and after barium swallow. It is the appropriate method of diagnosis and shows narrowing of the esophagus in esophageal stricture. This test can also be performed before endoscopy is arranged and is usually preferred when urgent confirmation of the diagnosis is needed.90004 90009 CT scan 90010 90003 Computerized tomography is a technology that uses computer-processed X-rays to produce topographical images of specific areas of the object that allows one to see what is inside of the body without cutting or opening it. CT-scan is useful mainly in malignant conditions, but it is also performed in benign esophageal stricture to rule the malignancy and confirm that it is non-cancerous condition. 90004 90009 Upper gastrointestinal endoscopy 90010 90003 Endoscopy means looking inside.It refers to looking inside the body with the help of endoscope for medical investigation. An endoscope is an instrument which is used to examine or view the interior of a hollow organ or cavity of the body by directly inserting it into the organ. Endoscope is a flexible tube to which light and camera are attached to its one end. It is passed under local anesthesia. It shows narrowing of the esophagus and also helps in finding out the cause. There are disadvantages of endoscopy too. It may delineate the lesion.There is a risk of perforation or a tear in the stomach or esophagus lining. Bleeding can occur and sometimes it may even cause stricture formation by narrowing down the esophagus. 90004 90009 Biopsy 90010 90003 The last option in diagnosis is a biopsy of the stricture. Endoscopy also allows the biopsy of the lesion. Biopsy helps in determining the cause, but this test is usually performed only in malignant conditions. 90004 90009 Esophageal pH monitoring 90010 90003 This test measures the pH of the esophagus.Usually pH is more in the esophagus as compared to stomach. When backflow of the stomach acid into the esophagus occurs its pH falls. To perform this test a tube is inserted from the mouth to the esophagus, which measures pH and amount of stomach acids in the esophagus over a period of 24 hours. 90004 90009 Esophageal manometry 90010 90003 It measures the tone in lower esophageal sphincter. Decreased tone and impaired motility detected by this technique are diagnostic of benign esophageal stricture.Esophageal manometry may not be possible with tight strictures. 90004 90007 Treatment of benign esophageal stricture 90008 90003 Followings are the treatment options: 90004 90009 Diet and lifestyle changes 90010 90003 Dietary and lifestyle changes are effective in managing esophageal strictures. Followings are recommended in patients of benign esophageal strictures: 90004 90101 90102 Raise the edge of your bed or use high pillows under your head. Elevation reduces the back flow of stomach contents into the esophagus.90103 90102 Avoid food intake just before sleep. Do not eat anything for at least one or two hours before bedtimes. 90103 90102 Stop smoking. Smoking can adversely affect your gastrointestinal tract and can increase the chances of this condition. 90103 90102 Avoid alcohol, as it can also upset your gut and can increase acid reflux. 90103 90102 Use fruits, drinks and soft food so that they can be swallowed easily and without pain. Avoid hard foods, these can damage your throat and increase dysphagia.Till dysphagia is managed avoid them. 90103 90102 Avoid swallowing corrosive substances. Observe safety measures before coming into contact with such chemicals. 90103 90102 Instead of large, heavy meals take small and divided meals. 90103 90102 Avoid tight clothes. 90103 90102 Some foods increase reflux to the esophagus. Avoid these foods. These include fatty foods, spicy foods, chocolates, carbonated beverages, colas, substances containing caffeine, coffee, citrus products and tomato products.90103 90102 Try to lose some weight. 90103 90102 Improve your oral health. 90103 90136 90009 Esophageal dilation 90010 90003 The best option for the treatment of benign esophageal stricture is esophageal dilatation. This procedure is usually performed at the same time when upper endoscopy is done. With the help of endoscope interior of the esophagus is viewed and if narrowing or benign stricture is found it can be dilated. There are many ways to dilate esophagus. 90004 90003 In one method a balloon dilator also known as boogie is passed with the aid of endoscope, and then this balloon is inflated within limits of the stricture to stretch the esophagus.This process is usually performed under local or general anesthesia, spray or mild sedative for comfort and pain free procedure. Instead of passing dilator through the endoscope it can be passed alone as well. This gives the same results. 90004 90003 Other types of dilators can also be passed during endoscopy. These include mallony and savory dilators. These are used in accordance with the size of a stricture. For smaller stricture mallony dilator is used while savory dilator is used for a large size stricture.There is a need to repeat the esophageal dilation after a period of time in order to prevent the esophageal stricture from narrowing again. Frequency of repetition of this method can be reduced by the use of proton pump inhibitors for a long time. 90004 90003 Some risks are associated with esophageal dilation. These include infections, tear, potential bleeding and perforations. Weight loss and heartburn are the most frequent problems seen in many patients after dilation. 90004 90009 Esophageal stent placement 90010 90003 Esophageal stents are an effective method of treating esophageal strictures.Insertion of stents can provide long term relief of stricture. A stent is a thin tube made of plastic, metal or other material. Local anesthesia should be given before this procedure to numb the throat and esophagus. 90004 90003 Different types of esophageal stents are available. They vary in length and range from 60-150 millimeters. Upper endoscopy is used to guide stent placement exactly at the site of the stricture. 90004 90003 Procedure of implantation of stent is very simple. After placement of a stent its proper positioning can be confirmed by X-ray.The length and diameter of the stricture are first measured, and then a stent is selected usually 1 to 2 centimeters larger than the stricture to avoid in folding of the ends. Complications of the esophageal stent placement are esophageal perforation and stent migration (the stent can move or displace from its original place). Erosion of surrounding tissues of the stent can occur with the use of permanent stents. Tumors can also grow in the stent. 90004 90009 Medications 90010 90009 Proton pump inhibitors 90010 90003 Proton pump inhibitors (PPIs) are the drugs which are used to control excessive gastric acid levels.They are inhibitors of acid secretion. These drugs are very effective for the management of GERD as well as for those conditions in which backflow of the stomach acid to the esophagus causes damage to the esophagus. 90004 90003 These drugs block the proton pump, which are necessary for the release of stomach acids. When these proton pumps are blocked there is less release of gastric acids. 90004 90003 Short term course or long term course of these drugs is prescribed by the doctor according to your condition to provide you relief and prevent recurrence.PPIs include omeprazole, pantoprazole, lansoprazole and esomeprazole. 90004 90003 Adverse effects of these drugs when they are used for short term are headache, fatigue, nausea, diarrhea and dizziness. Long term side effects are vitamin B12 deficiency, rash, constipation, itch, anxiety, flatulence, depression, erythema, constipation, acute interstitial nephritis and pancreatitis. 90004 90009 h3 antagonists 90010 90003 h3 antagonists are drugs that block the action of histamine (a chemical involved in the regulation of the functions of the gut and local immune responses) on the parietal cells in the stomach.The effect of these drugs is decreased production of the acid by these cells. Cimetidine and ramitidine belong to this group. 90004 90003 Ramitidine is the drug of choice from h3 antagonists for the treatment of esophageal stricture. When acid production is decreased there is less backflow of the stomach acids into the esophagus so there is less inflammation, less scarring and less damage. 90004 90003 Side effects of h3 antagonists are known as adverse drug reactions (ADR). 90004 90003 Frequent ADR is hypotension.90004 90003 Less common ADR are headache, tiredness, dizziness, confusion, diarrhea, constipation, and rash. Cimetidine gives severe adverse effects like hypotension, gynecomastia, impotence and loss of libido. 90004 90009 Surgical treatment 90010 90003 Usually surgery is not recommended for benign esophageal stricture but if your symptoms have not improved by the use of esophageal dilators or medications then you may need it. If the strictures are too wide then your doctors might go for surgical treatment.Anti-reflux procedures are one of surgical operations for treatment. These include Collis-Nissen or complete fundoplication and Belsey or partial gastroplasty. Esophageal resection is another surgical option in which esophagus can be replaced with either stomach, colon or jejunum. 90004 90007 Complications of bening esophageal stricture 90008 90003 Benign esophageal stricture can cause some complications. Commonly seen complications are described below. 90004 90101 90102 Food may get stuck in the esophagus causing complete obstruction.Drinking of water and other maneuvers fail to dislodge this obstruction. It is an emergency condition and demands immediate correction. Endoscopy can be used to relieve this complication. 90103 90102 Malnutrition can occur. As esophageal stricture is associated with difficult and painful swallowing. It may hinder one from food intake. One may completely avoid food to get over dysphagia. This can lead to severe nutritional deficiency called as malnutrition. 90103 90102 Aspiration pneumonia is the most serious complication that can occur.It occurs due to aspiration of the food in the lungs. Aspiration pneumonia gives symptoms of wheezing, shortness of breath and cough. 90103 90136 .90000 Esophageal Stricture — What You Need to Know 90001 90002 90003 CareNotes 90004 90005 Esophageal Stricture 90004 90007 90008 This material must not be used for commercial purposes, or in any hospital or medical facility. Failure to comply may result in legal action. 90009 90010 WHAT YOU NEED TO KNOW: 90011 90010 What is an esophageal stricture? 90011 90008 An esophageal stricture is a narrowing of your esophagus. Inflammation or damage to your esophagus may cause scar tissue that leads to narrowing.90009 90010 What increases my risk for an esophageal stricture? 90011 90018 90003 Long-term acid reflux 90004 90003 Birth defects, such as stenosis (narrowing) or diverticulosis (pouches) 90004 90003 Medicines, such as aspirin, pain medicines, or antimalarial antibiotics 90004 90003 Surgery, radiation, or sclerotherapy on the esophagus 90004 90003 Long-term placement of a nasogastric (NG) tube, or chemicals such as household cleaning liquids that are swallowed 90004 90003 Infections, skin diseases, scleroderma, esophagitis, or esophageal cancer 90004 90031 90010 What are the signs and symptoms of an esophageal stricture? 90011 90018 90003 Acid reflux, or burning pain in your chest 90004 90003 Bitter or acid taste in your mouth 90004 90003 Pain or trouble swallowing 90004 90003 Frequent burping or hiccups 90004 90003 Weight loss without trying 90004 90031 90010 How is an esophageal stricture diagnosed? 90011 90018 90003 90050 A barium swallow 90051 is an x-ray of your throat and esophagus.This may also be called a barium esophagram. You will drink a thick liquid called barium. Barium helps your esophagus and stomach show up better on x-rays. 90004 90003 90050 A CT scan, 90051 or CAT scan, is a type of x-ray taken of your esophagus and stomach. You may be given contrast dye to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. 90004 90003 90050 An endoscopy 90051 is a procedure used to find the cause of the narrowing of your esophagus.Healthcare providers use an endoscope to examine your esophagus. An endoscope is a bendable tube with a light and camera on the end. 90004 90031 90010 How is an esophageal stricture treated? 90011 90008 Treatment for esophageal stricture depends on its cause. You may also need any of the following: 90009 90018 90003 90050 Medicines 90051 may be given to decrease stomach acid that can irritate your esophagus and stomach. 90004 90003 90050 Surgery or procedures 90051 may be needed to dilate (widen), repair, or remove part of your esophagus.90004 90031 90010 How can I manage my symptoms? 90011 90018 90003 90050 Rest as needed. 90051 Slowly start to do more each day. Return to your daily activities as directed. 90004 90003 90050 Ask about safe foods to eat. 90051 You may not be able to eat solid foods for a period of time. You may be allowed to drink water, broth, apple juice, or lemon-lime soft drinks. You may also suck on ice chips or eat gelatin. As you improve, you may be given soft foods to eat or thickened liquids to drink.You may return to eating normal foods as your swallowing gets better. 90004 90031 90010 When should I contact my healthcare provider? 90011 90018 90003 You have a fever. 90004 90003 You are vomiting and can not keep any food or liquids down. 90004 90003 You feel very full and can not burp or vomit. 90004 90003 You have pain that does not decrease even after you take medicine. 90004 90003 Your symptoms get worse. 90004 90003 You have questions or concerns about your condition or care.90004 90031 90010 When should I seek immediate care or call 911? 90011 90018 90003 You have severe chest pain and sudden trouble breathing. 90004 90003 Your bowel movements are black, bloody, or tarry-looking. 90004 90003 Your vomit looks like coffee grounds or has blood in it. 90004 90031 90114 Care Agreement 90115 You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive.You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you. 90008 © Copyright IBM Corporation 2020 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health 90009 90010 Further information 90011 90008 Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. 90009 90008 Medical Disclaimer 90009 90010 Learn more about Esophageal Stricture 90011 90126 Associated drugs 90127 .90000 Esophageal achalasia: Symptoms, diagnosis, and treatment 90001 90002 Achalasia is a disorder of the esophagus, or food pipe, which causes the cells and muscles to lose function. This can lead to difficulties with swallowing, chest pain, and regurgitation. Food may also enter the lungs, causing coughing and breathing problems. 90003 90002 Achalasia can affect any part of the digestive tract, including the intestines. Hirschsprung’s disease is a type of achalasia. 90003 90002 People usually receive a diagnosis of oesophageal achalasia between 25-60 years of age.According to the American Journal of Gastroenterology, it affects around 1 in every 100,000 people and occurs equally in men and women. 90003 90002 Doctors do not know what causes achalasia, and there is currently no cure. However, treatment can relieve symptoms. 90003 Share on PinterestA person with esophageal achalasia may experience difficulty in swallowing food. 90002 Esophageal achalasia is a chronic disease of the esophagus, which causes a slow deterioration of nerve function. 90003 90002 The esophagus is the tube that connects the throat with the stomach.It sits between the windpipe and the spine and continues down the neck where it joins the upper, or cardiac, end of the stomach. 90003 90002 When a person swallows, the muscles in the esophagus walls contract and push the food or liquid into the stomach. Glands within the esophagus produce mucus, which supports the motion of swallowing. 90003 90002 In esophageal achalasia, the esophagus does not open to let food pass through. This is due to a weakness of the smooth muscle in the lower part of the esophagus.90003 90002 When this smooth muscle can not move food down, this is known as aperistalsis of the esophagus. 90003 90002 The cause remains unknown, but according to the Society of Thoracic Surgeons, recent studies suggest it may be an autoimmune disease in which the immune system attacks nerve cells in the esophagus muscles. 90003 90002 A parasite in South America that leads to Chagas disease can also cause types of achalasia. 90003 90002 The disorder does not run in families, and the risk is equal across all ethnic groups.90003 90002 At first, symptoms may be mild and easy to ignore. Eventually, however, achalasia progresses, making it harder for a person to swallow food and liquid. 90003 90002 The person may notice: 90003 90030 90031 dysphagia, or difficulty in swallowing food 90032 90031 bringing food and liquid back up after swallowing 90032 90031 coughing, especially when lying down 90032 90031 chest pain, similar to heartburn, which may resemble a heart attack 90032 90031 breathing difficulties when a person inhales food, liquid, and saliva into the lungs 90032 90041 90002 The person may also lose weight, have difficulty burping, and feel as though they have a lump in their throat.90003 90002 People may try to compensate by eating more slowly, lifting their neck, or throwing their shoulders back to assist swallowing. 90003 90002 However, symptoms often get worse. 90003 Share on PinterestA doctor may order an X-ray and barium swallow test to diagnose esophageal achalasia. 90002 Achalasia symptoms are similar to those of gastroesophageal reflux disease (GERD), hiatus hernia, and some psychosomatic disorders. This can make it harder for a doctor to make a diagnosis. 90003 90002 The doctor may order the following diagnostic tests to rule out other conditions.90003 90002 90053 X-ray and barium swallow test: 90054 An individual swallows a white liquid solution, known as barium sulfate. Barium sulfate is visible on X-rays. As the person swallows the suspension, the solution coats the esophagus. This shows up the hollow structure of the esophagus in X-ray images. 90003 90002 90053 Esophageal manometry: 90054 This measures muscle pressure and movements in the esophagus. A specialist in digestive disorders, or gastroenterologist, inserts a manometer, which is a thin tube, through the individual’s nose.90003 90002 The person with suspected achalasia will need to swallow several times. 90003 90002 The device measures muscle contractions in various parts of the esophagus. This procedure helps the doctor determine whether the lower esophageal sphincter is relaxing properly while the person swallows. 90003 90002 It can also assess the function of the smooth muscle, as well as ruling out cancer. 90003 90002 90053 Endoscopy: 90054 This involves using a camera on a thin, lighted tube. A gastroenterologist passes the tube down the esophagus while an individual is under sedation.90003 90002 This allows the doctor to see inside the esophagus and stomach. It can show signs of achalasia or any inflammation, ulcers, or tumors that could also be causing symptoms. 90003 90002 During endoscopy, the doctor may also take a biopsy to check for any cancers that may be causing digestive difficulties. This involves collecting a sample of tissue and sending it to a laboratory for analysis under a microscope. 90003 90002 Find out more about endoscopies here. 90003 90002 Treatment can not cure esophageal achalasia or restore nerve function completely.However, there are ways to reduce the severity of symptoms. 90003 90002 Medications: If a doctor diagnoses the disorder early in its progression, medications can help dilate the narrowed part of the esophagus so that that food can pass through. 90003 90002 Examples include calcium channel blockers and nitrates. Some people may experience headaches and swollen feet. 90003 90002 After a few months, some medications may stop working. If this occurs, a person might need to seek different treatments.90003 90002 Pneumatic balloon dilation: Surgeons inflate a balloon to widen the space by tearing the muscle in the lower esophageal sphincter. 90003 90002 For about 70% of people, balloon treatment will relieve symptoms. This procedure may need to take place more than once. According to the American Journal of Gastroenterology, about 30% of people who undergo a pneumatic balloon dilation may require a follow-up procedure. 90003 90002 Adverse effects include chest pain immediately after the procedure and a small risk of perforating the esophagus.If perforation occurs, a person will need further treatment. 90003 90002 Balloon dilation also leads to GERD in about 15-35% of patients. 90003 90002 90053 Myotomy: 90054 This is an operation to cut the muscle. It usually helps prevent obstruction. 90003 90002 The American Journal of Gastroenterology state that surgical myotomy has a success rate of 60-94%. However, up to 31% of people may develop GERD after a myotomy, depending on the type of procedure they have. 90003 90002 There is a range of different approaches to myotomy, including transabdominal myotomy, thoracoscopic myotomy, laparoscopic myotomy, and Heller myotomy.90003 90002 90053 Peroral endoscopy myotomy (POEM): 90054 The surgeon passes an electrical scalpel through an endoscope. They make an incision in the lining of the esophagus and create a tunnel within the esophageal wall. 90003 90002 This procedure appears to be safe and effective. However, it is a relatively new procedure, and its long term effects are unknown. 90003 90002 90053 Botox: 90054 A person can receive injections of the botulinum toxin, or Botox. This can relax the muscles at the lower end of the esophagus.90003 90002 Botox injections can help those who are unable or unfit to undergo surgery. A single injection provides relief for up to 6 months for about 50% of people. Many people need repeat injections after the effect of the first wears off. 90003 90002 Following noninvasive surgery, a person can expect to spend 24-48 hours in the hospital. They will usually be able to return to normal activities after 2 weeks. 90003 90002 A person who undergoes open surgery will probably need a more extended hospital stay but can resume an active lifestyle in 2-4 weeks.90003 90002 After surgery or some procedures, a doctor might prescribe a medication known as a proton pump inhibitor (PPI). This can help reduce the amount of acid involved in digestion and the risk of acid reflux. 90003 90002 Here, learn more about procedures to relieve esophageal spasms. 90003 90002 Since there is no cure for esophageal achalasia, people should seek regular follow-up appointments to detect and treat any complications in the early stages. 90003 90002 Acid reflux, severe enlargement of the esophagus, and squamous cell esophageal cancer are all possible complications.90003 90002 The American College of Gastroenterology do not recommend regular screening by endoscopy for esophageal cancer, as studies do not suggest that this reduces the risk of progression to cancer. 90003 90002 However, some doctors recommend screening every 3 years in people who have had a diagnosis of esophageal achalasia for 10-15 years. Rather than identifying cancer, this is more helpful for diagnosing complications, such as an enlarged esophagus, or megaesophagus. 90003 90002 Megaesophagus and esophageal cancer could make it necessary for a surgeon to remove the entire esophagus.However, early detection and treatment may prevent this. 90003 90002 The person will probably need a liquid diet for the first few days after treatment. When swallowing becomes easier, they can move onto a solid diet. 90003 90002 People with achalasia should eat slowly, chew their food thoroughly, and drink plenty of water during meals. They should avoid eating meals near bedtime. 90003 90002 Sleeping with the head slightly raised can help gravity empty the esophagus and reduce the risk of sticking of regurgitation.90003 90002 Foods to avoid include: 90003 90030 90031 citrus fruits 90032 90031 alcohol 90032 90031 caffeine 90032 90031 chocolate 90032 90031 ketchup 90032 90041 90002 These may encourage reflux. Fried and spicy foods can also irritate the digestive system and make symptoms worse. 90003 90002 There is no specific diet for people with achalasia. However, a 2017 review suggests that a low fiber diet could reduce the bulk of food and allow it to pass more easily through the esophagus. 90003 90002 While researchers have much left to learn about achalasia, according to the Genetic and Rare Diseases Information Center, around 90% of people see a long term improvement in symptoms after treatment.90003 90002 Sometimes, a surgeon might have to remove the entire esophagus. This occurs in approximately 10-15% of individuals. 90003 90002 If people start to experience swallowing difficulties, they should seek consultation as early as possible to improve their outlook. 90003.