Oesophageal Stricture

An oesophageal stricture is a narrowing of the oesophagus (the gullet) that makes it harder for food and sometimes liquids to pass from the mouth to the stomach. This can cause swallowing difficulties, a sensation of food “sticking”, and discomfort when eating.

Strictures are often linked to long-term acid reflux, but there are several possible causes. Because swallowing symptoms can sometimes indicate a serious underlying condition, timely assessment is important.

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment and investigation to confirm the cause and recommend the safest, most effective treatment plan.

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What causes an oesophageal stricture?

Common causes include:

Reflux-related inflammation and scarring

• Long-standing acid reflux (GORD) can inflame the oesophagus. Over time, repeated injury and healing can lead to scarring and narrowing.

Eosinophilic oesophagitis (EoE)

• An inflammatory condition often linked to allergy-type mechanisms that can cause rings, narrowing and food impaction.

Injury to the oesophagus

• Previous surgery or endoscopic treatments
• Radiotherapy to the chest/neck area
• Accidental swallowing of corrosive substances (rare)

Medication-related irritation

• Some tablets can irritate the oesophagus if they lodge or are taken without enough water (for example certain antibiotics, anti-inflammatories or osteoporosis tablets).

Cancer (less common but important to rule out)

• New or progressive swallowing difficulty must be assessed to exclude malignant causes, especially if accompanied by weight loss or persistent symptoms.

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Symptoms of an oesophageal stricture

Symptoms vary depending on how narrow the oesophagus has become. Common symptoms include:

• Difficulty swallowing (dysphagia) — often starting with solid foods
• A feeling that food is sticking in the chest or throat
• Regurgitation of food
• Heartburn or reflux symptoms
• Chest discomfort or pain on swallowing (odynophagia)
• Needing to chew more, eat slowly, or avoid certain foods
• Unintentional weight loss (if eating becomes difficult)
• Coughing or choking during meals (if food or fluid goes the wrong way)
• Episodes of food bolus obstruction (food completely stuck)

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When to seek urgent help

Seek urgent medical advice if you experience:

• Food stuck in the throat/chest and you cannot swallow saliva
• Breathing difficulty, choking, or severe distress
• Vomiting blood or passing black, tarry stools
• Severe chest pain (especially if sudden or associated with breathlessness)

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Diagnosis at Royal Buckinghamshire Hospital

Your consultant will assess symptoms, risk factors and possible causes. Investigations may include:

• Clinical assessment (symptom pattern, reflux history, medications, weight change)
• Gastroscopy (endoscopy) to look directly at the oesophagus, identify the narrowing, and assess inflammation
• Biopsies during endoscopy where appropriate (for example to assess inflammation, EoE, or to rule out other causes)
• Barium swallow (a contrast X-ray test) in selected cases to map the narrowing and swallowing function
• Additional tests if reflux is suspected as a driver (in selected cases)

You’ll be given a clear explanation of findings and a tailored treatment plan.

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Treatment & management

Treatment depends on the cause, length and severity of the stricture, and your overall health.

Managing reflux and inflammation

If reflux is contributing, treatment often includes:

• Acid suppression medication to reduce irritation and help prevent recurrence
• Lifestyle guidance (for example reducing reflux triggers, meal timing, weight management where relevant)

If eosinophilic oesophagitis is suspected or confirmed, treatment may include:

• Anti-inflammatory approaches (often swallowed topical therapy) and/or dietary strategies, guided by your clinician

Oesophageal dilatation (stretching)

A common treatment is endoscopic dilatation, where the narrowing is gently widened using special balloons or dilators during endoscopy. This can improve swallowing and reduce the chance of food getting stuck.

Some patients need more than one dilatation session, particularly if the stricture is tight or tends to recur.

Treating the underlying cause

Depending on findings, treatment may also include:

• Adjusting medications that may be irritating the oesophagus
• Treating infections if present (less common)
• Coordinating urgent referral pathways if there is concern about cancer or another serious cause

Nutrition support (if swallowing is significantly affected)

If symptoms are impacting intake and weight, your consultant may advise:

• Softer diet consistency temporarily
• High-calorie, high-protein approaches
• Dietitian support in selected cases

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Recovery and outlook

Many people improve significantly once the narrowing is treated and the underlying cause is controlled. However:

• Some strictures can recur, especially if reflux remains uncontrolled
• Ongoing management (such as acid suppression) may be recommended to reduce relapse risk
• Follow-up is tailored to symptom response and endoscopy findings

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If you have difficulty swallowing, food sticking, or repeated reflux symptoms that aren’t settling, contact Royal Buckinghamshire Hospital for assessment and investigation. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.