oesophagus, stricture of

Localized constriction of the oesophagus, making it less easy for food to pass, and occurring as a result of a benign or malignant tumour. Benign strictures usually consist of connective tissue which has formed in the wall in the course of time, usually as a reaction to irritants, as in inflammation of the oesophagus caused by gastric acid reflux, or the accidental drinking of corrosives (ammonia, strong acids). An unusual form occurs particularly in women over the age of 40, often associated with iron deficiency and inflammation of the tongue (Plummer-Vinson syndrome). Malignant strictures are the result of cancer of the oesophagus. Particular symptoms of benign stricture are difficulties in swallowing and, in the case of gastric acid reflux, heartburn and smarting behind the breastbone. If the stricture is malignant it is associated with increasingly severe problems in swallowing, loss of weight and reduced appetite. Pain is rare in such cases. Oesophagoscopy and possibly biopsy are the best intsruments of diagnosis. Treatment of benign stricture is by stretching; malignant strictures are treated in the same way as other cancers of the oesophagus.