Esophageal stricture pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]


Esophageal stricture is the result of lower pressure of esophageal sphincter in gastroesophageal reflux disease, esophageal motor disorder, and inflammation and fibrosis in neoplasia. The characteristic findings on gross pathology are thickening of the lower esophageal wall in gastroesophageal reflux disease, pale mucosa in lymphocytic esophagitis, and hemorrhagic congestion in caustic ingestion. Characteristic histopathological findings of esophageal stricture are intraepithelial lymphocytosis and basal cell hyperplasia in gastroesophageal reflux disease; T lymphocyte infiltration in squamous mucosa in lymphocytic esophagitis and eosinophilic necrosis in caustic ingestion.



Esophageal stricture due to GERD, via[1]

The normal esophageal diameter is up to 30 mm. An esophageal stricture is a narrowing of the esophagus usually 13 mm or less in diameter that causes dysphagia. Peptic strictures occur usually at the squamocolumnar junction.[2]

Esophageal stricture is the result of:[3][4]

Grade pathophysiological injury
0 Normal
1 Mucosal edema and hyperemia
2A Superficial ulcers, bleeding, exudates
2B Deep focal or circumferential ulcers
3A Focal necrosis
3B Extensive necrosis


Genes involved in the pathogenesis of esophageal stricture due to Dyskeratosis Congenita include:[8]

Associated Conditions

Gross Pathology

Microscopic Pathology

Normal esophagus, via​[13]
Gastroesophageal refllux disease, via​[14]


  1. From, Public Domain, <"">
  2. 2.0 2.1 Marks RD, Richter JE (1993). "Peptic strictures of the esophagus". Am. J. Gastroenterol. 88 (8): 1160–73. PMID 8338082.
  3. Holzheimer, R (2001). Surgical treatment : evidence-based and problem-oriented. München New York: Zuckschwerdt. ISBN 3-88603-714-2.
  4. Belevich VL, Ovchinnikov DV (2013). "[Treatment of benign esophageal stricture]". Vestn. Khir. Im. I. I. Grek. (in Russian). 172 (5): 111–4. PMID 24640761.
  5. Dhir V, Vege SS, Mohandas KM, Desai DC (1996). "Dilation of proximal esophageal strictures following therapy for head and neck cancer: experience with Savary Gilliard dilators". J Surg Oncol. 63 (3): 187–90. doi:10.1002/(SICI)1096-9098(199611)63:3<187::AID-JSO10>3.0.CO;2-2. PMID 8944064.
  6. Fisher RA, Eckhauser ML, Radivoyevitch M (1985). "Acid ingestion in an experimental model". Surg Gynecol Obstet. 161 (1): 91–9. PMID 4012549.
  7. Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1992). "Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history". Am. J. Gastroenterol. 87 (3): 337–41. PMID 1539568.
  8. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean L, Mefford HC, Stephens K, Amemiya A, Ledbetter N, Savage SA. PMID 20301779. Vancouver style error: initials (help); Missing or empty |title= (help)
  9. 9.0 9.1 Yamasaki, Yasushi; Ozawa, Soji; Oguma, Junya; Kazuno, Akihito; Ninomiya, Yamato (2016). "Long peptic strictures of the esophagus due to reflux esophagitis: a case report". Surgical Case Reports. 2 (1). doi:10.1186/s40792-016-0190-1. ISSN 2198-7793.
  10. 10.0 10.1 Maejima, Ryuhei; Uno, Kaname; Iijima, Katsunori; Fujishima, Fumiyoshi; Noguchi, Tetsuya; Ara, Nobuyuki; Asano, Naoki; Koike, Tomoyuki; Imatani, Akira; Shimosegawa, Tooru (2016). "A Japanese case of lymphocytic esophagitis". Digestive Endoscopy. 28 (4): 476–480. doi:10.1111/den.12578. ISSN 0915-5635.
  11. 11.0 11.1 Contini, Sandro (2013). "Caustic injury of the upper gastrointestinal tract: A comprehensive review". World Journal of Gastroenterology. 19 (25): 3918. doi:10.3748/wjg.v19.i25.3918. ISSN 1007-9327.
  12. Wilcox CM (2013). "Overview of infectious esophagitis". Gastroenterol Hepatol (N Y). 9 (8): 517–9. PMC 3980995. PMID 24719600.
  13. <""> via Wikimedia Commons
  14. "">via Wikimedia Commons
  15. "Esophageal stricture - Libre Pathology".