Overview of Esophageal Obstructions

In most cases, the cause is

• Progression of an injury to the esophagus

• Tumor growth

• Food and foreign bodies

Injuries that can progress to obstruction can result from damage to the esophagus caused by the repeated backflow of acid from the stomach (gastroesophageal reflux or GERD), usually over years. Eosinophilic esophagitis can cause chronic esophageal inflammation that can lead to narrowing and obstruction of the esophagus. Obstruction can also be caused by damage to the esophagus that occurs after swallowing a corrosive substance (erosive esophagitis) or rarely after inflammation of the esophagus caused by a pill that gets stuck in the esophagus for a period of time.

Tumors are serious causes of narrowing, including cancerous tumors and noncancerous tumors of the esophagus.

Narrowing may also occur when something presses against (compresses) the outside of the esophagus. Compression can result from a number of causes, such as

• Enlargement of the left atrium of the heart

• Aortic aneurysm

• An abnormally formed blood vessel (dysphagia lusoria)

• An abnormal thyroid gland

• A bony outgrowth from the spine

• Cancer (most commonly lung cancer)

Occasionally, the cause is hereditary (for example, lower esophageal rings or an esophageal web). These disorders usually cause only partial obstruction.

Because all these conditions decrease the diameter of the esophagus, people who have one of them usually have difficulty swallowing solid foods, particularly meat and bread. Difficulty in swallowing liquids develops much later, if at all.