Oesophageal Strictures (Esophageal Strictures)

An oesophageal stricture is an abnormal narrowing of the oesophagus, the muscular tube that carries food and fluid from the mouth to the stomach. This narrowing makes the passage smaller than normal, which can make swallowing difficult or uncomfortable. The medical term for difficulty swallowing is dysphagia. An oesophageal stricture, sometimes spelled esophageal stricture, can affect people of any age, although the cause behind it often differs between children and adults.

What is an oesophageal stricture?

Strictures are generally grouped as either benign, meaning non-cancerous, or malignant, meaning related to cancer. The normal oesophagus is wide enough to allow food to pass through comfortably. When scarring, inflammation or a growth narrows this passage, food and sometimes liquid can have trouble getting through, leading to the symptoms described below.

Some strictures develop gradually over months or years, which is why they are often described as a chronic oesophageal stricture. Others can develop more quickly, sometimes referred to as an acute oesophageal stricture, particularly after an injury to the oesophagus or in the case of a tumour. Understanding how quickly the narrowing has developed helps your gastroenterologist work out the likely cause.

What causes an oesophageal stricture?

An oesophageal stricture is not a disease in itself, but rather the result of another condition that has caused damage, scarring or growth within the oesophagus. Several different conditions can lead to a stricture forming.

Long standing reflux and other benign causes

The most common cause of a benign oesophageal stricture in adults is long standing gastro oesophageal reflux disease, often shortened to GORD or reflux. When stomach acid repeatedly washes up into the lower oesophagus over a long period, it can damage the lining and lead to scarring and narrowing. This type of stricture is sometimes called a peptic stricture and usually develops slowly.

Other benign causes include eosinophilic oesophagitis, a chronic immune related condition affecting the lining of the oesophagus, swallowing a corrosive substance such as a strong cleaning product, previous radiation treatment to the chest or neck, scarring following oesophageal surgery or an earlier endoscopic procedure, and certain medications that can irritate the oesophagus if they are not taken with enough water or while lying down. Infections affecting the oesophagus, which mainly occur in people with a weakened immune system, and rarer conditions such as scleroderma or Crohn disease can also lead to stricture formation.

Cancer related strictures

Less commonly, a stricture can form because a cancer is growing within or pressing on the oesophagus. These strictures often develop more quickly than peptic strictures and may be associated with unintentional weight loss. Because the early symptoms of a cancer related stricture can look similar to those of a benign stricture, your gastroenterologist will always assess for signs of malignancy as part of your work up, usually by taking a biopsy during endoscopy. If a stricture is found to be related to cancer, your ongoing care will involve a wider team, which may include a surgeon and an oncologist, working alongside your gastroenterologist.

What are the signs and symptoms of an oesophageal stricture?

The main symptom of an oesophageal stricture is difficulty swallowing. This often begins with solid foods, such as meat or bread, feeling like they are getting stuck, and over time it may progress to include softer foods and eventually liquids. Many people notice they are eating more slowly, cutting food into smaller pieces, or avoiding certain foods because of how they feel going down.

Other symptoms can include food or fluid coming back up after eating, discomfort or pain behind the breastbone, pain when swallowing, and in some cases unintentional weight loss. A stricture that has developed gradually, such as one related to long standing reflux, tends to cause symptoms that build up slowly over months or years. A stricture that develops quickly is more likely to cause symptoms that worsen rapidly over days or weeks.

IMPORTANT: If food becomes completely stuck and you are unable to swallow even your own saliva, this is a medical emergency. You should seek urgent care at your nearest emergency department or call triple zero (000) rather than waiting for a routine appointment.

How is an oesophageal stricture diagnosed?

If you have ongoing swallowing difficulty, your GP will usually examine you and may arrange some initial tests before referring you on for specialist assessment. You will need a referral from your GP to see a gastroenterologist, as this helps make sure your care is properly coordinated from the start.

The main test used to diagnose an oesophageal stricture is an upper gastrointestinal endoscopy, also known as a gastroscopy. During this procedure, your gastroenterologist passes a thin, flexible tube with a camera through your mouth and down into the oesophagus, stomach and the first part of the small intestine, called the duodenum. This allows the narrowing to be seen directly, and small tissue samples, known as biopsies, can be taken at the same time to check for inflammation or signs of cancer.

In some cases, particularly when a stricture is severe or difficult to assess with the endoscope alone, your gastroenterologist may also recommend a barium swallow, an x-ray test that uses a contrast liquid to outline the shape and size of the narrowing. If a stricture turns out to be related to cancer, further imaging such as a CT scan may be arranged to help plan the next steps of treatment.

How are oesophageal strictures treated?

Dilatation, the main treatment for benign strictures

For most benign oesophageal strictures, the main treatment is dilatation, a procedure carried out during gastroscopy that gently stretches the narrowed area to make swallowing easier. Your gastroenterologist may use a mechanical dilator, sometimes called a bougie, or a balloon dilator that is inflated inside the stricture once it is in place. The choice between these options depends on the size, length and location of the narrowing.

Dilatation is generally carried out gradually and carefully to reduce the risk of injury to the oesophagus, often increasing the width of the passage a small amount at a time rather than all in one step. Some people need more than one session to reach a comfortable swallowing capacity, and a number of strictures return after treatment, which may mean further dilatation sessions are needed over time.

If your stricture is related to reflux, your gastroenterologist will also recommend ongoing treatment to reduce stomach acid and protect the oesophagus from further damage. This usually involves long term use of acid suppressing medication, alongside any lifestyle measures discussed with your GP or gastroenterologist.

Other treatment options

For strictures that are difficult to treat or that keep coming back, your gastroenterologist may consider injecting a steroid medication into the narrowed area at the time of dilatation, which can help lower the chance of the stricture returning. Stents, which are small tube shaped devices that hold the oesophagus open, are sometimes used for strictures that do not respond well to dilatation, or for strictures caused by cancer where the goal is to relieve symptoms.

Surgery is not usually the first treatment for a benign oesophageal stricture, but it may be considered in certain situations, such as a stricture that does not improve despite repeated dilatation, or when an underlying problem like a hiatus hernia needs to be corrected. Surgical treatment is carried out by a surgeon rather than a gastroenterologist, and your gastroenterologist will refer you on if surgery becomes the most appropriate option. Strictures related to cancer are managed by a team that includes surgical and medical oncology specialists working together with your gastroenterologist.

What to expect during a dilatation procedure

A dilatation procedure is usually carried out as a day case, which means you go home the same day. You will need to avoid eating or drinking for at least six hours beforehand so that your oesophagus and stomach are empty. The procedure itself typically takes around ten to twenty minutes, although you should plan for two to three hours in total once preparation and recovery time are included.

Most people are offered a light sedative or anaesthetic to help them stay relaxed and comfortable, although some people choose to have the procedure without sedation. Before the procedure begins, a small needle is placed in your hand or arm to allow the sedation to be given, and your throat may be sprayed with a numbing medication to help prevent gagging.

If you receive sedation, you will need a responsible adult to take you home afterwards. For the rest of that day, you should not drive any vehicle, operate machinery, drink alcohol, or make important decisions or sign legal documents, as the sedation can affect your judgement for around twenty four hours.

What are the risks of oesophageal dilatation?

As with any medical procedure, oesophageal dilatation carries some risks, and your gastroenterologist will talk you through these in detail before you agree to treatment. Common, usually mild effects include a sore throat, nausea, bloating or cramping from the air introduced during the procedure, and some discomfort, redness or bruising where the sedation needle was placed.

Less common complications include bleeding, particularly if a biopsy or tissue sample has been taken, and a bloodstream infection called bacteraemia, which can usually be treated successfully with antibiotics if it occurs.

The most serious, although rare, risk is a small tear or hole forming in the wall of the oesophagus, known as a perforation. If this happens, you would need to be admitted to hospital for further treatment, which may include surgery. Other rare risks include damage to teeth, an allergic reaction to medication, and heart or lung problems, particularly in people who already have other health conditions. Death as a result of this procedure is rare. Your gastroenterologist will always weigh these risks against the expected benefit of treating your stricture before recommending the procedure.

Recovering after dilatation and ongoing care

After the procedure, you will rest in a recovery area until the sedation wears off, which usually takes around two hours. Your gastroenterologist will let you know what was found and discuss this with you, along with any biopsy results, which can take a little longer to come back from pathology. Your throat may feel sore for a day or two, and you may notice some mild bloating or cramping, which usually settles by itself.

Because some strictures can return, your gastroenterologist may suggest a follow up plan that includes repeat dilatation sessions, ongoing reflux treatment, or monitoring, depending on the underlying cause of your stricture. Keeping up with follow up appointments and medication advice gives you the best chance of keeping your swallowing comfortable over the long term.

When to seek urgent medical care

Contact your nearest hospital emergency department or call triple zero (000) straight away if you develop severe ongoing chest or abdominal pain, a sudden inability to swallow your own saliva, a high fever, or redness, swelling or tenderness around an injection site that lasts more than forty eight hours after your procedure. Food that becomes completely stuck in the oesophagus also needs urgent attention, as it can sometimes be cleared during an emergency endoscopy.

Living well with an oesophageal stricture

For most people, a benign oesophageal stricture can be managed successfully with a combination of dilatation and ongoing reflux treatment, allowing a return to comfortable eating. If you are finding it hard to maintain your weight or manage your diet because of swallowing difficulties, your gastroenterologist may suggest involving a dietitian for tailored nutrition advice.

Strictures related to cancer are managed differently, with treatment and outlook depending on the type and stage of the cancer, and care provided through a coordinated team of specialists working alongside your gastroenterologist.

Talk to your GP about swallowing difficulties

If you have noticed ongoing difficulty swallowing, food regularly catching in your chest, or unexplained weight loss, it is important to speak with your GP. Your GP can arrange an initial assessment and, where appropriate, refer you to a gastroenterologist at Queensland Gastroenterology for further investigation and treatment of an oesophageal stricture.

Our specialist team provides comprehensive assessment and ongoing care for patients with Oesophageal Strictures across Brisbane and South East Queensland. Once you have your referral, please contact our practice directly to arrange an appointment.

This information has been sourced and adapted from the following educational and research resources, as at 25/6/2026:

• Health Direct Australia.
• Queensland Health. Upper Gastrointestinal Endoscopy & Dilatation Consent information. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0019/146341/gastro_09.pdf
• Desai JP, Moustarah F. Esophageal Stricture. [Updated 2023 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542209/