Most esophageal obstruction develops slowly and is incomplete when patients first seek care, typically for difficulty swallowing solids. However, sometimes complete esophageal obstruction develops suddenly because of an impacted esophageal foreign body Esophageal Foreign Bodies Food and a variety of other swallowed objects can become impacted in the esophagus. Esophageal foreign bodies cause dysphagia and sometimes lead to perforation. Diagnosis is clinical, but imaging... read more or food bolus.
(See also Overview of Esophageal and Swallowing Disorders Overview of Esophageal and Swallowing Disorders The swallowing apparatus consists of the pharynx, upper esophageal (cricopharyngeal) sphincter, the body of the esophagus, and the lower esophageal sphincter (LES). The upper third of the esophagus... read more .)
Obstruction may have intrinsic or extrinsic causes.
Intrinsic obstruction may be caused by
Esophageal tumors (benign esophageal tumors Benign Esophageal Tumors There are many types of benign esophageal tumors; many are found incidentally, remain asymptomatic, and warrant only observation. Some can cause swallowing symptoms and rarely ulceration or... read more or esophageal cancer Esophageal Cancer The most common malignant tumor in the proximal two thirds of the esophagus is squamous cell carcinoma; adenocarcinoma is the most common in the distal one third. Symptoms are progressive dysphagia... read more )
Strictures caused by gastroesophageal reflux Gastroesophageal Reflux Disease (GERD) Incompetence of the lower esophageal sphincter allows reflux of gastric contents into the esophagus, causing burning pain. Prolonged reflux may lead to esophagitis, stricture, and rarely metaplasia... read more , eosinophilic esophagitis Eosinophilic Esophagitis Eosinophilic esophagitis is a chronic immune-mediated disease of the esophagus resulting in eosinophil-predominant inflammation of the esophagus; it can cause reflux-like symptoms, dysphagia... read more , or, rarely, caustic ingestion Caustic Ingestion Caustics (strong acids and alkalis), when ingested, burn upper gastrointestinal tract tissues, sometimes resulting in esophageal or gastric perforation. Symptoms may include drooling, dysphagia... read more
Extrinsic obstruction may be caused by compression resulting from
An enlarged left atrium
A substernal thyroid gland
Cervical bony exostosis
For evaluation of potential esophageal obstruction, see Dysphagia Evaluation Dysphagia is difficulty swallowing. The condition results from impeded transport of liquids, solids, or both from the pharynx to the stomach. Dysphagia should not be confused with globus sensation... read more .
Treatment of obstruction is directed at the specific cause. Emergent upper endoscopy is essential for patients with complete obstruction.