Merck Manual

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Overview of Esophageal Obstructions

By

Kristle Lee Lynch

, MD, Perelman School of Medicine at The University of Pennsylvania

Reviewed/Revised Mar 2022 | Modified Sep 2022
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In most cases, the cause is

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 Gastroesophageal Reflux Disease (GERD) In gastroesophageal reflux disease, stomach contents, including acid and bile, flow backward from the stomach into the esophagus, causing inflammation in the esophagus and pain in the bottom... read more Gastroesophageal Reflux Disease (GERD) ), usually over years. Obstruction can also be caused by damage to the esophagus that occurs after swallowing a corrosive substance Caustic Substances Poisoning Caustic substances are highly acidic or alkaline chemicals that can cause severe burns to the mouth and digestive tract when swallowed. When swallowed, caustic substances can burn all tissues... read more (erosive esophagitis) or rarely after inflammation of the esophagus caused by a pill that gets stuck in the esophagus for a period of time.

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

Because all these conditions decrease the diameter of the esophagus, people who have one of them usually have difficulty swallowing Difficulty Swallowing Some people have difficulty swallowing (dysphagia). In dysphagia, foods and/or liquids do not move normally from the throat (pharynx) to the stomach. People feel as though food or liquids become... read more solid foods, particularly meat and bread. Difficulty in swallowing liquids develops much later, if at all.

Diagnosis

  • Upper endoscopy

  • Biopsy

  • Barium swallow x-rays

To diagnose a blockage in the esophagus, doctors do an upper endoscopy. In this procedure, doctors examine the esophagus using a flexible tube called an endoscope Endoscopy Endoscopy is an examination of internal structures using a flexible viewing tube (endoscope). In addition to examinations, doctors can use endoscopy to do biopsies and give treatment. Endoscopes... read more . During the endoscopy, doctors take tissue samples to analyze under a microscope (called a biopsy).

Treatment and outcome depend on the cause of the narrowing or blockage.

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