Abstract

Patient: Female, 58
Final diagnosis: esophageal obstruction
Esophageal obstruction signs and Symptoms: difficulty in swallowing food, dysphagia, shortness of breath, nausea
Specialty: Gastroenterology and hepatology

Objective

Causes, symptoms, and treatment of esophageal Obstruction

Background

Esophageal obstruction (commonly known as steakhouse syndrome) is usually caused due to blockage or obstruction in the esophagus by a foreign body. In this condition, the esophagus narrows down and gets blocked, eventually if not treated at the right time. The main esophageal obstruction complication is that it restricts the ability of a person to swallow. Thus, restoration of the ability to swallow is the primary objective of the treatment. The problem of difficulty in swallowing might lead to dehydration and even malnutrition in the long run.

Case Review:

A 58-year-old female with a former medical history of arthritis, , chronic back pain, hypertension, depression, and liver disease presented with difficulty in swallowing food, dysphagia, shortness of breath, nausea, and vomiting. She later reported that her symptoms started one month ago. However, the severity of the symptoms has increased over the last 10 days. She also reported throat, stomach, and chest pain and had difficulty in swallowing both solid and liquid food.

Due to her past medical history of arthritis, she was taking painkillers like ibuprofen and aspirin which greatly helped her with her joint pain. Social history includes heavy use of alcohol for 20 years which she stopped after being diagnosed with liver disease 3 years back. She has no episodes of bleeding whatsoever but has had a fever a few times in the last 7 days. Physically, she is a lean lady, with a normal heart rate, and high blood pressure. During one day of surveillance, she has episodes of vomiting and choking.

Case Discussion:

Possible esophageal obstruction causes include esophageal injuries, abnormal esophagus, esophageal atresia, esophageal webs, injury due to prolonged use of ibuprofen and aspirin, exposure or use of nasogastric or stomach tube, esophagus cancer, excessive vomiting due to bulimia, both cancerous and noncancerous tumors might be a cause of narrowing esophagus, enlargement of the left atrium of the heart, enlarged thyroid gland.

As mentioned in the report, the patient was consuming painkillers such as ibuprofen and aspirin for over 10 years. After performing Upper endoscopy on the patient, suspecting the case of esophageal obstruction, followed by taking tissue samples and conducting a biopsy, esophagus injuries were noticed, probably by taking too many pain killer drugs. This caused violent vomiting which had resulted in multiple ulcers  in the esophagus

One of the main risk factors of esophageal obstruction is alcohol consumption. As the patient has a past record of being an alcoholic, she is highly vulnerable to this disease.

Clinical symptoms:

The most evident Esophageal obstruction signs and Symptoms is difficulty in swallowing food. The esophagus is a hollow tube that leads from the throat to the stomach. The food or liquid passes through the esophagus and reaches the stomach. Esophagus injury doesn’t happen overnight but is injured eventually due to prolonged backflow of acid from the stomach. Other common symptoms include dysphagia, pain in the throat while swallowing, weight loss, reflux of food and liquid substances, chest pain, choking, breath shortness, nausea, vomiting, heartburn fever, and fatigue.

The patient has clear and visible symptoms of vomiting, nausea, difficulty in swallowing, weight loss, and sometimes, fever.

Management:

Different esophageal obstruction management techniques can be adopted depending upon the severity of the disease and the cause of its happening. In case of very acute blockage, the esophageal obstruction medications such as acid-blocking medicines or PPIs may be taken and the patient might be kept under observation. Other treatment procedures that can be adopted include esophageal dilation, esophageal stent placement.

Esophageal dilation has been proved as a promising treatment procedure for esophageal obstruction cure. This procedure might be a little painful and is conducted under sedation. The doctor inserts an endoscope through the patient’s mouth into the esophagus. Stomach and small intestine. Once they spot the obstruction area, they will put/ place the dilator into the esophagus. The dilator is a thin tube-like structure with a balloon on its tip. Upon the inflation of the balloon, the narrowed area of the esophagus expands or stretches. This procedure may be repeated a few more times to prevent esophageal obstruction in the future.

Esophageal stent placement is conducted in special cases. The esophageal stents are thin plastic tubes, or metal, or flexible mesh that is inserted to provide relief to the obstruction area. This treatment can help remove the blockage so that the patient can swallow solid and liquid food items. The doctor performs the procedure under mild or moderate anesthesia.

In this case, the doctor performed esophageal dilation on the patient multiple times. The results are evident and the patient is on the road to recovery. After a few weeks of dilation, the endoscopy results demonstrate that the esophagus has returned to its normal state. The patient can now swallow food and liquid easily and doesn’t have signs of vomiting, nausea anymore. However, the patient is still experiencing pain in her throat, which will eventually get better. The patient is under constant observation and is advised to make some specific diet and lifestyle changes. She is advised to completely stay away from alcohol and tobacco and avoid foods that can lead to acid reflux like spicy, fatty food, carbonated beverages, citrus foods, caffeine, and chocolate.

Routine checkups and proper treatment can cure esophageal obstruction. If you are experiencing any symptoms mentioned above, consult food pipe specialist, gastroenterologist near you. You can either tele consult gastroenterologist, talk to gastroenterologist, consult gastroenterologist online free or opt for Gastroenterologist live chat. Services are available in different cities, consult her as hepatologist in Patna, best doctors for hepatitis b in Patna, gastroenterologist doctor in Patna, gastroenterologist in Faridabad, liver expert doctor in Jaipur, food pipe specialist,  best gastrointestinal doctor in Delhi , gastro surgeon in Delhi, good gastroenterologist in Delhi , best liver specialist in Delhi,NCR , best gastroenterologist in north Delhi , top liver doctor in Delhi , best hepatologist Delhi , liver specialist doctor in Gurgaon.

FAQS

1.   What causes esophageal obstruction?

There can be many reasons for blockage in the esophagus. Some of the causes include Esophageal injury, swallowing some foreign substances, tumor, GERD, excessive vomiting, gastroesophageal reflux, etc

2.   How can I tell if my esophagus is blocked?

The common symptoms of esophageal obstruction are difficulty in swallowing food and liquid, weight loss, heartburn, burping or hiccups, chest pain, vomiting, etc

3.   What is esophageal obstruction?

Esophageal obstruction is blockage of the esophagus due to narrowing thickness, or obstruction caused by a foreign body like meat, pork, etc.