Singh AK, Singh A, Kochhar R, Manrai M. Esophageal strictures: Management beyond dilation. World J Gastrointest Endosc 2025; 17(11): 110024 [PMID: 41256305 DOI: 10.4253/wjge.v17.i11.110024]
Corresponding Author of This Article
Manish Manrai, Professor, FRCPE, Department of Gastroenterology, Command Hospital, Lucknow Cantt, Lucknow 226002, Uttar Pradesh, India. manishmanrai75@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Anupam Kumar Singh, Arjun Singh, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Rakesh Kochhar, Department of Gastroenterology, Paras Hospital, Panchkula 134109, India
Manish Manrai, Department of Gastroenterology, Command Hospital, Lucknow 226002, Uttar Pradesh, India
Author contributions: Singh AK and Singh A were engaged with resources and writing of the manuscript; Kochhar R and Manrai M conceptualized and supervised the review study, and were involved with resources, editing, and validation; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manish Manrai, Professor, FRCPE, Department of Gastroenterology, Command Hospital, Lucknow Cantt, Lucknow 226002, Uttar Pradesh, India. manishmanrai75@gmail.com
Received: May 28, 2025 Revised: June 26, 2025 Accepted: September 29, 2025 Published online: November 16, 2025 Processing time: 170 Days and 16.5 Hours
Abstract
Esophageal stricture refers to a pathological narrowing of the esophageal lumen, causing dysphagia and impairing the patient's quality of life. There are various etiologies including esophageal malignancy, peptic injury, caustic ingestion, post-surgical anastomosis, radiation therapy, and inflammatory disorders such as eosinophilic esophagitis. The primary goal in managing esophageal strictures is to relieve dysphagia by maintaining luminal patency. Endoscopic dilation remains the mainstay of treatment for most benign strictures, with either bougie or balloon dilators. For patients who develop refractory or recurrent strictures that are difficult to manage with dilation alone, adjunctive therapies like intralesional steroid injections, topical or injected mitomycin C, incisional therapy, stent placement, and finally surgery may enhance outcomes and reduce the frequency of repeat procedures. The present review focuses on the basics of dilation and adjunctive strategies for the management of esophageal stricture.
Core Tip: Esophageal strictures are managed by dilation, and most often, they respond depending on the etiology of the stricture. At times, when a stricture evolves into a refractory or recurrent stricture, management requires additional techniques and devices to successfully maintain a desired diameter to avoid dysphagia for optimal clinical success. The other aim is to maintain a satisfactory luminal diameter for an adequate duration once the target diameter has been achieved. In this mini-review, we discuss the management of esophageal strictures beyond dilation and deliberate the use of drugs, techniques, and devices for their management.
