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Damage Esophagus

What do doctors call this condition?

Corrosive esophagitis and stricture

What is this condition?

Damaged esophagus refers to the inflammation and injury to the throat after someone swallows a caustic chemical. Similar to a burn, this injury may be temporary or lead to permanent narrowing that requires surgery. If severe, the injury can quickly cause inflammation, perforation, and death from infection, shock, and bleeding (if perforation involves the nearby aorta).

What causes it?

The most common cause is swallowing lye or another strong alkali; less often, a strong acid. After exposure to the toxic chemical, tissue becomes swollen and inflamed, sores form and dead tissue sloughs off, leaving scars. Damage may be limited to the mucous lining or it may affect all layers of the esophagus. In children, damaged esophagus usually results from accidentally swallowing household chemicals; in adults, it usually accompanies attempted suicide.

What are its symptoms?

Symptoms range from none at all to intense pain in the mouth and chest, excessive salivation, inability to swallow, and rapid breathing. Bloody vomit that contains pieces of tissue signals severe damage. A rattling sound may mean that the esophagus has been destroyed. If the person can't speak, the voice box may be damaged. The first 3 to 4 days afterward are critical. During this time, the person will be unable to eat. Fever may mean the wound is infected. In rare cases, scar tissue may make swallowing difficult - even years later.

How is it diagnosed?

The doctor will ask about the type and amount of chemical the person has swallowed and will inspect the throat for burn, white membranes, or swelling. He or she may use a scope or order a barium swallow X-ray and other X-ray studies to measure the injury and its progress over several weeks.

How is it treated?

Conservative treatment includes drugs to control inflammation and inhibit scarring, and an antibiotic to prevent infection. The doctor may use a thin, flexible, instrument called a bougie to dilate the person's esophagus and, thereby, minimize narrowing. Some doctor begin this treatment immediately and continue it regularly; others delay starting for a week to avoid the risk of perforating the esophagus. Intravenous fluids and nutrients are administered while the person can't swallow. Clear liquids and then soft foods are added to the diet as recovery progresses.

perforation of the esophagus require immediate surgery. Also, surgery may be used to correct a narrowing that can't be treated with a bougie. This procedure usually involves transplanting a piece of the colon to the damaged esophagus. However, ever after surgery, closing may recur at the site of the damage.

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