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Spectrum, Etiology, and Outcomes of Esophageal Strictures in Patients Presenting With Dysphagia: A Three-Year Endoscopic Experience From a Resource-Limited Tertiary Care Center
Poster Abstract

Aims

To evaluate the frequency, etiological patterns, and clinical outcomes of esophageal strictures diagnosed on endoscopy in patients presenting with dysphagia, and to highlight challenges in management within a resource-limited environment.

Methods

This prospective observational study was conducted at Naimat Begum Hamdard University Hospital from January 2022 to January 2025. A total of 200 consecutive patients presenting with dysphagia (120 males, 80 females) underwent upper gastrointestinal endoscopy. Findings were categorized into stricturing lesions and non-stricturing causes (candida esophagitis, motility disorders, or normal examination). Patients with strictures were further classified by etiology, clinical presentation, need for repeated dilatation, complications, and requirement of palliative interventions.

Results

Of the 200 dysphagia patients, 130 (65%) were found to have esophageal strictures. Among these:

  • 55 (42.3%) had benign peptic strictures related to chronic GERD.

  • 43 (33.1%) had malignant strictures, predominantly in the mid and distal esophagus.

  • 5 (3.8%) had radiation-induced strictures following treatment for head and neck cancer.

  • 9 (6.9%) had corrosive strictures secondary to caustic ingestion.

  • 18 (13.8%) had proximal smooth strictures/webs linked to iron deficiency anemia.

  • Patients with corrosive and peptic strictures frequently required multiple sessions of endoscopic dilatation. Five patients (3 corrosive, 2 peptic) developed perforations during dilatation. Tumor-related strictures typically presented late, with most patients requiring palliative self-expandable metal stent placement due to inoperability.

Conclusions

Esophageal strictures constitute a major cause of dysphagia in our population, with peptic and malignant strictures being the most prevalent etiologies. Corrosive and peptic strictures pose significant management challenges, often requiring repeated interventions and carrying a risk of perforation. Late presentation of malignant strictures limits curative options, necessitating palliative stenting. In resource-constrained settings, early referral and timely endoscopy are essential to improve outcomes and reduce morbidity.