Chronic fibrosis esophagitis
Last reviewed: 23.04.2024
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Chronic fibrosis esophagitis should be considered as a late complication of chronic nonspecific esophagitis, resulting from the proliferation of connective tissue fibers leading to fibrotic degeneration of the esophagus.
Read also: Chronic esophagitis
Chronic fibrosis esophagitis may be limited or diffuse. Most often this disease of the gastrointestinal tract is manifested by a concentric narrowing of the lumen of the esophagus and very rarely by longitudinal, entailing its shortening. Fibrosis in the region of the upper or lower esophageal narrowing can be either localized or diffuse.
[Symptoms of chronic fibrotic esophagitis
Fibrosis of the upper third of the esophagus usually occurs as a result of a descending infection, as mentioned above, and is more common in women. The fibrosclerotic process develops slowly. The first signs are difficulties in swallowing dense food, since the muscular layer of the esophagus undergoes a lesion, gradually losing its peristaltic function.
Fibrosis of the lower part of the esophagus, especially pronounced in the diaphragmatic-cardial part of it, occurs as a result of an ascending infection and the action of gastric juice, in particular pepsin, on the mucous membrane, as mentioned above. Fibrosis of this localization leads to a marked stenosis of the esophagus and a secondary expansion of it above the stricture.
Diffuse fibrosis of the esophagus usually begins in its lower part and spreads to the aortic narrowing. The cause of this narrowing is peptic esophagitis. In peptic fibrosis, X-ray and esophagoscopic data are similar to those of esophageal cancer. With fibrogastroscopy, hyperemia of the mucous membrane is determined, the latter has the form of mushroom-shaped erosized formations that bleed when touching. Differentiate from cancer, these formations can only be done by histological examination. Many authors consider them as a precancer.
Treatment of chronic fibrotic esophagitis
Treatment of chronic fibrotic esophagitis is carried out by bougification of the esophagus.
The treatment of such stenoses is slow and unsuccessful and consists in extinguishing the granulation tissue by methods of applying silver nitrate solutions, galvanic caustics, laser therapy, whose goal is to transform the disease into a purely sclerotic form, followed by dilatation or plastic surgery. It should be noted, however, that these methods, especially chemical coagulation, can provoke and accelerate the malignant degeneration of the existing pathomorphological changes in the esophageal wall.