This protocol addresses caustic esophageal stricture — a narrowing of the esophagus that develops after ingestion of a corrosive agent. The scenario and first-line management approach are outlined below; the complete structured regimen is available via the link.

Clinical Scenario

Corrosive agents — most commonly strong bases — can cause significant tissue damage within seconds of ingestion, leading to esophageal stricture formation. Caustic strictures can involve all esophageal segments and vary in length, making individualised management essential.

Treatment Goals

The aim is to improve symptoms and nutritional status. Wide luminal patency is not the primary endpoint of management.

First-Line Approach (overview only)

Endoscopic dilation is the established first-line intervention, initiated after the acute injuries have healed. The complete protocol — including scheduling, repeat strategies, and options for complex strictures — is available via the link below.

References

DOI: 10.1016/j.giec.2025.02.002

Corrosive agents, most commonly strong bases, can cause significant tissue damage within seconds of ingestion.

Caustic strictures can involve all esophageal segments and vary in length.

Dilation is the first-line treatment and can be started safely after the acute injuries have healed, generally between 3 and 6 weeks following ingestion.

The goal of caustic stricture management is to improve symptoms and nutritional status rather than achieve wide luminal patency.

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Treatment of Esophageal Stricture Following Corrosive (Caustic) Agent Ingestion