Esophageal Stricture
ICD-10 K22.2 · ICD-11 DA20.0.2

Treatment of Esophageal Stricture in Eosinophilic Esophagitis with Esophageal Remodeling

This protocol covers esophageal stricture arising in patients with eosinophilic esophagitis (EoE), where chronic inflammation has led to esophageal remodeling — manifesting as rings, strictures, or a narrow-caliber esophagus.

Clinical Scenario

The patient has eosinophilic esophagitis — a chronic immune-mediated inflammatory disease that can lead to fibrosis and stricturing of the esophagus — with documented remodeling features: rings, strictures, or a narrow-caliber esophagus.

Treatment Approach

Management addresses both the underlying inflammatory process and the mechanical narrowing. The specific interventions, their sequencing, and technical considerations are detailed in the full protocol.

Treatment Goal

Relief of dysphagia at a target esophageal diameter of 16 mm.

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References

DOI: 10.1016/j.giec.2025.02.002

Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory disease that can lead to fibrosis and stricturing of the esophagus.

While the cornerstone of therapy is treating the underlying inflammation with medication or dietary management, endoscopic dilation is frequently utilized as an adjunct to manage symptomatic patients with remodeling features such as rings, strictures, or narrow-caliber esophagus (characterized by inability to pass an adult endoscope with 9 mm diameter).

The goal diameter that generally relieves dysphagia and prevents food impactions is 16 mm.

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