Causes and risk factors
The exact cause is unknown. Genetic, environmental, immunologic, infectious factors are responsible for the condition. Certain nutritional deficiencies like iron deficiency is one of the causes of the disease. Due to iron deficiency anemia, inner lining of esophagus thickens and causes esophageal stenosis. It can be associated with cancer of esophagus. The condition is more common in children and adolescents. It is seen more in females.
Clinical presentation
Difficulty in swallowing [dysphagia] is the main symptom of the disease. It is intermittent and limited to solids in this disease. There is choking sensation in the throat. Aspiration may occur. Patient complains of food sticking in the throat. Associated symptoms include heartburn, squeezing, and intense chest pain. There is slow growth rate in children, no weight gain, weakness, fatigue, and anorexia. Patient may have a nasal voice. Constitutional symptoms of nutritional deficiency anemia are observed. Many a times the condition is associated with angular stomatitis and atrophic glossitis.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Barium swallow is recommended. esophageal manometry is done. Esophagogastroduodenoscopy is advised. Esophageal pH monitoring is advised. Cine-esophagogram is useful in observing esophageal webs.
Treatment
The treatment is focused on correcting nutritional deficiency, i.e., iron deficiency. Oral iron supplement will help in treating sideropenic dysphagia. Muscle relaxants, antianxiety medicines may be required. If medical treatment fails, surgical intervention, i.e., mechanical dilation is necessary for widening of the webs in the upper esophagus which will help in swallowing. Nd:YAG laser therapy has also been proved effective in managing sideropenic dysphagia. Needle knife electroincision is an alternative treatment for mechanical dilation.
Other Modes of treatment
The other modes of treatment can also be effective in treating sideropenic dysphagia. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating sideropenic dysphagia.
