Esophageal food bolus obstruction

Esophageal food bolus obstruction (EFBO) is a medical condition characterized by the impaction of a food bolus in the esophagus. This condition can lead to difficulty swallowing (dysphagia), pain, and potentially serious complications if not promptly addressed. EFBO is considered a gastrointestinal emergency and requires immediate medical attention.

Causes[edit | edit source]

EFBO is most commonly caused by an underlying esophageal disorder that narrows the esophagus, making it difficult for food to pass. These conditions include:

Esophageal stricture: Narrowing of the esophagus due to scar tissue, often resulting from chronic gastroesophageal reflux disease (GERD) or radiation therapy.
Eosinophilic esophagitis: An allergic condition causing inflammation and narrowing of the esophagus.
Esophageal cancer: A malignant tumor that can obstruct the passage of food.
Achalasia: A disorder affecting the ability of the esophagus to move food toward the stomach.

Symptoms[edit | edit source]

The primary symptom of EFBO is the sudden onset of dysphagia, especially with solid foods. Other symptoms may include:

Pain or discomfort in the chest
Regurgitation of food
Salivation
Coughing or choking (if the food enters the airway)

Diagnosis[edit | edit source]

Diagnosis of EFBO typically involves a combination of medical history, physical examination, and diagnostic tests, including:

X-ray with a barium swallow: A special type of X-ray that visualizes the esophagus after the patient swallows a barium solution.
Endoscopy: A procedure using a flexible tube with a camera to visually inspect the esophagus and remove the food bolus.

Treatment[edit | edit source]

Treatment for EFBO aims to remove the obstruction and address the underlying cause. Methods include:

Endoscopic removal: The most common and effective treatment, where an endoscope is used to either push the food bolus into the stomach or extract it.
Pharmacological treatment: The use of glucagon or nitroglycerin to relax the esophageal muscles and facilitate the passage of the food bolus.
Esophageal dilation: Widening of the esophagus using a balloon or dilators to prevent future obstructions.

Prevention[edit | edit source]

Prevention of EFBO involves managing underlying esophageal conditions, chewing food thoroughly, and avoiding large bites of hard-to-swallow foods.

Complications[edit | edit source]

If not treated promptly, EFBO can lead to complications such as:

Aspiration pneumonia: Inhalation of food particles into the lungs.
Esophageal perforation: A tear in the esophagus, leading to a serious infection.
Airway obstruction: A life-threatening condition if the food bolus blocks the airway.