Characterization and Management of Benign Esophageal Strictures

Benign esophageal strictures can be complex or refractory to traditional dilation techniques, requiring frequent or repeated treatments. A range of approaches may be implemented to offer improved symptom relief and durability, including self-expandable stents, intralesional injections, incisional therapies, and cryoablation. We review the essential anatomy of the esophagus, methods to evaluate characteristics of benign esophageal strictures (including endoscopy, endoscopic ultrasound, EndoFLIP, optical coherence tomography, and various radiological imaging), and potential underlying conditions important for understanding the characteristics and depth of the stricture that may be crucial in guiding optimal management. This review summarizes the current diagnostic and therapeutic landscape for benign (as opposed to malignant) esophageal strictures, highlighting the importance of an individualized approach based on symptoms, history, stricture etiology and characteristics, and local expertise to improve patient outcomes.