Esophageal Web

What is an esophageal web?

An esophageal web is a thin membrane that grows across the inside of your upper esophagus. Most people don’t know they have esophageal webs because they don’t usually cause symptoms. But in severe cases, this web of tissue may partially or completely block your esophagus, making it difficult to swallow.

Most people with this condition only have one “web,” but it’s possible to have more. There’s also a chance the webbing could come back (recur) after treatment, though it’s rare.

Esophageal webs occur most often in people with severe, untreated iron-deficiency anemia. It also happens in people with Plummer-Vinson syndrome — a condition with three hallmark symptoms, including iron-deficiency anemia, dysphagia (difficulty swallowing) and webbing.

How common are esophageal webs?

It’s hard to say exactly how many people have esophageal webs because they typically don’t cause symptoms. Healthcare providers usually detect esophageal webbing during tests for unrelated reasons.

About 5% to 15% of people who see their healthcare provider for dysphagia (difficulty swallowing) have esophageal webs.

Esophageal web vs. ring

Esophageal webs are similar to esophageal rings (Schatzki rings). Both conditions cause your esophagus to narrow and may interfere with swallowing. The difference is where they occur: Webs form in your upper esophagus, and rings form in your lower esophagus. Webs and rings are types of esophageal strictures (narrowed areas in your esophagus).

Some people are born with esophageal webs and rings. But most of the time, they develop later alongside other conditions. Esophageal webs and rings don’t cause issues most of the time. But if they make swallowing painful, treatment can help.

What are the symptoms of esophageal webs?

Most people with esophageal webs don’t have symptoms. If you don’t have symptoms, you probably don’t need treatment.

Difficulty swallowing foods and liquids is the most common symptom of esophageal webs. Sometimes, food can even get caught. When this happens, it may feel painful or like there’s something stuck in your throat.

If you have webbing associated with Plummer-Vinson syndrome, symptoms may include a sore tongue and cracks in the corners of your mouth.

What causes esophageal webs?

Experts don’t know exactly what causes esophageal webs. If you were born with the condition, it might be due to how your esophagus formed during fetal development. If you acquired it later in life, it could be a byproduct of another condition.

Esophageal web risk factors

Esophageal webs tend to occur most often in people with:

• Autoimmune thyroid diseases (like Hashimoto’s thyroiditis and Graves’ disease)
• Blistering skin diseases (like pemphigus)
• Celiac disease
• Chronic acid reflux/GERD
• Graft vs. host disease
• Iron-deficiency anemia
• Psoriasis
• Rheumatoid arthritis

How are esophageal webs diagnosed?

Healthcare providers use these tests to diagnose esophageal webs:

• Esophagram (barium swallow test). This imaging test captures video of what happens when you swallow. It can tell your provider if you have an esophageal web or another type of stricture.
• Upper endoscopy. A provider uses a scope to look at the inside lining of your esophagus. If you have an esophageal web, your provider will be able to see it during this test.

How are esophageal webs treated?

Treating underlying conditions may get rid of esophageal webbing. Healthcare providers use medications, in-office treatments and surgery. They’ll tailor a care plan to your specific needs.

Medications

For example, if you have iron-deficiency anemia, you’ll need iron supplements or infusions. If you have GERD, you’ll need reflux medication like H2 blockers or proton pump inhibitors.

These treatments might be enough to change your esophageal structure and ease your symptoms.

In-office treatments

If medications don’t work, your healthcare provider might recommend esophageal dilation. Healthcare providers do this during an upper endoscopy. They’ll use a surgical balloon or a series of surgical dilators to stretch the narrowed section of your esophagus.

Surgery

Most people with webbing won’t need surgery. But if you have severe esophageal webbing, you might need electrocauterization to remove the affected tissue. This process uses heat to cut away the webbing.

Can esophageal webs be prevented?

You can’t prevent esophageal webs. But you might be able to reduce your risk by managing related conditions like iron-deficiency anemia and acid reflux.

What’s the outlook for people with esophageal webs?

The outlook is excellent with treatment. For most people, symptoms go away after esophageal dilation. But some people might need repeat dilations in severe cases because there’s a small chance the webbing could come back.

When should I see my healthcare provider?

Tell your healthcare provider any time you have symptoms of esophageal webs, like trouble swallowing. They’ll need to find a cause so they can recommend appropriate treatment.

What questions should I ask my doctor?

If you have an esophageal web, here are some questions you might want to ask your healthcare provider:

• Do I need treatment?
• What kind of treatment do you recommend?
• Do I have any underlying conditions associated with esophageal webs?
• Will I need to take medication?
• Are there things I can do to reduce my symptoms?