Stenosis or Stricture

What do stenosis and stricture mean?

Stenosis and stricture are medical terms that refer to the abnormal narrowing of any channel or passageway in your body. You’ll see stenosis or stricture in the names of medical conditions affecting blood vessels, digestive organs and more. 

Many people use stenosis and stricture interchangeably because they both mean narrowing. In general, stenosis and stricture both refer to processes that shouldn’t be happening and that may harm you.

You’ll typically need treatment (like medication or surgery), especially if the stenosis or stricture is causing symptoms. Learning more about these medical terms can help you get a sense of what’s going on inside your body and take an active role in your care.

Stenosis definition

Stenosis is the narrowing of a passageway in your body that prevents a certain substance or structure (like blood or nerves) from passing through as easily as it should. You’ll most commonly see the word stenosis used to refer to the narrowing of:

• Arteries, like your carotid arteries or renal arteries.
• Heart valves, like your aortic valve or mitral valve.
• Parts of your respiratory system, like your windpipe (trachea) or voice box (larynx).

Sometimes, stenosis is very mild and causes no symptoms. But even mild stenosis can worsen over time and lead to symptoms or complications down the road. 

Severe stenosis can cause life-threatening complications. For example, narrowing in your carotid arteries that limits blood flow to your brain can cause a stroke.

Stricture definition

Like stenosis, the word stricture also refers to the narrowing of a passageway in your body. Most often, healthcare providers use stricture to refer to narrowing in parts of your:

• Digestive system, like your esophagus, intestines or bile ducts.
• Urinary system, like your urethra or bladder neck.
• Reproductive system, like your vagina or cervix.

Types of stenoses and strictures

You can develop narrowing in many different parts of your body. So, there are many types of stenoses and strictures. Here are some examples, broken down according to the parts of your body they affect.

Heart valves and arteries (circulatory system)

Your heart valves are the “doors” that open and close to allow blood to move through each section (chamber) of your heart. Your arteries are blood vessels that send oxygen-rich blood to all the organs and tissues in your body. Your heart and blood vessels make up your circulatory system. Stenosis in heart valves or arteries can lead to serious medical issues.

Here are some examples of specific conditions:

• Aortic valve stenosis (aortic stenosis). This is narrowing or blockage of the door that lets blood leave your heart to nourish the rest of your body. Your aortic valve connects the bottom left chamber of your heart (left ventricle) with your aorta. Narrowing of your aortic valve interferes with normal blood flow out of your heart and may lead to heart damage.
• Carotid artery stenosis. This is narrowing or blockage of your carotid arteries, which send oxygen-rich blood to your brain. Most people don’t have symptoms until lack of blood flow leads to a transient ischemic attack (TIA) or stroke.
• Coronary artery disease. Although stenosis isn’t in the name, that’s the process that’s occurring. Plaque gradually narrows your coronary arteries. Severe narrowing limits blood flow to your heart and may lead to a heart attack.
• Mitral valve stenosis (mitral stenosis). This is narrowing or blockage of the door that lets blood travel from your top left heart chamber (left atrium) to your bottom left heart chamber (left ventricle).
• Pulmonary artery stenosis. This is a condition that affects babies and children. It involves narrowing in one or more of the arteries that carry blood from your child’s heart to their lungs.
• Renal artery stenosis. This is narrowing of the arteries that supply blood to your kidneys. There usually aren’t any symptoms until the condition progresses and leads to reduced kidney function.
• Subclavian artery stenosis. This is narrowing of the artery that supplies blood to your arm. You have a subclavian artery on each side of your body. Stenosis usually affects your left subclavian artery, so symptoms (like muscle cramps or tingling) will occur in your left arm.

Spine

Your spine supports your body and helps you move. It’s made up of 33 small bones (vertebrae) stacked on top of one another. Your vertebrae align to form a narrow passageway, called your spinal canal. This passageway contains your spinal cord.

Just like a boat traveling along a canal, your spinal cord runs down the length of your spinal canal. And like the canal needs to be wide enough for the boat to pass through, your spinal canal must be wide enough to allow room for your spinal cord.

If your spinal canal grows too narrow in any one spot, it can irritate the nerves in your spinal cord and lead to symptoms like pain or tingling. Healthcare providers call this condition spinal stenosis. It can affect any portion of your spine, but it most often affects the parts that run through your lower back (lumbar spine) or your neck (cervical spine).

One specific type of spinal stenosis, called foraminal stenosis, causes narrowing of the openings where nerves exit your spinal cord.

Airways (respiratory system)

Your airways are the routes for air to travel into and out of your body. They’re a vital part of your respiratory system, and you rely on them to stay open so you can breathe.

Tracheal stenosis is narrowing of your trachea, which sends air from your throat to your lungs. It happens when scar tissue forms along your trachea and makes it harder for air to pass through. Tracheal stenosis is typically a complication of intubation. It can also affect people with medical conditions that cause inflammation and scarring in their tracheas.

Subglottic stenosis is less common than tracheal stenosis. It’s when the lower part of your voice box (subglottis) becomes abnormally narrow. While it’s known to happen from intubation or infection, the cause is often unknown.

Digestive system

Your digestive system breaks down and absorbs nutrients from your food. It also prepares solid waste (poop) and gets rid of it.

Narrowing can affect various parts of your digestive system. For instance:

• Esophageal stricture is the narrowing of your esophagus. Chronic acid reflux is the most common cause.
• Intestinal stricture refers to the narrowing of part of your small intestine or colon. You might also see the terms small bowel stricture or colonic stricture. Such narrowing may occur due to inflammation, scar tissue or both. People with Crohn’s disease have an increased risk of intestinal strictures due to chronic inflammation in their digestive organs. Intestinal strictures can lead to bowel obstruction.
• Anal stenosis refers to the narrowing of your anal canal, typically due to scar tissue. It may occur as a complication of anorectal surgery, such as anoplasty.
• Biliary stricture is the narrowing or blockage of the bile ducts that carry bile (a fluid that helps with digestion) from your liver to your small intestine. Pancreatic cancer and bile duct cancer are the main causes.

Urinary and reproductive systems

Sometimes, parts of your urinary system or reproductive system (male or female) can grow too narrow. This might happen as a complication of certain treatments or surgeries. Or it could happen due to injuries or infections.

The specific types of stenosis or stricture you might have can vary according to your sex assigned at birth. Examples include:

• Bladder neck contracture. This is when there’s a narrowing of the outlet at the bottom of your bladder that lets urine (pee) pass to your urethra. This condition affects people assigned male at birth (AMAB) as a possible complication of prostate surgery.
• Urethral stricture. This is the narrowing of the tube (urethra) that lets pee exit your body. Posterior urethral stenosis refers to narrowing of the uppermost part of your urethra. These conditions mostly affect people assigned male at birth (AMAB).
• Vaginal stenosis. This is the narrowing of the vaginal canal that’s a possible side effect of radiation therapy to your pelvis. This condition affects people assigned female at birth (AFAB).

What are the symptoms of stenoses and strictures?

Symptoms of stenoses or strictures can vary widely according to the part of your body that’s affected. It’s also possible to have no symptoms at all. The chart below lists symptoms for several types of stenoses and strictures.

What causes stenoses and strictures?

Common causes of stenoses and strictures include:

• Plaque buildup (in your arteries).
• Complications of medical procedures, surgeries or treatments.
• Infection.
• Injury or trauma.
• Other medical conditions, especially those that cause chronic inflammation.
• Wear and tear to your body as you get older.

In some cases, the cause is unknown.

How are stenoses and strictures diagnosed?

Healthcare providers typically diagnose stenoses and strictures through one or more of the following:

• Physical exam and review of your symptoms.
• Blood and/or urine tests.
• Imaging tests like ultrasound, MRI (magnetic resonance imaging) or CT scan (computed tomography scan).
• Tests that use a scope to get a close-up view from inside your body (endoscopy).

If you don’t have symptoms, you might not realize there’s an issue. In this case, your provider might diagnose a stenosis or stricture through testing done for other reasons (incidental finding).

What is the treatment for stenoses and strictures?

Treatment can vary widely depending on your specific diagnosis. Your healthcare provider will discuss available options and tailor treatment to your needs. In general, possible treatments include:

• Oral medications.
• Steroid injections.
• Physical therapy.
• Procedures or surgeries.

Procedures and surgeries typically involve doing one or more of the following:

• Using a balloon or another device to open up the space that’s too narrow (for example, angioplasty treats stenosis in arteries).
• Placing a small device called a stent to help keep the space open.
• Removing plaque buildup (endarterectomy).
• Removing scar tissue.
• Replacing or reconstructing damaged parts of an organ.

Surgeons can often use minimally invasive methods to give you the treatment you need. Your care team will tell you more about what’s possible in your situation. They’ll also explain your recovery timeline and how to take care of yourself.

What can I expect if I have a stenosis or stricture?

It’s important to keep in mind:

• Treatment may take a while. You may need multiple visits to your provider to take care of the issue. For example, dilation to treat esophageal strictures is an outpatient procedure (meaning you go home the same day) that typically happens once a week for several weeks. Your provider will use a device to widen the narrowed space in your esophagus a little at a time.
• Stenosis or stricture can happen again after treatment. For example, a previously opened coronary artery can narrow again (restenosis). If this happens, you may need another procedure or surgery.
• Follow-ups are crucial. Your provider will keep a close eye on your condition and make sure you’re healing well after a procedure or surgery. They’ll also look for signs that a stenosis or stricture is happening again (recurring).
• You might need to make changes in your daily life. Your provider may recommend some changes to what you eat or your activity level. You might need to move around more or less, depending on your situation. For example, if you’re recovering from surgery, you might need to rest a while. After successful treatment for stenosis in an artery, you may need to move around more in your daily life to lower the risk of future cardiovascular disease.

When should I see my healthcare provider?

Follow the appointment schedule your provider gives you and ask if anything is unclear. Call your provider right away if:

• You have new or worsening symptoms.
• Treatment doesn’t seem to be helping as expected.
• You have signs of complications after surgery, like fever, or changes at your incision site (discoloration, draining or swelling).