What is an oesophageal web?
An oesophageal web is a thin membrane that grows across the upper part of the food pipe (oesophagus).
We don’t know exactly how common oesophageal webs are. Many people have no symptoms and therefore never see a doctor. Sometimes they are found by chance during a scan. They don’t often cause any problems.
What symptoms can an oesophageal web cause?
Oesophageal webs can narrow the upper food pipe. This can cause the sensation of food sticking when you swallow.
What causes an oesophageal web?
Some people are born with an oesophageal web (congenital). Others develop one because of conditions like acid reflux or low iron levels (iron-deficiency anaemia). In some people, no clear cause is found.
Oesophageal webs occur most often in people with severe, untreated iron-deficiency anaemia. It also happens in people with Plummer-Vinson syndrome, a condition with symptoms that include iron-deficiency anaemia, dysphagia (difficulty swallowing) and webbing. Some patients may also have a sore tongue and cracks in the corners of the mouth.
What other conditions are linked to an oesophageal web?
Other conditions that make people more likely to have a web include:
- Autoimmune thyroid diseases (like Hashimoto’s thyroiditis and Graves’ disease)
- Blistering skin diseases (like pemphigus)
- Coeliac disease
- Gastro-oesophageal acid reflux
- Graft vs. host disease (people who have had a transplant)
- Iron-deficiency anaemia
- Psoriasis
- Rheumatoid arthritis
Do I need any tests?
Your doctor may suggest some tests to find the cause of the web or check for any related conditions. These tests may include:
- Blood tests to check your blood count, iron levels, thyroid function and for certain autoimmune conditions.
- You may need to be checked for Coeliac disease by the gastroenterology team.
- You may need a gastroscopy to check for acid reflux. You may be offered antacid medications first to see if your symptoms improve.
- A barium swallow - you swallow a liquid called barium and have X-ray pictures taken of the throat and food pipe.
How is an oesophageal web treated?
Most do not cause symptoms. If you do not have any symptoms, you do not need treatment.
If the web makes swallowing difficult, treating the underlying cause, such as low iron levels or acid reflux, can often help.
In some people, stretching the foodpipe under local anaesthetic, or as a day case procedure under a short general anaesthetic (where you are asleep) may help. The procedure sometimes needs to be repeated.
What are the risks of treatment?
Stretching (dilating) the oesophageal web is a safe procedure. Serious complications are very rare.
Possible risks include:
- Mild soreness or discomfort when swallowing for a few days
- A small risk of bleeding during or after the procedure
- Very rarely, a small tear (perforation) in the wall of the food pipe, which may need treatment.
How successful is the surgery?
Most people do not need surgery. For those who do, treatment has a high chance of getting rid of the web with just one procedure. Most people improve straight away. Very few people will need more than one procedure.
Can an oesophageal web come back after treatment?
Yes, but this is rare as long as other risk factors are treated.
Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.