Nelie,
What kind of doctor discovered the stricture? Were you referred to an ENT specialist? What kind of doctor did the surgical removal of the stricture?

In terms of discovering the stricture, it should have been discovered by the speech pathologist and radiologist who did the first modified barum swallow I had about 4 months after the end of rad. when I was complaining about swallowing problems. It was visible on the xray but they missed it (because they were so focused on how small my epiglottis was and how it was not moving right).

I then went to see another ENT in Boston about 4 months later (8 months post treatment) when the exercises I had been given by the speech pathologist here didn't seem to be helping and that Boston ENT referred me to a speech pathologist in Boston who specializes in treating people with problems from oral cancer treatment. She did another modified barium swallow and saw the stricture right away (to be fair it was worse by then so I suppose harder to miss). She was at Mass General and told me that they did not do surgery to remove strictures as severe as mine because there can be serious complications (a ruptured esophagus) and referred me to another ENT at Brigham and Womens/Dana Farber who, in cobination with a thoracic surgeon, ended up doing the surgery. It is the thoracic surgeon who is now seeing me there for followup on that (the stricture keeps coming back but it never gets as bad as it was when I had the first surgery when it had almost totally closed my esophagus).

There are gastroenterologists do surgery to remove strictures as well- the esophagus is one of those areas of the body that has several different surgical specialists who deal with it apparently.

If you're asking because you are concerned about having a stricture, I would tell you to ask for a modified barium swallow test--which can be done anywhere. But then if you do have a stricture and need surgery for it, it is worth going somehwere where they know what to do if the worst case happens--the esophagus is perforated. This is rare (of course it happened to me though) but if it happens it can be serious so you want to be treated at a very good hospital for this.

Nelie

If anyone is interested if you PM me I will give you the name of the speech pathologist in Boston, who really has a lot of expertise working with swallowing problems caused by oral cancer radiation.

nelie, i was under the impression that your stricture was in the back of your throat,,,not in your esophagus. i've already had three esophageal dilations. i think my choking problems are caused by a stricture in the back of my throat. that's what i thought you were using the bougie for....the back of your throat. how in the world do you get it all the way down to your esophagus? or did i misunderstand something? please clarify.

The total stricture I had was in my esophagus but I am prone to strictures happening from the back of the throat on down.

Honestly, I don't really know how far down I get the bougie but sword swallowers get things quite far down their esophagus (an analogy that more than one doctor has used when I've discussed with them using a bougie) and my impression is the bougie also goes down there if you use it right. That's why you have to overcome the gag reflex.

nelie,
how did you overcome the gag reflex? i have a bad gag reflex.

So do I. And truth to tell, I haven't overcome it totally which is why I am bad about using the bougie everyday. The main thing is to keep sliding it down slowlu even if you gag a little, but it's not very pleasant.