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