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Last updated: 14-Oct-2026
Eosinophilic oesophagitis and benign stricture treatment in Ahmedabad · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
When solid food sticks on the way down, the food pipe is either inflamed, narrowed by scar, or both. A camera test with biopsies tells which, and rules out cancer.
Eosinophilic oesophagitis, or EoE, is an allergy-type swelling of the food pipe lining. It is settled with tablets, a swallowed steroid, a food plan or an injection.
A scarred narrowing is stretched in small stages through the endoscope. Most people never need an operation. Surgery is kept for scars that will not stay open.
The food pipe is a muscular tube from the throat to the stomach. Swelling of its lining, or a ring of scar, makes the passage tight. Solid food then hangs up.
Dr. Jivraj Mehta Hospital. Dr Harsh Shah has 18 years of experience in food pipe, stomach and gut surgery. Biopsy, medicines, diet advice, endoscopic stretching and, when needed, reconstruction are planned in one place, by one team.
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Food Pipe & Gastro Surgeon · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Google rating 4.94 from 18 reviews at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad.
In EoE, the lining fills with a type of white blood cell called the eosinophil. The lining swells and stiffens. Over years, untreated swelling can lay down scar. Rings form, and the whole tube can become narrow. So EoE is treated early, before the scar sets in.
A stricture is a narrowing made of scar. Long-standing acid reflux is a common cause. Others are a tablet that stuck and burnt the lining, an old acid or chemical swallow, radiotherapy, or a join left by an earlier operation. A thin ring near the stomach, called a Schatzki ring, and a thin web near the throat also narrow the passage.
The two problems often travel together. EoE can cause rings and strictures. That is why treatment has two arms. One arm settles the swelling. The other stretches the scar. Stretching alone, without treating the swelling, does not hold.
Your age, allergies, reflux history, any chemical swallowed, and the medicines you take each point towards a cause. The doctor uses these clues to plan the tests.
| Clue in your story | Likely cause to look for |
|---|---|
| Young adult, solid food sticks, a bite once got stuck. | EoE. It is the commonest cause of food sticking in young adults. |
| Asthma, eczema, hay fever or a food allergy as well. | EoE is more likely. |
| Years of heartburn, and a smooth narrowing low down. | A reflux, or peptic, stricture. |
| An acid or chemical swallowed, even years ago. | A caustic stricture. |
| Solid food sticks now and then, with long gaps. | A Schatzki ring near the stomach. |
| A woman with low iron, and food sticking high in the throat. | A web near the top of the food pipe. |
| Sudden sharp pain on swallowing after a tablet taken with little water. | Tablet injury to the lining. |
Go to an emergency department now, not to a clinic, with any of these.
The first and key test is an endoscopy with biopsies. Every new narrowing is biopsied, even if it looks harmless. A barium swallow maps long or twisted narrowings before stretching.
A bite of food stuck in the food pipe is removed through the endoscope. Biopsies are taken in the same sitting. Sending a patient home without biopsies, after removing the food, misses the cause. Many of these patients turn out to have EoE.
EoE is confirmed by three things together. There are swallowing symptoms. The biopsies show many eosinophils. And other causes have been ruled out. Getting better on acid tablets does not rule EoE out. It is part of the same condition.
A harmless look is never enough. Every new narrowing is biopsied to exclude cancer before it is stretched. Some long-standing narrowings also need cancer checks for life.
| Finding | What it means, and what follows |
|---|---|
| A smooth, short narrowing with clear biopsies. | A benign stricture. Stretching and treating the cause can go ahead. |
| Rings, furrows and many eosinophils on biopsy. | EoE. Treatment to settle the swelling comes first or alongside. |
| Unusual features, or biopsies that do not give an answer. | Cancer is excluded before any further stretching. Repeat biopsies, a CT scan or a specialist review follow. |
| A narrowing that comes back fast after good stretching. | The cause is re-checked, and biopsies are repeated. |
| A web with low iron. | Iron is replaced and the web is biopsied. It needs regular camera checks, because this web can turn into cancer. |
| An old chemical-burn narrowing. | Lifelong follow-up. Camera checks start many years after the injury. Any change in swallowing is biopsied. |
If a biopsy ever shows cancer, the plan changes completely. The patient then moves to a separate cancer pathway. This page covers narrowings that are not cancer.
People who cannot swallow well often lose weight. A dietitian sees anyone at risk before planned treatment, because a well-fed patient heals better and tolerates stretching better.
| Check | When it is a warning |
|---|---|
| Weight | Clear weight loss over the last six months. |
| Body size | Very low weight for height. |
| Blood protein | A low albumin level. |
| Eating | Less than half the usual amount for more than a week. |
Soft and liquid nutrition drinks fill the gap. In the few patients heading for surgery, a feeding tube into the small bowel is placed early. It keeps them strong while the plan unfolds.
EoE has four first choices. Acid tablets, a swallowed steroid, a food-elimination plan, or an injection called dupilumab. One is chosen, used for eight to twelve weeks, then checked by biopsy.
| Choice | What it involves | Points to weigh |
|---|---|---|
| Acid tablets (PPI) | A tablet twice a day for eight to twelve weeks. The dose is then lowered if it works. | Simple and cheap. It works for some patients, not all. |
| Swallowed steroid | A steroid swallowed as a thick liquid, or puffed from an inhaler and swallowed, not breathed in. Nothing by mouth for half an hour after. | Works for many. Can cause thrush in the food pipe, which is treated while the steroid continues. |
| Food-elimination plan | Milk is removed first. If needed, more food groups are removed, one step at a time. Biopsy follows each change. | No medicine. Needs several scopes and a careful diet. |
| Dupilumab injection | An injection under the skin once a week. | Effective but costly. Kept for hard-to-control disease, often with asthma or eczema as well. |
There is no fixed order among these. The choice is shared. It depends on the pattern of disease, the cost, and how many endoscopies you are willing to have. The steroid tablet used abroad is not sold in India. A swallowed liquid or a swallowed inhaler spray is the usual local substitute.
Treatment aims at two things together. You should swallow easily, and the biopsy should show the swelling has settled. Symptoms alone can mislead, so biopsies guide every change.
A narrowing that is stretched but not treated at its cause comes back. So each type has its own long-term treatment, alongside any stretching.
| Type | What keeps it open |
|---|---|
| Reflux (peptic) stricture | Acid tablets twice a day, long term. Untreated reflux is the commonest reason a narrowing returns. |
| Tablet injury | The tablet is stopped or changed. Tablets are taken sitting up, with a full glass of water. |
| Web with low iron | Iron is replaced, which may ease the web. Biopsy and regular camera checks follow. |
| Radiotherapy narrowing | Gentle, repeated stretching. Progress is slow. Stents are poorly tolerated here. |
| Schatzki ring | One stretch to a wider size often gives years of relief. A small cut through the ring is an option if it returns. |
| Old chemical burn | Many stretching sessions over months, and lifelong camera checks. |
The first weeks after swallowing an acid or chemical are a different problem. Our page on corrosive food pipe injury and stricture covers that emergency and the long road after it. Reflux itself is covered on our reflux treatment page.
Stretching is called dilatation. A tapered tube or a balloon widens the narrowing through the endoscope. It is done in stages over several visits, never all at once.
In EoE, the lining tears easily during stretching. A small surface tear is expected, not a failure. Some chest soreness for a day or so is common. Pain that is more than mild soreness is not, and needs the emergency pathway below.
A short, simple narrowing usually needs one to three sessions. A long or complex one often needs many sessions over months. Needing repeat sessions is normal, not a failure.
| Type | What it looks like | Usual course |
|---|---|---|
| EoE without narrowing | Swelling only, no fixed narrow spot. | Medicine or diet alone. No stretching. |
| EoE with rings or narrowing | Rings, a stricture, or a narrow tube. | Medicine or diet, plus stretching. Repeat stretching if the swelling is not controlled. |
| Simple stricture | Short, straight, single, and the scope passes. | Usually one to three sessions. |
| Complex stricture | Long, angled, multiple or very tight. Often after a chemical burn, radiotherapy or an old join. | Sessions every one to two weeks for months. Return of the narrowing is common. |
| Hard-to-open stricture | Cannot reach 14 mm after five sessions two weeks apart. | Moves up the escalation ladder below. |
| Fast-returning stricture | Reaches 14 mm but cannot hold it for four weeks. | The cause is treated, then stretching repeats. |
A narrowing that will not open or will not stay open moves up a ladder. Cheap, repeatable steps come first. A stent is a temporary bridge. Surgery is the last step.
A stent is almost never used for EoE narrowings. There the answer is to control the swelling and stretch.
Most people with these narrowings never need surgery. An operation is considered only when stretching keeps failing, eating stays poor, or the scar is too long or in many places.
Surgery replaces the scarred food pipe. If the stomach is healthy, it is pulled up into the chest to make a new food pipe. If the stomach is also damaged, which is common after an acid swallow, a length of large bowel is used instead. The join is made in the neck.
A feeding tube is placed early for anyone heading towards surgery. After a chemical burn, surgery waits at least three to six months, until the swelling has settled. These decisions are made with the surgeon and the wider team, never in a rush.
| Situation | Usual plan |
|---|---|
| EoE, with or without rings | No surgery. Medicine or diet, and stretching if needed. |
| Simple stricture, treated cause | No surgery. A few stretching sessions. |
| Complex stricture that slowly improves | No surgery. A stretching programme over months. |
| Stricture that defeats the whole ladder | Rebuilding the food pipe is discussed. |
| Poor nutrition despite every step, or stretching too often to live with | Rebuilding the food pipe is discussed, with a feeding tube first. |
Stretching is a day procedure. You sip water once fully awake, eat soft food that evening, and restart your EoE or reflux treatment the same day.
| When | What happens |
|---|---|
| First two hours | Watched closely. Sips of water once fully awake, if there is no pain. |
| Same evening | Soft food. The usual medicine restarts. Written advice on danger signs. |
| Next clinic visit | The next session is booked, often every one to two weeks for a complex narrowing. |
After the rare rebuilding operation, the stay is longer. You sit out of bed on the day of surgery. Feeds start through the feeding tube that day. Walking starts the next day. Around the end of the first week, an X-ray swallow checks the new join. If it is sound, sips begin and soft food follows. You go home when free of fever, walking, comfortable on tablets and managing feeds, with the family trained to care for the feeding tube.
A tear through the full wall is rare but serious. It needs hospital care at once, not a night of watching at home. Know these signs before you leave.
Come back at once, or go to the nearest emergency department, with any of these.
★★★★★
“Dr. Harsh shah is really great doctor and he is very kind and calm . he gives enough time to patent and explain deeply so patent is very clear about his illness. he is not providing unnecessary medicine also. thanks DR.Harsh shah — Ankit Patel, Google review”
★★★★★
“The staff and dr. Harsh shah were all very friendly and helpfull. I especially loved how dr.harsh shah really took his time to explain my conditions with me as well as my treatment options. I had a great visit and the doctors demeanor has really put me at ease so i highly recommend this hospial and especially dr.harsh shah. — pravin vaishnav, Google review”
★★★★★
“Dr. Harsh Shah is an excellent doctor who handled our case with great diligence and care. He listens attentively and addresses every concern with utmost patience. He's very humble and answers all of your questions in detail which is very assuring. I would highly recommend Dr. Harsh Shah for consultation and treatment. — Srinath Vasudevan, Google review”
These reviews are from Dr Harsh Shah’s Google listing, quoted exactly as written. None names a food pipe narrowing. They describe how he explains a condition and its treatment.
Stretching is safe for most people, but it has risks. They are explained in person before consent, with the figures that apply to your narrowing. Complex narrowings carry more risk.
Sedation and general risks: a reaction to sedation, food or fluid going into the lungs, a chest or blood infection, and bleeding that needs treatment.
Stretching itself: a tear through the wall of the food pipe, which is the most serious risk and can need an emergency operation. A surface tear in the lining, which is expected in EoE and usually harmless. Chest pain afterwards. Not enough relief from one session, which is routine for complex narrowings. The narrowing coming back. With a stent: slipping, pain, reflux and tissue growing over the ends. Death is very rare and comes almost only from a full tear.
In the long run: EoE needs treatment for life. Complex narrowings may need stretching for months or years. Old chemical-burn narrowings need lifelong cancer checks. Surgery remains the fallback if stretching fails. Dr Harsh Shah goes through each of these in person before consent.
Follow-up is planned from the first visit. EoE is re-checked by biopsy after every treatment change. Each narrowing type has its own schedule of checks.
| Situation | Follow-up |
|---|---|
| Eight to twelve weeks after starting or changing EoE treatment | Endoscopy with biopsies from two levels, and a symptom check. The treatment is kept, switched or stepped up. |
| Food plan for EoE | A biopsy six to eight weeks after each food is added back. |
| During a stretching programme | Sessions every one to two weeks until 15 to 18 mm and easy swallowing. Then only if symptoms return. |
| EoE in control | The working treatment continues at the lowest dose. A scope if symptoms return. A check for thrush on steroid. |
| Reflux stricture | Long-term acid tablets. A scope if swallowing worsens. |
| Web with low iron | Iron, and regular camera checks. |
| Old chemical burn | Lifelong follow-up. Camera checks from about fifteen to twenty years after the injury. |
| Any benign narrowing | New or worse swallowing, pain on swallowing or weight loss means a fresh scope and biopsy. |
Most care here is outpatient or day-case. Cost depends on the number of endoscopies and stretching sessions, the EoE treatment chosen, and whether surgery is ever needed.
A stretching session is usually a day-case at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad. Dupilumab and some swallowed steroids cost more over time, and this is discussed before choosing. Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad, works with the major insurers and cashless schemes. The office handles pre-authorisation when an admission is needed. Bring: endoscopy and biopsy reports, barium films, blood reports, a list of medicines, the insurance card and identification. You can also call +91-63555-64601 to ask what to bring.
Yes. EoE is patchy, and the lining can look normal. That is why at least six biopsies are taken from two levels, even when nothing is seen.
No. Getting better on acid tablets is part of the EoE picture. It is one of the four ways to treat it, not a sign that EoE is absent.
No. Skin and blood allergy tests do not predict the food trigger. The trigger is found by removing a food, then checking with a biopsy.
No. Stretching is done in small stages over several sessions. Pushing too wide in one sitting raises the risk of a tear without easier swallowing.
Usually for life. EoE returns when treatment stops. The treatment that works continues at the lowest dose that keeps it settled.
No. A removable covered stent is a short bridge for a hard narrowing. It comes out within six to eight weeks. In EoE a stent is almost never used.
Only when the whole ladder of stretching and other steps has failed, eating stays poor, or the scar is too long. Most people never reach this step.
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Google: Dr Harsh Shah · 4.94 from 18 reviews
Directions to Dr. Jivraj Mehta Hospital, Vasna · WhatsApp +91-63555-64601
Patients come to Ahmedabad from across Gujarat, including Gandhinagar, Mehsana, Nadiad, Anand, Rajkot and Kutch, and from southern Rajasthan.
Does food stick in your chest, or has a bite ever got stuck and needed removal? Endoscopy and biopsy reports, barium swallow films and a list of medicines can be sent ahead, so the consultation starts with them already read. Treatment is decided at the consultation, after examination. If you cannot swallow even your own saliva, go to the nearest emergency department today. Call +91-63555-64601 · Send the reports ahead on WhatsApp
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