Skip to main contentCorrosive oesophageal injury and stricture treatment in Ahmedabad and Gandhinagar · Dr Harsh Shah · Food Pipe Surgeon · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Treatment after swallowing acid, a toilet cleaner or another corrosive depends on how deep the burn goes, and that is measured, not guessed. A contrast CT of the chest and abdomen shows whether the wall of the food pipe and stomach is still alive; a gentle endoscopy in the first day or two shows how deep the injury is. A superficial burn heals with support alone. A deep burn is fed through a tube and watched for narrowing, and a narrowing that forms is first stretched with an endoscope, often over many sessions. Surgery is kept for a wall that has died, a tear, or a narrowing that will not stay open — and a rebuilt food pipe is planned months later, never in a hurry.
Dr. Jivraj Mehta Hospital
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Food Pipe Surgeon
· Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr Harsh Shah has 18 years of experience in surgery of the food pipe and stomach, qualified twice over in surgical gastroenterology. A corrosive injury is never one doctor’s problem: at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad, the intensive care team, the endoscopy suite for grading and dilation, contrast CT, dietitians, psychiatry and the operating theatre for emergency resection or later reconstruction work as one service — so the same team that sees the burn on the first day plans the dilations in the months after it. Google rating 4.94 from 18 reviews at the Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad listing.
After swallowing a corrosive, the first priority is breathing, then fluids through a vein, an acid-suppressing injection and pain relief, with nothing by mouth. Three things that people do with good intentions cause real harm: trying to neutralise the chemical, making the person vomit, and passing a feeding tube blindly through the nose. Charcoal and "diluting" drinks do not help either.
Swelling of the voice box can block the airway within hours. Noisy breathing, a hoarse voice or drooling means an early, controlled breathing tube placed by an experienced anaesthetist, before the swelling makes it impossible. Neutralising — giving an alkali for an acid, or the reverse — releases heat and deepens the burn. Vomiting brings the chemical back over the same lining and risks it entering the lungs. A tube pushed blindly through the nose can go straight through a softened wall. When a feeding tube is needed, it is placed under direct vision through an endoscope, which is a different, deliberate act.
Two facts surprise families. A clean mouth does not mean a clean food pipe — severe damage lower down can sit behind normal lips and tongue. And how much pain the person has does not tell you how deep the burn is. Both are reasons why the tests below are done even when the patient “looks fine”.
Where the swallowing was deliberate, a psychiatrist sees the patient in the same admission, alongside the surgical care and not after it. This is part of treatment, not a judgement, and the follow-up continues through the first year.
The history comes first — which product, how much, liquid or granules, when, and whether it was accidental. Blood tests, including blood gas and lactate, follow at once. A contrast-enhanced CT of the chest and abdomen is the test that decides whether an emergency operation is needed, because it shows whether the wall still has a blood supply. A gentle endoscopy within the first day or two then grades the depth of the injury once breathing is safe.
| Order | Test | What it answers |
|---|---|---|
| First | History, with the container or a photograph of it | Acid or alkali, liquid or granules, how much and when — which tells the team where to expect the worst damage |
| At once | Blood counts, kidney and liver tests, salts, blood gas and lactate; a pregnancy test where relevant | Rising acid in the blood or a rising lactate warns of dead tissue before the abdomen shows it |
| Same day | Contrast-enhanced CT of the chest and abdomen | Does the wall of the food pipe and stomach still take up contrast? A wall that does not enhance has died, and that — not the endoscopy grade — decides an emergency operation |
| Within the first day or two | Gentle flexible endoscopy, after the airway is safe and a tear is excluded | How deep and how long the burn is — from simple redness, through shallow and deep ulcers, to patches of dead lining. The scope is never forced past a tight, burnt segment |
| From the third week | Endoscopy, with a barium swallow where useful | Is a narrowing (stricture) forming, how long is it, and is the stomach outlet narrowing too after an acid |
Acid and alkali damage different places. Drain and oven cleaners (alkali) burn deeply into the food pipe. Toilet and bathroom cleaners (acid) — the commoner story in Gujarat — tend to scar the lower stomach and its outlet, so weeks later the problem may be vomiting after meals rather than food sticking in the chest. A swallowed button battery is a separate emergency: it is removed by endoscopy within hours.
A corrosive stricture is a benign scar, but it is not the only cause of a narrowed food pipe, and an old corrosive scar itself carries a small lifelong risk of a cancer of the lining decades later. So a narrowing with no clear history of swallowing a chemical is biopsied before it is treated as a scar, and a long-standing corrosive stricture that changes — tighter, harder to dilate, or causing new trouble swallowing after years of stability — is examined and biopsied, never simply stretched again.
| Finding | Points towards | What happens next |
|---|---|---|
| A clear history of swallowing a corrosive, a smooth narrowing appearing from the third week onwards | A benign corrosive stricture | The dilation pathway below |
| Long-standing heartburn, a short narrowing low down, no chemical exposure | A reflux (peptic) stricture | Acid suppression and dilation; managed on the reflux pathway |
| Rings or furrows along the food pipe in a younger person with allergies | An allergic (eosinophilic) narrowing | Biopsies to confirm, then treatment of the inflammation |
| Rapid weight loss, an irregular or ulcerated narrowing, no corrosive history — or an old corrosive scar that has changed after many quiet years | A growth must be excluded | Biopsy, CT and further staging before any dilation; if a cancer is found, it is treated on an entirely different pathway |
That lifelong watch is the reason for one rule this service keeps without exception: a change in an old stricture means an endoscopy and a biopsy first. Surveillance endoscopy is also planned from many years after the injury, including for any part of the original food pipe that has been bypassed rather than removed.
Corrosive injury is treated in steps, and most patients never reach the top of the ladder. Superficial burns need only support. Deep burns with a living wall need feeding support and planned surveillance for narrowing. A narrowing is stretched endoscopically, with injections and other adjuncts for stubborn ones. A stent is a last endoscopic step, not a first one. Surgery is kept for dead tissue, a tear, or a narrowing that will not stay open despite all of this.
| Rung | What it is | Where it fits |
|---|---|---|
| Supportive care | Fluids through a vein, acid-suppressing medicine, pain relief, then early eating once swallowing is comfortable | Redness or shallow ulcers only — these heal, usually after a short stay, with no long-term follow-up needed for the mildest |
| Feeding support | A thin tube placed under endoscopic vision, which also keeps the passage open; or a feeding tube into the small intestine (jejunostomy) if that route fails | Deep ulcers or patchy damage with a wall that is still alive on CT; nutrition is the backbone of the months ahead |
| Endoscopic dilation | The narrowing is stretched gradually with tapered bougies passed over a guide wire, or a balloon, a little more at each session | From about the third to sixth week, once the lining has healed; repeated sessions over months are expected, not a sign of failure |
| Adjuncts for a stubborn narrowing | A steroid injected into the scar itself; mitomycin applied to a short stricture; for motivated adults, learning to pass a dilator at home | A narrowing that keeps closing despite well-spaced dilations |
| A fully covered stent | A removable tube left across the narrowing for a limited period | Only for a stricture that has resisted the steps above — never as the first treatment, and taken out on schedule |
| Reconstruction surgery | A new food pipe made from the stomach or the large bowel | Long, multiple or repeatedly failing strictures, or a patient who cannot be nourished despite dilation |
| Emergency resection | Removal of all dead food pipe and stomach, with a feeding tube and a neck opening for saliva; reconstruction deferred | A wall that does not enhance on CT, a perforation or peritonitis — a life-saving operation, not a planned one |
A note about steroids, because families often ask. Steroid tablets or injections into a vein are not given routinely to adults after a corrosive injury at this centre — the evidence for them comes from children, and in an adult they can mask infection and raise the risk of a tear. In a child with a deep burn, a short course is a reasonable, documented choice. A steroid injected into a mature scar during dilation is a different, local treatment and is used when a stricture keeps returning.
Most people who swallow a corrosive never need an operation. Superficial burns heal with support alone. Deep burns whose wall stays alive on CT are fed and watched, and most narrowings that follow are managed by endoscopic dilation, however many sessions that takes. An operation is not the answer to a stricture simply because dilation has had to be repeated.
The commonest misunderstanding is that a narrowing which needs stretching again “has failed” and therefore needs surgery. Repeat dilation is the normal course of a corrosive stricture, and every patient is told this before the first session. A team decision to move towards reconstruction is made only when dilations stop holding despite the adjuncts above — after a long series of well-spaced sessions — or when nutrition cannot be kept up.
Timing matters as much as the decision. No dilation is done in the second week after the injury, when the healing wall is at its weakest; the first planned endoscopy is from about the third week onwards. And no reconstruction is attempted until the inflammation has settled and nutrition has been rebuilt — usually some months after the injury.
There are two quite different operations. The emergency operation removes all dead tissue when the wall has died or perforated, brings the upper food pipe out at the neck and places a feeding tube — no new food pipe is made at this stage. The planned reconstruction, months later, builds a new food pipe from the stomach if it is healthy, or from the large bowel if acid has scarred the stomach.
Emergency resection. Every part of the food pipe and stomach that has died is removed back to bleeding, living tissue, with the whole stomach inspected because an acid often does its worst damage at the outlet. Dead tissue can keep spreading after the first operation, so any fever or deterioration afterwards leads to an early second look on suspicion alone, not after waiting. Where the duodenum is involved, the team chooses the least destructive operation that removes the dead bowel.
Planned reconstruction. The choice of the new food pipe depends on the state of the stomach. After an alkali, the stomach is often healthy and can be pulled up to the neck. After an acid — the common Indian scenario — the stomach is often scarred, and a segment of the large bowel with its own blood supply is used instead. The blood supply of the new segment is checked before the join is made in the neck, and the old food pipe is removed where it safely can be, because an old corrosive scar left in place keeps its lifelong cancer risk. Where it has to be bypassed instead, it stays under endoscopic watch.
Before reconstruction: nutrition is built up through the feeding tube, haemoglobin and protein are brought up, the stomach or bowel chosen for the new food pipe is checked with endoscopy and CT, smoking and alcohol stop, and breathing exercises begin. After it, the patient is in intensive care for a short period, walks from the first day, is fed through the feeding tube while the neck join heals, and starts sips only after the join has been checked.
The complications every patient hears about before agreeing: for dilation, a tear in the food pipe, bleeding, food going into the lungs, chest pain after the session, the narrowing returning, and eventually needing an operation; for reconstruction, bleeding, wound and chest infection, clots in the legs or lungs, heart and anaesthetic complications, a leak at the neck join, loss of blood supply to the new food pipe that may need a further operation, narrowing at the join that needs dilation, a change in the voice, food going into the lungs, reflux or rapid emptying with a stomach conduit, and a risk to life, which is considerably higher in an emergency operation. Swallowing after reconstruction is much better but never completely normal — small, upright meals for life. Dr Harsh Shah goes through each of these personally before consent, with the figures that apply to the operation proposed, your age and your nutrition — they are not general numbers and are not quoted on a page.
A corrosive injury is managed over months, and nutrition holds the whole plan together. The gut is used for feeding wherever possible; feeding through a vein is only a bridge. Any operation on the abdomen includes a feeding tube into the small intestine, and weight, intake and vitamins are checked at every visit while the stricture is being treated.
Families are taught to care for the feeding tube at home — flushing it with warm water, never forcing a blocked tube, and coming in for a replacement over a guide wire rather than trying at home. A dietitian sets the feed volumes and adjusts them as swallowing improves. Patients who arrive already thin after weeks of poor swallowing are fed up first; an operation on an undernourished patient carries avoidable risk.
Emergency care, dilation and reconstruction for corrosive injury are covered by cashless health insurance and by corporate schemes at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad, subject to the policy's terms. What moves an estimate is the number of dilation sessions, any intensive care days, feeding-tube placement, and whether a reconstruction is planned. A written estimate is prepared for your own policy rather than a figure being quoted in general.
Pre-authorisation is arranged by the hospital’s insurance desk, with a note from Dr Harsh Shah’s office describing the injury, the grading and the planned treatment. Bring policy papers, identification and every report.
★★★★★
“Met with Dr. Harsh Shah for the consultation of one of my relative. Dr. Harsh Shah is an exceptional surgical oncologist in Ahmedabad. His expertise in treating complex GI cancers like liver, pancreas, and colon cancers is truly remarkable. He explains everything clearly and gives patients full confidence in their treatment. Highly recommended for anyone looking for a skilled and compassionate cancer specialist. — Nagesh Patidar, 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”
★★★★★
“Excellent service, very polite, very well explained the treatment plan and follow up after surgery. I am truly grateful to him for the treatment. — Amar Singh, Google review”
Real Google reviews from Dr Harsh Shah’s listings, reproduced exactly as written.
No. Do not try to neutralise the chemical, do not make the person vomit, and do not give drinks to dilute it. Go straight to the nearest emergency department and take the bottle or a photograph of the label with you.
Yes. A clean mouth does not rule out serious damage lower down, and the amount of pain does not tell you how deep the burn is. That is why a CT and an endoscopy are done even when the patient seems well.
A corrosive scar contracts as it matures, so repeated dilation over months is the normal course, not a failure. Spacing, adjuncts such as a steroid injection into the scar, and patience usually win; surgery is considered only when dilations stop holding despite them.
Most people do not. Superficial burns heal on their own, and most strictures are managed endoscopically. Surgery is for a wall that has died, a perforation, or a narrowing that will not stay open despite every endoscopic step.
Swallowing is much better after reconstruction but never completely normal. Most people eat small meals, sitting upright, for life, and some need extra feeding through the tube during the first year.
A corrosive stricture is benign, but it carries a small lifelong risk of a cancer of the lining, usually many years later. That is why surveillance endoscopy is planned for the long term, and why any change in an old stricture is biopsied rather than simply stretched.
Dr Harsh Shah consults at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad.
Patients come to Dr Harsh Shah from across Gujarat and from Rajasthan and Madhya Pradesh. The grading, the dilation plan and any operation are carried out here; a stable dilation schedule can sometimes be shared with a gastroenterologist closer to home, with reviews here at the planned points.
Swallowed acid or a cleaner, or struggling to swallow months after it? If it happened today, go to the nearest emergency department now — do not wait for a reply. For a narrowing that has formed since, endoscopy reports, a barium study and discharge papers can be sent ahead of the appointment so the consultation starts with them already read; treatment is decided at the consultation, after examination. Call +91-63555-64601 · Send the reports ahead on WhatsApp
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