Categories: Gastroenterology

What is an esophageal stent?

The esophagus, generally known as a food pipe is a hollow muscular tube that carries food and liquids from the mouth to the stomach. If the esophagus becomes narrowed or blocked swallowing and eating can be difficult. In order to make it easier, the doctor will recommend an esophageal stent.

What is an esophageal stent?

An esophageal stent is a hollow plastic or metal tube that is placed in the esophagus to help keep it open so that food and liquids to easily pass through.

It is a flexible mesh tube that is placed through the constricted area of the esophagus (food tube) to easily allow food and beverages from mouth to stomach for digestion and nutrients absorption. The stent gently expands on its own to hold the esophageal area open but it is not as wide or as flexible as a normal esophagus so one has to be cautious while consuming certain foods which may cause the blockage of the stent.

Stents can be useful for patients with advanced metastatic esophageal cancer since it is often diagnosed at an advanced stage. This can also help those with poor functional status who cannot tolerate surgery or chemoradiotherapy, or for those with locally recurrent disease after primary treatment. These patients generally suffer from dysphagia due to esophageal obstruction. Esophageal stents are important tools for the palliative treatment of esophageal malignancies that are inoperable. Today, due to the development of medical science – multiple self-expandable stents are used to treat benign esophageal disorders such as esophageal leaks, fistulas, and refractory strictures.

Esophageal stents may provide relief in case of dysphagia caused by esophageal malignancies.

The below self-expanding stents are safe and cost-effective.

  • Self-expanding plastic stents (SEPS)
  • self-expanding metal stents (SEMS)

3 types of stents are available: uncovered, fully covered, and partially covered. 

The original esophageal metal stent was uncovered but nowadays covering materials are being used due to complications of tumor and in-growth of tissue. Fully covered are more prone to stent migration. Metal stents that are partially covered have a small portion of exposed bare metal which helps in preventing migration.

Diet post Esophageal Stent Placement

Diet is an important factor to be considered post-stent placement. There are 3 stages of food consumption.

Stage 1

In this stage, it is recommended to consume only fluids – water, tea, coffee, fruit juices, milk, soft drinks, or sports drinks. It is important to start with small sips and increase the volume gradually.

Stage 2

Smooth food (without lumps), soups, fruit juice, yogurt, ice cream, pudding, or gelatin. It is recommended to increase the texture of food to a soft consistency until swallowing becomes easier. This gives the stent time to fully expand post which one can start gradually eating solid food.

  • Cooked vegetables that are soft.
  • Scrambled eggs.
  • Mashed potatoes, mashed banana, and pudding.
  • Soft fresh fruits without skins or seeds – Ex. banana
  • Dry cereal softened with milk
  • Finely chopped meat
  • Cooked beans, peas, lentils.

Stage 3

In this stage, a wide variety of foods and fluids can be included in the diet to achieve a normal diet to ensure nutritional needs are met.

  • Consume soft foods or foods that are moist, either naturally or when cooked.
  • Take small bites and chew slowly.
  • Consume plenty of fluids during and after meals.
  • It is important to sit up straight when eating and after eating.
  • Rather than having large meals break it down into small meals often during the day.
  • Sometimes nutritional supplements should be added to maintain a healthy weight.
  • Always chew them well before swallowing.
  • Consume liquids along with the meals to help food pass through the stent.
  • Eating in an upright sitting position is always recommended. Gravity will facilitate food pass through the esophagus and stent.
  • Drink at least 4 ounces of water after swallowing pills.

Preventing reflux 

Reflux is esophageal burning and heartburn. Following things are recommended to prevent reflux:

  • One has to stay in a sitting position for at least 100-120 minutes after each meal.
  • One has to sleep with the head of the bed raised to 30 to 45 degrees.

Food to avoid- 

The stent placement will facilitate you to eat normally but sometimes the stent may get blocked. Undigested food that is swallowed without being sufficiently chewed or from foods that do not break down enough when chewed is the most common cause for the stent to get blocked. Some examples:

  • Bread and toast
  • Raw meat
  • Hard-boiled or fried egg
  • Fish
  • Fruits such as pineapple, orange
  • Vegetables such as beans
  • Potato skins
  • Raw vegetables
  • Chips or junk food
  • Ice cream
  • Yogurt with chunks of fruit, cereal, or nuts.

How can one prevent blocking the stent?

  • Meals should be consumed slowly and in a relaxed manner.
  • Avoid swallowing lumps or large chunks of food as this may cause your stent to block.
  • Introduce new foods in small quantities.
  • Consume soft, moist foods which will make swallowing easier.
  • Make sure you have well-fitting dentures.
  • Eat slowly and at your own pace
  • Small – frequent meals are recommended as opposed to large-heavy meals.
  • Food should be cut into smaller pieces and take small mouthfuls and chew slowly.
  • Add plenty of sauces, gravy or will make food moist, therefore easier to swallow and pass through your stent.
  • Consume a lot of liquids during and after each meal to help keep your stent clear.
  • Sit upright while having food and for one to two hours post eating.

Call Your Physician if you have: 

  • Chest pain
  • Pain when swallowing that lasts longer than a day
  • Abdominal pain and bloating.
  • Back or shoulder pain
  • Trouble breathing
  • Black or dark stools
  • Fatigue
  • Nausea
  • Vomiting
  • Chills
  • Unexpected fever

It is important to consult the doctor if you have any of the above symptoms. Once the stent is placed one needs to take care of the diet to ensure the smooth functioning of the stent.

Dr. Sanjoy Basu | Consultant – Gastroenterology Medical |  Narayana Superspeciality Hospital, Howrah & Narayana Multispeciality Hospital, Howrah

Narayana Health

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