There is a lower esophageal stricture with inflammation seen here on upper GI endoscopy in the left panel, with dilation being attempted in the right panel. Stricture may be due to a variety of causes, achalasia, including reflux of gastric acid contents, ingestion of a caustic substance, infection, congenital stenosis, or fibrosis from scleroderma. The stricture leads to difficulty in swallowing.