Beyond the Sting: Herbal Remedy–Induced Corrosive Esophageal Strictures from Nigeria – A Case Series

Abstract

Background: Scorpion stings are common in rural Sub-Saharan Africa and often managed with traditional herbal remedies. Some of these preparations contain caustic substances that can cause corrosive esophageal strictures (CES). While caustic soda ingestion is a well-recognized cause of CES in children, herbal remedy–induced strictures following scorpion stings remain underreported.

Methods: This retrospective case series reviewed all patients presenting with  CES after ingestion of herbal preparations administered for scorpion stings at a tertiary hospital in South-East Nigeria between January 2024 and November 2025. Demographic data, time to presentation, severity of dysphagia (Mellow & Pinkas scale), interventions, and outcomes were documented.

Results: Five patients (3 males, 2 females) aged 5–45 years were identified. The median delay to presentation was 3 months (range: 6 weeks–8 months). Severe dysphagia was the predominant symptom, with 40% presenting with Grade 4 dysphagia. All patients had long-segment strictures confirmed by barium swallows. Three patients (60%) underwent surgery: two adolescents had a successful retrosternal colon bypass, while one child died in the immediate postoperative period following gastric pull-up. Two patients (40%) defaulted from treatment for socioeconomic reasons.

Conclusion: Herbal remedies for scorpion stings represent an emerging and preventable cause of CES in Nigeria. Public education, regulatory oversight of caustic herbal preparations, and timely referral for nutritional rehabilitation and surgical intervention are critical to improving outcomes.