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Peptic strictures of the esophagus
1Department of Gastroenterology, Cleveland Clinic Foundation, Ohio, USA.
Gastroenterology Clinics of North America
|March 1, 2000
Summary
Peptic esophageal strictures, often seen in elderly patients with GERD, require dilation and medical therapy. Proton pump inhibitors help prevent stricture recurrence after treatment.
Area of Science:
- Gastroenterology
- Esophageal Diseases
Background:
- Peptic esophageal strictures are a complication of inadequately treated gastroesophageal reflux disease (GERD).
- Elderly patients are particularly susceptible, exhibiting more significant esophageal dysfunction and prolonged reflux episodes.
Purpose of the Study:
- To outline the diagnosis and management of peptic esophageal strictures.
- To discuss treatment strategies including dilation, medical therapy, and surgical options.
Main Methods:
- Diagnosis involves a combination of barium esophagram and endoscopy.
- Management typically includes esophageal dilation to alleviate dysphagia.
- Medical therapy, particularly proton pump inhibitors, is crucial for preventing recurrence.
Main Results:
- Esophageal dilation effectively relieves dysphagia in most patients.
- Proton pump inhibitors demonstrate efficacy in preventing stricture recurrence post-dilation.
- Surgery may be considered for refractory or complex cases, but outcomes can be variable.
Conclusions:
- Peptic esophageal strictures necessitate a multimodal treatment approach.
- Effective management combines endoscopic dilation with appropriate medical therapy, primarily proton pump inhibitors.
- Surgical intervention is reserved for select cases with potentially less predictable outcomes.