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Do corticosteroids prevent oesophageal stricture after corrosive ingestion?
Daniela Pelclová1, Tomás Navrátil
1Department of Occupational Medicine and Poisons Information Centre, First Medical Faculty and General Teaching Hospital, Charles University, Prague, Czech Republic. daniela.pelclova@LF1.cuni.cz
Toxicological Reviews
|September 27, 2005
Summary
Corticosteroids do not prevent esophageal strictures from corrosive burns and may worsen outcomes in severe cases. Their use in managing corrosive ingestions should be discontinued due to lack of benefit and potential harm.
Area of Science:
- Gastroenterology
- Toxicology
- Otolaryngology
Background:
- Corrosive damage to the esophagus can lead to stricture formation, a serious complication.
- The efficacy of corticosteroids in preventing these corrosive-induced strictures remains a subject of debate.
Purpose of the Study:
- To critically evaluate the usefulness of corticosteroid treatment in preventing corrosive-induced esophageal strictures.
- To assess clinical reports on corticosteroid use for esophageal burns from 1991 to 2004.
Main Methods:
- Systematic review of clinical reports on corrosive esophageal injuries (second- or third-degree).
- Inclusion criteria: endoscopic documentation of injury and management with or without corticosteroids (≥8-day course).
- Analysis of ten studies involving 572 patients.
Main Results:
- In second-degree burns, stricture incidence was 13.8% with corticosteroids vs. 6.3% without.
- In third-degree burns, stricture incidence was 71.0% with corticosteroids vs. 23.1% without.
- Overall, 35.1% of corticosteroid-treated patients developed strictures compared to 33.3% of non-treated patients.
Conclusions:
- Systemic corticosteroids do not appear beneficial for second- and third-degree corrosive esophageal burns.
- Corticosteroid use should be abandoned in managing corrosive ingestions as they do not prevent strictures and may cause adverse effects.