Esophageal strictures: Management beyond dilation.

Area of Science:

• Gastroenterology
• Gastrointestinal Endoscopy

Background:

• Esophageal stricture causes lumen narrowing, leading to dysphagia and reduced quality of life.
• Etiologies include malignancy, peptic injury, caustic ingestion, post-surgery, radiation, and inflammatory conditions like eosinophilic esophagitis.

Purpose of the Study:

• To review the fundamental principles of endoscopic dilation for esophageal strictures.
• To discuss adjunctive therapies for managing refractory or recurrent esophageal strictures.

Main Methods:

• Review of current literature on esophageal stricture management.
• Focus on endoscopic dilation techniques (bougie and balloon dilators).
• Exploration of adjunctive treatments such as intralesional steroids, mitomycin C, incisional therapy, stenting, and surgery.

Main Results:

• Endoscopic dilation is the primary treatment for most benign esophageal strictures.
• Adjunctive therapies can enhance outcomes and decrease the need for repeat procedures in complex cases.
• A range of options exists for managing difficult-to-treat strictures.

Conclusions:

• Effective management of esophageal strictures aims to restore luminal patency and alleviate dysphagia.
• Endoscopic dilation is a cornerstone therapy, with various adjunctive strategies available for challenging strictures.