Conservative management of esophageal stricture using dilatation and antireflux therapy

Ninety patients with benign esophageal stricture were treated conservatively with bougienage, antireflux, and antacid therapy. There was improvement in 79% of these patients, only 14% were unchanged, and 7% became worse. Only three patients eventually were operated upon. Bougienage was accomplished in many cases using the fiberscope as a bougie, followed by progressive dilatations with soft mercury-filled dilators. Many patients had initial dilatation with a guidewire placed through the stricture into the stomach under direct vision through the fiberscope. All patients were treated with antireflux measures and antacid subsequent to their dilatations. These measures were found to be both safe and effective in most cases. Surgery was believed to be indicated only in patients who failed to respond to these measures.