Self-bougienage in the treatment of benign esophageal stricture

Although recommended for patients requiring frequent dilations in whom surgery is not feasible, self-bougienage for benign esophageal stricture has not been examined critically. Thirteen patients performing self-dilations over a mean period of 4.8 years were evaluated. Dysphagia decreased in all patients and reflux symptoms were well-controlled in most patients with an antireflux regimen of elevation of the head of the bed, antacids, and cimetidine. Major complications of bleeding or perforation were not encountered, although three episodes of esophageal food impaction related to missed home dilation sessions did occur. Long-term self-bougienage is both safe and effective therapy for benign esophageal stricture for patients who require frequent dilations.