Peptic esophageal stricture: medical treatment.
Peptic esophageal stricture as a consequence of gastroesophageal reflux disease is the most frequent among benign esophageal strictures. The incidence is low and has been decreasing since the 1990s with a parallel increase in proton pump inhibitor use. Dysphagia is a common symptom: accurate diagnostic procedures (barium esophagogram, upper endoscopy with biopsies) have to be performed to exclude malignant causes first. Medical (acid-suppressive) therapy, endoscopic dilation and surgical intervention are the main therapeutic options. Based on the results of randomized and observational studies evaluating the effect of acid-suppressive therapy on peptic stricture outcome, healing the coexistent esophagitis seems to be essential. Effective acid-suppressive therapy with proton pump inhibitors may reduce the need for repeated dilations and provide symptom relief and better clinical outcome. In refractory strictures, local steroid injection is likely beneficial.
Pregun
István
I
2nd Department of Medicine, Semmelweis University and Clinical Gastroenterology Research Unit, Hungarian Academy of Sciences, Budapest, Hungary. pregunistvan@yahoo.com
Hritz
István
I
Tulassay
Zsolt
Z
Herszényi
László
L
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D004106:Dilatation; D004940:Esophageal Stenosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D004941:Esophagitis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D004945:Esophagoscopy; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D015994:Incidence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012008:Recurrence; D019233:Retreatment
D000305:Adrenal Cortex Hormones; D054328:Proton Pump Inhibitors