Esophageal stricture natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration. | If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration. Common complications of esophageal stricture include perforation, bleeding, pneumonia, bacteremia. Prognosis is generally good but recurrence of symptoms after dilation are prevalent and usually recurrent dilation is necessary. | ||
Common complications of esophageal stricture include perforation, bleeding, pneumonia, bacteremia | |||
Prognosis is generally good but recurrence of symptoms after dilation are prevalent and usually recurrent dilation is necessary . | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
* The natural history of | * The natural history of benign esophageal strictures starts with gradual dysphagia to solid food and heartburn. <ref name="pmid26828759">{{cite journal |vauthors=Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML |title=Natural history and management of refractory benign esophageal strictures |journal=Gastrointest. Endosc. |volume=84 |issue=2 |pages=222–8 |year=2016 |pmid=26828759 |doi=10.1016/j.gie.2016.01.053 |url=}}</ref> | ||
* In some cases of esophageal stricture, symptoms of heartburn disappear when fibrosis is | * In some cases of esophageal stricture, symptoms of heartburn disappear when fibrosis is established.<ref name=":0">{{Cite journal|last=Lundell, M.D., Ph.D.|first=Lars|date=|title=Reflux esophagitis and peptic strictures|url=http://www.nature.com/gimo/contents/pt1/full/gimo43.html|journal=GI Motility online|volume=|pages=|via=}}</ref> | ||
*If left untreated, patients with esophageal stricture | *If left untreated, patients with esophageal stricture may progress to develop:<ref name="pmid28783923">{{cite journal |vauthors=Hwang JJ |title=Safe and Proper Management of Esophageal Stricture Using Endoscopic Esophageal Dilation |journal=Clin Endosc |volume=50 |issue=4 |pages=309–310 |year=2017 |pmid=28783923 |pmc=5565041 |doi=10.5946/ce.2017.100 |url=}}</ref> | ||
**Pulmonary aspiration | |||
**Weight loss | |||
**Dehydration | |||
===Complications=== | ===Complications=== | ||
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===Prognosis=== | ===Prognosis=== | ||
*Prognosis is generally good and | *Prognosis is generally good and depends on the cause of esophageal stricture. More than 80-90 % of esophageal strictures respond well to endoscopic dilation but one third of patients have recurrent symptoms after one year.<ref name=":1" /><ref name="pmid25647687">{{cite journal |vauthors=van Boeckel PG, Siersema PD |title=Refractory esophageal strictures: what to do when dilation fails |journal=Curr Treat Options Gastroenterol |volume=13 |issue=1 |pages=47–58 |year=2015 |pmid=25647687 |pmc=4328110 |doi=10.1007/s11938-014-0043-6 |url=}}</ref> | ||
*Weight loss is associated with poor prognosis among patients with esophageal stricture.<ref name="pmid24876933">{{cite journal |vauthors=Berry MF |title=Esophageal cancer: staging system and guidelines for staging and treatment |journal=J Thorac Dis |volume=6 Suppl 3 |issue= |pages=S289–97 |year=2014 |pmid=24876933 |pmc=4037413 |doi=10.3978/j.issn.2072-1439.2014.03.11 |url=}}</ref> | *Weight loss is associated with poor prognosis among patients with esophageal stricture.<ref name="pmid24876933">{{cite journal |vauthors=Berry MF |title=Esophageal cancer: staging system and guidelines for staging and treatment |journal=J Thorac Dis |volume=6 Suppl 3 |issue= |pages=S289–97 |year=2014 |pmid=24876933 |pmc=4037413 |doi=10.3978/j.issn.2072-1439.2014.03.11 |url=}}</ref> | ||
*Progressive [[gastroesophageal reflux]] may lead to extended esophageal stricture which prevent gastric acid to flow back in the esophagus. Loss of previous heartburn is related to more esophageal stricture.<ref name=":0" /> | *Progressive [[gastroesophageal reflux]] may lead to extended esophageal stricture which prevent gastric acid to flow back in the esophagus. Loss of previous heartburn is related to more esophageal stricture.<ref name=":0" /> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]
Overview
If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration. Common complications of esophageal stricture include perforation, bleeding, pneumonia, bacteremia. Prognosis is generally good but recurrence of symptoms after dilation are prevalent and usually recurrent dilation is necessary.
Natural History, Complications, and Prognosis
Natural History
- The natural history of benign esophageal strictures starts with gradual dysphagia to solid food and heartburn. [1]
- In some cases of esophageal stricture, symptoms of heartburn disappear when fibrosis is established.[2]
- If left untreated, patients with esophageal stricture may progress to develop:[3]
- Pulmonary aspiration
- Weight loss
- Dehydration
Complications
- Common complications of esophageal stricture include:[4][5]
- Perforation
- Bleeding
- Pneumonia
- Bacteremia
Prognosis
- Prognosis is generally good and depends on the cause of esophageal stricture. More than 80-90 % of esophageal strictures respond well to endoscopic dilation but one third of patients have recurrent symptoms after one year.[4][6]
- Weight loss is associated with poor prognosis among patients with esophageal stricture.[7]
- Progressive gastroesophageal reflux may lead to extended esophageal stricture which prevent gastric acid to flow back in the esophagus. Loss of previous heartburn is related to more esophageal stricture.[2]
References
- ↑ Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML (2016). "Natural history and management of refractory benign esophageal strictures". Gastrointest. Endosc. 84 (2): 222–8. doi:10.1016/j.gie.2016.01.053. PMID 26828759.
- ↑ 2.0 2.1 Lundell, M.D., Ph.D., Lars. "Reflux esophagitis and peptic strictures". GI Motility online.
- ↑ Hwang JJ (2017). "Safe and Proper Management of Esophageal Stricture Using Endoscopic Esophageal Dilation". Clin Endosc. 50 (4): 309–310. doi:10.5946/ce.2017.100. PMC 5565041. PMID 28783923.
- ↑ 4.0 4.1 van Boeckel PG, Siersema PD (2015). "Refractory esophageal strictures: what to do when dilation fails". Curr Treat Options Gastroenterol. 13 (1): 47–58. doi:10.1007/s11938-014-0043-6. PMC 4328110. PMID 25647687.
- ↑ Liu SY, Xiao P, Li TX, Cao HC, Mao AW, Jiang HS, Cao GS, Liu J, Wang YD, Zhang XS (2016). "Predictor of massive bleeding following stent placement for malignant oesophageal stricture/fistulae: a multicentre study". Clin Radiol. 71 (5): 471–5. doi:10.1016/j.crad.2016.02.001. PMID 26944699.
- ↑ van Boeckel PG, Siersema PD (2015). "Refractory esophageal strictures: what to do when dilation fails". Curr Treat Options Gastroenterol. 13 (1): 47–58. doi:10.1007/s11938-014-0043-6. PMC 4328110. PMID 25647687.
- ↑ Berry MF (2014). "Esophageal cancer: staging system and guidelines for staging and treatment". J Thorac Dis. 6 Suppl 3: S289–97. doi:10.3978/j.issn.2072-1439.2014.03.11. PMC 4037413. PMID 24876933.