Esophageal stricture natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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

Natural history and management of refractory benign esophageal strictures.

Natural history and management of refractory benign esophageal strictures

Peptic esophageal stricture: is surgery still necessary?

Predictor of massive bleeding following stent placement for malignant oesophageal stricture/fistulae: a multicentre study

Complications of esophageal stricture dilation

Over time, the damage caused by stomach acid can scar the lining of the esophagus.When this scar tissue builds up, it makes the esophagus narrow. Called strictures, these narrow spots make it hard to swallow food and drinks, which can lead to weight lossand dehydration. medscape

Refractory Esophageal Strictures: What To Do When Dilation Fails

Patterns of acid reflux in complicated oesophagitis.https://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity/Esophagus

https://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity/Esophagus

  • 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 progressed[2]
  • If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration.[3]

Complications

  • Common complications of esophageal stricture include:[4]
    • Perforation
    • Bleeding[5]
    • Pneumonia
    • Bacteremia

Prognosis

  • Prognosis is generally good and it depends what causes esophageal stricture. More than 80-90 % of esophageal strictures respond well to endoscopic dilation [4] but one third of patients have recurrent symptoms after one year. [6]
  • Weight loss is associated with poor prognosis among patients with esophageal stricture.[7]
  • Loss of previous heartburn is related to more esophageal stricture[2]

References

  1. 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. 2.0 2.1 Lundell, M.D., Ph.D., Lars. "Reflux esophagitis and peptic strictures". GI Motility online.
  3. 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. 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.
  5. 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.
  6. 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.
  7. 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.

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