Abstract
Dysphagia or difficulty swallowing is a common complaint seen in gastroenterology clinics. The first step in the evaluation of patients with dysphagia is an upper endoscopy to rule out an anatomical etiology of these symptoms such as a mass, hiatus hernia, diverticulum or stricture. Esophageal strictures are a common finding and are most often the result of benign pathology; however, they may also be due to malignancy or prior surgical anastomosis. Once the diagnosis of a benign esophageal stricture has been made, there are two main facets to therapy: (1) opening of the luminal narrowing, and (2) treatment of the underlying disease process to stop stricture recurrence. Treatment of the luminal narrowing is typically performed during upper endoscopy with either a bougie dilator or through-the-scope dilation balloon. Targeted therapy aimed at the underlying etiology is typically needed to stop stricture recurrence (e.g., antacid medication, topical steroids, systemic immunomodulation, etc.). Most strictures can be managed with dilation; however, advanced techniques, medications, and even surgery can be required for difficult to manage refractory and recurrent strictures.
Original language | English (US) |
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Title of host publication | Encyclopedia of Gastroenterology, Second Edition |
Publisher | Elsevier |
Pages | 386-395 |
Number of pages | 10 |
ISBN (Electronic) | 9780128124604 |
DOIs | |
State | Published - Jan 1 2019 |
Keywords
- Anastomosis
- Balloon dilator
- Bougie dilator
- Dilation
- EoE
- Esophageal stent
- Peptic stricture
- PPI
- Recurrent stricture
- Refractory stricture
ASJC Scopus subject areas
- General Medicine