Factors Affecting the Prevalence of Gastro-oesophageal Reflux in Childhood Corrosive Oesophageal Strictures

Abstract

Oesophageal stricture is the most common complication of corrosive ingestion in childhood and standard dilatation treatment has a success rate of approximately 50-70% (1-3). Clinical studies conducted on the achievement of dilatation treatment emphasise the effects of the following parameters: start of dilatation treatment, stricture length, largest dilatator diameter used in the dilatation program and development of any perforations during the dilatation process (4). With the exception of corrosive substance ingestion, negative effects of gastro-oesophageal reflux (GER) on other causes of oesophageal strictures are clearly known. Previous studies published in English have not discussed the details of the relationship between stricture formation and GER, nor the risk factors which cause the development of GER in patients suffering from oesophageal stricture due to corrosive substance ingestion (5-9). The aim of this clinical study is to investigate the relating factors affecting the prevalence of GER and the effects of GER on the treatment of patients suffering from oesophageal stricture due to corrosive substance ingestion. MATERIAL AND METHODSÇukurova University Ethics Committee approved the study and written informed consent forms were signed by families of the parBackground: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic between 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER), were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastrooesophageal reflux (63.5%). Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean distance of stricture was longer in patients with reflux (3.7±1.8 cm) than in patients without (2.2±1.0 cm) (p<0.005). Only one patient among 17 who had a long stricture (≥4 cm) did not suffer from reflux. Patients with long stricture were 1.9-times more likely to have reflux. Dilatation treatment was successful in 69.6% of patients with reflux and in 78.9% of patients with...

Clinical outcome of endoscopic balloon dilatations employed in benign paediatric oesophageal pathologies

“…Although regarded as one of the main determinants of outcome, the length of the stricture caused by corrosive ingestion has not been defined uniformly in published studies. A long stricture was defined as a stricture longer than 2 cm,[ 4 ] 3 cm,[ 13 ] 4 cm,[ 17 ] or 5 cm[ 1 ] in different studies. A few authors used vertebral height as a correlation to stricture length and considered two vertebral body height as the cut-off to define a long stricture.…”

Changes of the ultrastructural organization of cells of rats esophagus in the modeling of second-degree esophageal stricture

“…Scar strictures that lead to obstruction of the esophagus do not tend to decrease lately, but on the contrary, the number of such patients is increasing, which is caused by the use of a large range of chemicals in human life [4,8,10,24,27,30]. The results of treatment of scarring strictures depend on the degree of stenosis.…”