Management of Peptic Oesophageal Stricture

Abstract

Peptic oesophageal stricture develops in approximately 10-15% of patients with inadequately treated reflux oesophagitis and poses a difficult clinical problem. The management of reflux oesophagitis has been revolutionised by improvements in medical management, endoscopic and balloon techniques of oesophageal dilatation. The major advance has been the development of inhibitors of gastric acid secretion: histamine receptor antagonists and H⁺ + K⁺ + ATPase inhibitors. Studies have recently shown that the H⁺ + K⁺ + ATPase inhibitor omeprazole is effective in the management of severe resistant reflux disease with peptic stricture formation, leading to a reduction in the number of oesophageal dilatations required by up to 60% of patients. The aim of this article is to review the current medical, endoscopic and surgical management of severe peptic oesophagitis with stricture formation.

Reflux esophageal stricture—a review of 30 years' experience in children

“…This physiologic process is separate from GERD, a pathologic process with an incidence of 2% to 7% in children defined as GER associated with complications [9]. These complications may include esophagitis, Barrett esophagus, esophageal stricture, or extraesophageal conditions such as asthma, pneumonia, chronic cough, sleep apnea, and poor dentition and occur with a frequency of 5% to 15% in children with GERD [10,11]. In agreement with other studies, we found a higher incidence of GERD leading to PS in male children; and the majority of our strictures were identified in the lower third of the esophagus [12].…”