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Esophageal stricture

Background

Overview

Definition
Esophageal stricture is a chronic condition characterized by dysphagia due to esophageal inflammation, collagen deposition and scar tissue.
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Pathophysiology
Esophageal stricture is caused mainly by GERD, esophagitis, tumors (adenocarcinoma, SCC), corrosive injury to the esophagus, intrinsic/extrinsic compressions, Plummer-Vinson syndrome, postsurgical complications, and congenital defects.
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Disease course
Clinical manifestations of an esophageal stricture include dysphagia, gastroesophageal reflux, vomiting, chest pain, cough, hoarseness, gastrointestinal bleeding, anemia, and weight loss. There is an increased risk of recurrence after initial dilatation.
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Prognosis and risk of recurrence
In-hospital mortality in benign and malignant esophageal strictures is 1.4% and 3.1%, respectively.
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Guidelines

Key sources

The following summarized guidelines for the management of esophageal stricture are prepared by our editorial team based on guidelines from the American Society for Gastrointestinal Endoscopy (ASGE 2014).
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Medical management

Antisecretory treatment: as per ASGE 2014 guidelines, initiate antisecretory treatment in patients undergoing endoscopic dilation for a peptic esophageal stricture, in order to reduce the risk of recurrent strictures.
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Therapeutic procedures

Endoscopic dilation: as per ASGE 2014 guidelines, perform endoscopic dilation for patients with dysphagia secondary to benign intrinsic strictures of the esophagus.
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