Association of Gastro-Oesophageal Reflux Disease with Oesophageal Stricture: What can be Done to Prevent It
Journal of Surgery
Volume 1, Issue 2, June 2013, Pages: 18-21
Received: May 6, 2013;
Published: Jun. 10, 2013
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Abdulzahra Hussain, Upper GI Unit, General surgery department;Senior lecturer,King’s College Medical School, London
Tahir Chohan, Upper GI Unit, General surgery department
Ali Adnan, Otolarngology, Head and neck department.Sahlgrenska university hospitalGröna stråket 9.413 45 Gothenburg.Sweden
Shamsi El-Hasani, Upper GI Unit, General surgery department
Maxwell Asante, Gastroenterology unit, Department of medicine, Princess Royal University Hospital.Orpington, Greater London, BR6 8ND
Objectives: GORD is associated with benign oesophageal stricture. Endoscopic management of which is safe, effective and commonly applied. The aim of this study is to assess the causes of benign oesophageal stricture,the outcome of endoscopic management and to explore the literatures on ways of preventions. Patients and Methods: Data from our endoscopy unit was reviewed using unisoft software. Seventy -one patients who have been diagnosed with oesophageal strictures during March 2006-January 2012,were selected for this study. Twelve oesophageal cancers, 4 patients with achalasia and 6 patients with anastomotic stricture were excluded. The data was collected from case notes of the remaining forty-nine patients. Results: Forty-nine patients were diagnosed with symptomatic benign stricture due to reflux disease and inflammation (47 and 2 patients respectively). The age range was 38-92 (mean 59), 17(34.7%) women and 32(65.3%) men were included. 42(85.71%) patients underwent dilatation, of which 88.7% had 1-4 dilatations (mean of 2 dilatations). The remaining 14.28% (6 patients) had very tight strictures and each had 5-7 dilatations. One (2.04%) patient had anti-reflux surgery. Six (12.24%) patients were treated conservatively using proton pump inhibitors and they didn’t need dilatation. There were 34 patients developed minor morbidities such as chest pain (11%); minor bleeding (15) and nausea (3%),no oesophageal perforation or other major complications were reported. Conclusions: Endoscopic dilatation for benign oesophageal stricture is a safe and an effective procedure. Follow up of younger patients are necessary to achieve satisfactory symptomatic relief and to prevent advanced and severe stricture developing at a later age.
Association of Gastro-Oesophageal Reflux Disease with Oesophageal Stricture: What can be Done to Prevent It, Journal of Surgery.
Vol. 1, No. 2,
2013, pp. 18-21.
S A Riley, S E A Attwood Guidelines on the use of esophageal dilatation in clinical practice. Gut 2004; 53(Suppl I): i1–i6
H. B. El-Serag, M. Lau. Temporal Trends in New and Recurrent Oesophageal Strictures in a Medicare Population Aliment PharmacolTher. 2007;25:1223-1229.
Chiu YC, Hsu CC, Chiu KW,Chuah SK, Changchien CS, Wu KL,et al. Factors influencing clinical applications of endoscopic balloon dilation for benign esophageal strictures. Endoscopy. 2004; 36:595–600.
Kabbaj N, Salihoun M, Chaoui Z, Acharki M, Amrani N. Safety and outcome using endoscopic dilatation for benign esophageal stricture without fluoroscopy.World J GastrointestPharmacolTher.2011; 2: 46-9.
Lew RJ, Kochman ML.A review of endoscopic methods of esophageal dilation. J ClinGastroenterol. 2002; 35:117–126.
Fan Y, Song HY, Kim JH, Park JH, Ponnuswamy I, Jung HY,et al. Fluoroscopically guided balloon dilation of benign esophageal strictures: incidence of esophageal rupture and its management in 589 patients.AJR Am J Roentgenol.2011; 197: 1481-6.
Hernandez LV, Jacobson JW, Harris MS. Comparison among the perfo- ration rates of Maloney, balloon, and savary dilation of esophageal strictures. GastrointestEndosc 2000;51:460-2
Guidelines on the use of oesophageal dilatation in clinical practice.S A Riley, S E A Attwood.Gut 2004;53(Suppl I):i1–i6
Pregun I, Hritz I, Tulassay Z, Herszényi L. Peptic esophageal stricture: medical treatment.Dig Dis.2009; 27: 31-7.
Vetter S, Jakobs R, Weickert U. [Benign non-peptic esophageal stenosis: causes, treatment and outcome in routine clinical practice].Dtsch Med Wochenschr. 2010;135:1061-6.
Cheung TK, Wong BC, Lam SK. Gastro-oesophageal reflux disease in Asia : birth of a 'new' disease.Drugs. 2008;68:399-406.
NawalKabbaj, MounaSalihoun, ZakiaChaoui, Mohamed Acharki, and NaïmaAmrani .Safety and outcome using endoscopic dilatation for benign esophageal stricture without fluoroscopy.World J GastrointestPharmacolTher. 2011 ; 2: 46–49
De la Garza González SJ, García RG. [Update in the endoscopic management of benign esophageal stenoses]. Rev Gastroenterol Mex. 2005; 70: 20-4.
deWijkerslooth LR, Vleggaar FP, Siersema PD. Endoscopic management of difficult or recurrent esophageal strictures. Am J Gastroenterol. 2011;106:2080-91.
Kim JH, Shin JH, Song HY. Benign strictures of the esophagus and gastric outlet: interventional management.Korean J Radiol.2010 ;11:497-506.
Shen KR, Harrison-Phipps KM, Cassivi SD, Wigle D, Nichols FC 3rd, Allen MS,et al. Esophagectomy after anti-reflux surgery.JThoracCardiovasc Surg.2010 ;139:969-75.
Menon S, Jayasena H, Nightingale P, Trudgill NJ. Influence of age and sex on endoscopic findings of gastrooesophageal reflux disease: an endoscopy database study.Eur J GastroenterolHepatol. 2011;23:389-95.
Lee SJ, Jung MK, Kim SK, Jang BI, Lee SH, Kim KO,et al. [Clinical characteristics of gastroesophageal reflux disease with esophageal injury in korean: focusing on risk factors].Korean J Gastroenterol. 2011;57:281-7.
Cho JH, Kim HM, Ko GJ, Woo ML, Moon CM, Kim YJ, et al.Old age and male sex are associated with increased risk of asymptomatic erosive esophagitis: analysis of data from local health examinations by the Korean National Health Insurance Corporation.JGastroenterolHepatol. 2011;26:1034-8
Olson JS, Lieberman DA, Sonnenberg A. Practice patterns in the management of patients with esophageal strictures and rings.GastrointestEndosc.2007 ;66:670-5
Pereira-Lima JC, Ramires RP, Zamin I Jr, Cassal AP, Marroni CA, Mattos AA.Endoscopic dilation of benign esophageal strictures: report on 1043 procedures.Am J Gastroenterol.1999 ;94:1497-501.
Mäntynen T, Färkkilä M, Kunnamo I, Mecklin JP, Juhola M, Voutilainen M.The impact of upper GI endoscopy referral volume on the diagnosis of gastroesophageal reflux disease and its complications: a 1-year cross-sectional study in a referral area with 260,000 inhabitants.Am J Gastroenterol.2002 ;97:2524-9.
Kaplan M, Mutlu EA, Jakate S, Bruninga K, Losurdo J, LosurdoJ,et al. Endoscopy in eosinophilicesoph-agitis: ‘‘feline’’ esophagus and perforation risk. ClinGastroenterolHepatol 2003;1:433-7.
Francis D, Schreiber J, Dierkhising RA, Talley NJ, Smyrk TC, Alexander JA.Occurrence of and risk factors for complications after endoscopic dilation in eosinophilicesophagitis.Jung KW, Gundersen N, Kopacova J, Arora AS, Romero Y, KatzkaGastrointestEndosc. 2011;73:15-21
Ally MR, Dias J, Veerappan GR, Maydonovitch CL, Wong RK, MoawadFJ.Safety of dilation in adults with eosinophilicesophagitis.Dis Esophagus. 2012 ;7. doi: 10.1111/j.1442-2050.2012.01363.