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https://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity/Esophagus
https://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity/Esophagus
* The natural history of  benign esophageal strictures starts with gradual dysphagia to solid food and heartburn. <ref name="pmid26828759">{{cite journal |vauthors=Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML |title=Natural history and management of refractory benign esophageal strictures |journal=Gastrointest. Endosc. |volume=84 |issue=2 |pages=222–8 |year=2016 |pmid=26828759 |doi=10.1016/j.gie.2016.01.053 |url=}}</ref> Sometimes there is no history of heartburn and reflux symtoms before diagnosis of esophageal stricture due to progression of fibrosis<ref name=":0">{{Cite journal|last=Lundell, M.D., Ph.D.|first=Lars|date=|title=Reflux esophagitis and peptic strictures|url=http://www.nature.com/gimo/contents/pt1/full/gimo43.html|journal=GI Motility online|volume=|pages=|via=}}</ref>
* The natural history of  benign esophageal strictures starts with gradual dysphagia to solid food and heartburn. <ref name="pmid26828759">{{cite journal |vauthors=Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML |title=Natural history and management of refractory benign esophageal strictures |journal=Gastrointest. Endosc. |volume=84 |issue=2 |pages=222–8 |year=2016 |pmid=26828759 |doi=10.1016/j.gie.2016.01.053 |url=}}</ref>  
* In some cases of esophageal stricture, after ++there is no history of heartburn and reflux symtoms before diagnosis of esophageal stricture due to progression of fibrosis<ref name=":0">{{Cite journal|last=Lundell, M.D., Ph.D.|first=Lars|date=|title=Reflux esophagitis and peptic strictures|url=http://www.nature.com/gimo/contents/pt1/full/gimo43.html|journal=GI Motility online|volume=|pages=|via=}}</ref>
*If left untreated, patients with esophageal stricture  may progress to develop pulmonary aspiration, weight loss, and dehydration.<ref name="pmid28783923">{{cite journal |vauthors=Hwang JJ |title=Safe and Proper Management of Esophageal Stricture Using Endoscopic Esophageal Dilation |journal=Clin Endosc |volume=50 |issue=4 |pages=309–310 |year=2017 |pmid=28783923 |pmc=5565041 |doi=10.5946/ce.2017.100 |url=}}</ref>  
*If left untreated, patients with esophageal stricture  may progress to develop pulmonary aspiration, weight loss, and dehydration.<ref name="pmid28783923">{{cite journal |vauthors=Hwang JJ |title=Safe and Proper Management of Esophageal Stricture Using Endoscopic Esophageal Dilation |journal=Clin Endosc |volume=50 |issue=4 |pages=309–310 |year=2017 |pmid=28783923 |pmc=5565041 |doi=10.5946/ce.2017.100 |url=}}</ref>  
*More than 80–90 % of esophageal strictures can be treated successfully with endoscopic dilation using Savary bougies or balloons.   
*More than 80–90 % of esophageal strictures can be treated successfully with endoscopic dilation using Savary bougies or balloons.   

Revision as of 17:44, 9 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

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Natural History, Complications, and Prognosis

Natural History

Natural history and management of refractory benign esophageal strictures.

Natural history and management of refractory benign esophageal strictures

Peptic esophageal stricture: is surgery still necessary?

Predictor of massive bleeding following stent placement for malignant oesophageal stricture/fistulae: a multicentre study

Complications of esophageal stricture dilation

Over time, the damage caused by stomach acid can scar the lining of the esophagus.When this scar tissue builds up, it makes the esophagus narrow. Called strictures, these narrow spots make it hard to swallow food and drinks, which can lead to weight lossand dehydration. medscape

Refractory Esophageal Strictures: What To Do When Dilation Fails

Patterns of acid reflux in complicated oesophagitis.https://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity/Esophagus

https://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity/Esophagus

  • The natural history of benign esophageal strictures starts with gradual dysphagia to solid food and heartburn. [1]
  • In some cases of esophageal stricture, after ++there is no history of heartburn and reflux symtoms before diagnosis of esophageal stricture due to progression of fibrosis[2]
  • If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration.[3]
  • More than 80–90 % of esophageal strictures can be treated successfully with endoscopic dilation using Savary bougies or balloons. 
  • RBES resolution was achieved in only 22 of 70 (31.4%) patients. Two deaths (3%) were related to RBES. The success rate was lower in those who also were treated with endoprosthetics (odds ratio [OR] 3.7; 95% confidence interval [CI], 1.01-18.0). The mean dysphagia-free period was 3.3 months (95% CI, 2.4-4.1) for patients treated with dilation and 2.4 months (95% CI, 1.2-3.6) for those treated with stents (P = .062). Over time, the total dysphagia-free period increased at a rate of 4.1 days (95% CI, 1.7-6.4) per dilation. There was no difference in the rate of change across groups defined by sex (P = .976), age (P = .633), or endoscopic treatment (P = .267).

Complications

  • Common complications of esophageal stricture include:[4]
    • Perforation
    • Bleeding[5]
    • Bacteremia

Prognosis

  • Prognosis is generally good and it depends what causes esophageal stricture. More than 80-90 % of esophageal strictures respond well to endoscopic dilation [4] but one third of patients have recurrent symptoms after one year. [6]
  • Weight loss is associated with poor prognosis among patients with esophageal stricture.[7]
  • Loss of previous heartburn is related to more esophageal stricture[2]

References

  1. Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML (2016). "Natural history and management of refractory benign esophageal strictures". Gastrointest. Endosc. 84 (2): 222–8. doi:10.1016/j.gie.2016.01.053. PMID 26828759.
  2. 2.0 2.1 Lundell, M.D., Ph.D., Lars. "Reflux esophagitis and peptic strictures". GI Motility online.
  3. Hwang JJ (2017). "Safe and Proper Management of Esophageal Stricture Using Endoscopic Esophageal Dilation". Clin Endosc. 50 (4): 309–310. doi:10.5946/ce.2017.100. PMC 5565041. PMID 28783923.
  4. 4.0 4.1 van Boeckel PG, Siersema PD (2015). "Refractory esophageal strictures: what to do when dilation fails". Curr Treat Options Gastroenterol. 13 (1): 47–58. doi:10.1007/s11938-014-0043-6. PMC 4328110. PMID 25647687.
  5. Liu SY, Xiao P, Li TX, Cao HC, Mao AW, Jiang HS, Cao GS, Liu J, Wang YD, Zhang XS (2016). "Predictor of massive bleeding following stent placement for malignant oesophageal stricture/fistulae: a multicentre study". Clin Radiol. 71 (5): 471–5. doi:10.1016/j.crad.2016.02.001. PMID 26944699.
  6. van Boeckel PG, Siersema PD (2015). "Refractory esophageal strictures: what to do when dilation fails". Curr Treat Options Gastroenterol. 13 (1): 47–58. doi:10.1007/s11938-014-0043-6. PMC 4328110. PMID 25647687.
  7. Berry MF (2014). "Esophageal cancer: staging system and guidelines for staging and treatment". J Thorac Dis. 6 Suppl 3: S289–97. doi:10.3978/j.issn.2072-1439.2014.03.11. PMC 4037413. PMID 24876933.

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