Esophageal stricture medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The mainstay of treatment for esophageal stricture is dilation. Supportive medical therapy for esophageal stricture secondary to gastroesophageal reflux disease includes proton pump inhibitors or H2 antagonists. | The mainstay of treatment for esophageal stricture is dilation. Supportive medical therapy for esophageal stricture secondary to gastroesophageal reflux disease includes proton pump inhibitors or H2 antagonists. P | ||
OR | OR | ||
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* Pharmacologic medical therapy is recommended among all patients who develop esophageal stricture due to gastroesophageal reflux disease. Studies show proton pump inhibitors are more effective than acid blocking agent<ref name="pmid7926495" /><ref name="pmid7848395">{{cite journal |vauthors=Marks RD, Richter JE, Rizzo J, Koehler RE, Spenney JG, Mills TP, Champion G |title=Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis |journal=Gastroenterology |volume=106 |issue=4 |pages=907–15 |year=1994 |pmid=7848395 |doi= |url=}}</ref> | * Pharmacologic medical therapy is recommended among all patients who develop esophageal stricture due to gastroesophageal reflux disease. Studies show proton pump inhibitors are more effective than acid blocking agent<ref name="pmid7926495" /><ref name="pmid7848395">{{cite journal |vauthors=Marks RD, Richter JE, Rizzo J, Koehler RE, Spenney JG, Mills TP, Champion G |title=Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis |journal=Gastroenterology |volume=106 |issue=4 |pages=907–15 |year=1994 |pmid=7848395 |doi= |url=}}</ref> | ||
* Life | * Life style modification | ||
** For esophageal stricture due to gastroesophageal reflux disease, patients are advised to avoid: <ref>{{Cite journal|last=Richter|first=Joel|date=2009|title=Advances in GERD Current Developments in the Management of Acid-Related GI Disorders|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886414/|journal=Gastroenterol Hepatol (N Y)|volume=5|pages=613-615|via=}}</ref><ref name="pmid16682569">{{cite journal |author=Kaltenbach T, Crockett S, Gerson LB |title=Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach |journal=Arch. Intern. Med. |volume=166 |issue=9 |pages=965–71 |year=2006 |pmid=16682569 |doi=10.1001/archinte.166.9.965}}</ref> | ** For esophageal stricture due to gastroesophageal reflux disease, patients are advised to avoid: <ref>{{Cite journal|last=Richter|first=Joel|date=2009|title=Advances in GERD Current Developments in the Management of Acid-Related GI Disorders|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886414/|journal=Gastroenterol Hepatol (N Y)|volume=5|pages=613-615|via=}}</ref><ref name="pmid16682569">{{cite journal |author=Kaltenbach T, Crockett S, Gerson LB |title=Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach |journal=Arch. Intern. Med. |volume=166 |issue=9 |pages=965–71 |year=2006 |pmid=16682569 |doi=10.1001/archinte.166.9.965}}</ref> | ||
*** Spicy foods, | *** Spicy foods, | ||
Revision as of 21:28, 7 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The mainstay of treatment for esophageal stricture is dilation. Supportive medical therapy for esophageal stricture secondary to gastroesophageal reflux disease includes proton pump inhibitors or H2 antagonists. P
OR
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
OR
The majority of cases of [disease name] are self-limited and require only supportive care.
OR
[Disease name] is a medical emergency and requires prompt treatment.
OR
OR The optimal therapy for [malignancy name] depends on the stage at diagnosis.
OR
[Therapy] is recommended among all patients who develop [disease name].
OR
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
OR
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
OR
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
OR
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
Medical Therapy
- The mainstay of treatment for esophageal stricture is dilation.[1] Self dilation can be considered at home with bougie dilators [2]
- Pharmacologic medical therapy is recommended among all patients who develop esophageal stricture due to gastroesophageal reflux disease. Studies show proton pump inhibitors are more effective than acid blocking agent[1][3]
- Life style modification
Esophageal stricture
- Adult[6]
- Preferred regimen : Omeprazole (Prilosec) :20 mg PO daily following esophageal dilatation.
- Omeprazole (Prilosec): 40 mg twice daily for patients who do not respond to the standard dose
- Alternative regimen : Ranitidine 150 mg twice daily
- Preferred regimen : Omeprazole (Prilosec) :20 mg PO daily following esophageal dilatation.
- Pediatric[7]
- Omeprazole 2 mg/kg PO per day
References
- ↑ 1.0 1.1 Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A (1994). "A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group". Gastroenterology. 107 (5): 1312–8. PMID 7926495.
- ↑ Dzeletovic I, Fleischer DE, Crowell MD, Pannala R, Harris LA, Ramirez FC, Burdick GE, Rentz LA, Spratley RV, Helling SD, Alexander JA (2013). "Self-dilation as a treatment for resistant, benign esophageal strictures". Dig. Dis. Sci. 58 (11): 3218–23. doi:10.1007/s10620-013-2822-7. PMID 23925823.
- ↑ Marks RD, Richter JE, Rizzo J, Koehler RE, Spenney JG, Mills TP, Champion G (1994). "Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis". Gastroenterology. 106 (4): 907–15. PMID 7848395.
- ↑ Richter, Joel (2009). "Advances in GERD Current Developments in the Management of Acid-Related GI Disorders". Gastroenterol Hepatol (N Y). 5: 613–615.
- ↑ Kaltenbach T, Crockett S, Gerson LB (2006). "Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach". Arch. Intern. Med. 166 (9): 965–71. doi:10.1001/archinte.166.9.965. PMID 16682569.
- ↑ Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A (1994). "A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group". Gastroenterology. 107 (5): 1312–8. PMID 7926495.
- ↑ Hagander, Lars; Muszynska, Carolina; Arnbjornsson, Einar; Sandgren, Katarina (2012). "Prophylactic Treatment with Proton Pump Inhibitors in Children Operated on for Oesophageal Atresia". European Journal of Pediatric Surgery. 22 (02): 139–142. doi:10.1055/s-0032-1308698. ISSN 0939-7248.