Esophageal stricture medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
* The mainstay of treatment for esophageal stricture is dilation.<ref name="pmid7926495">{{cite journal |vauthors=Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A |title=A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group |journal=Gastroenterology |volume=107 |issue=5 |pages=1312–8 |year=1994 |pmid=7926495 |doi= |url=}}</ref> Self dilation can be considered at home with bougie | * The mainstay of treatment for esophageal stricture is dilation.<ref name="pmid7926495">{{cite journal |vauthors=Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A |title=A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group |journal=Gastroenterology |volume=107 |issue=5 |pages=1312–8 |year=1994 |pmid=7926495 |doi= |url=}}</ref> Self dilation can be considered at home with bougie dilators. <ref name="pmid23925823">{{cite journal |vauthors=Dzeletovic I, Fleischer DE, Crowell MD, Pannala R, Harris LA, Ramirez FC, Burdick GE, Rentz LA, Spratley RV, Helling SD, Alexander JA |title=Self-dilation as a treatment for resistant, benign esophageal strictures |journal=Dig. Dis. Sci. |volume=58 |issue=11 |pages=3218–23 |year=2013 |pmid=23925823 |doi=10.1007/s10620-013-2822-7 |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> | * Pharmacologic medical therapy is recommended among all patients who develop esophageal stricture due to [[gastroesophageal reflux disease]]. Studies show [[Proton pump inhibitor|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 style modification === | === 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 | ||
:* Tobacco | :* Tobacco | ||
:* Alchohol | :* Alchohol | ||
:* Peppermint | :* Peppermint | ||
| Line 24: | Line 24: | ||
===Esophageal stricture=== | ===Esophageal stricture=== | ||
* '''Adult<ref name="pmid79264952">{{cite journal |vauthors=Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A |title=A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group |journal=Gastroenterology |volume=107 |issue=5 |pages=1312–8 |year=1994 |pmid=7926495 |doi= |url=}}</ref>''' | * '''Adult<ref name="pmid79264952">{{cite journal |vauthors=Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A |title=A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group |journal=Gastroenterology |volume=107 |issue=5 |pages=1312–8 |year=1994 |pmid=7926495 |doi= |url=}}</ref>''' | ||
** Preferred regimen : Omeprazole (Prilosec) :20 mg PO daily following esophageal dilatation. | ** 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 | *** [[Omeprazole]] (Prilosec): 40 mg twice daily for patients who do not respond to the standard dose | ||
** Alternative regimen : Ranitidine 150 mg twice daily | ** Alternative regimen : [[Ranitidine]] 150 mg twice daily | ||
* '''Pediatric<ref name="HaganderMuszynska2012">{{cite journal|last1=Hagander|first1=Lars|last2=Muszynska|first2=Carolina|last3=Arnbjornsson|first3=Einar|last4=Sandgren|first4=Katarina|title=Prophylactic Treatment with Proton Pump Inhibitors in Children Operated on for Oesophageal Atresia|journal=European Journal of Pediatric Surgery|volume=22|issue=02|year=2012|pages=139–142|issn=0939-7248|doi=10.1055/s-0032-1308698}}</ref>''' | * '''Pediatric<ref name="HaganderMuszynska2012">{{cite journal|last1=Hagander|first1=Lars|last2=Muszynska|first2=Carolina|last3=Arnbjornsson|first3=Einar|last4=Sandgren|first4=Katarina|title=Prophylactic Treatment with Proton Pump Inhibitors in Children Operated on for Oesophageal Atresia|journal=European Journal of Pediatric Surgery|volume=22|issue=02|year=2012|pages=139–142|issn=0939-7248|doi=10.1055/s-0032-1308698}}</ref>''' | ||
** Omeprazole 2 mg/kg PO per day | ** [[Omeprazole]] 2 mg/kg PO per day | ||
==References== | ==References== | ||
Revision as of 18:42, 8 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]
Overview
The mainstay of treatment for esophageal stricture is dilation. Pharmacologic medical therapy for esophageal stricture secondary to gastroesophageal reflux disease includes proton pump inhibitors or H2 antagonists. Patients are advised to consider life style modification for gastroesophageal reflux disease.
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
- For esophageal stricture due to gastroesophageal reflux disease, patients are advised to avoid: [4][5]
- Spicy foods
- Tobacco
- Alchohol
- Peppermint
- Chocolate
- Food before bedtime
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.