Esophageal stricture natural history, complications and prognosis: Difference between revisions
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* The natural history of benign esophageal strictures | * 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 because of progression of fibrosis. | ||
* e typical presentation of esophageal stricture includes the insidious and sometimes sudden occurrence of dysphagia to solid food with antecedent pyrosis. However, in up to 25% of cases there is no prior history of heartburn and other acid-related symptoms. In fact, some patients present a history in which reflux-related symptoms might even resolve over time secondary to progression of fibrosis and esophageal narrowing, only to return after therapeutic dilation. | * e typical presentation of esophageal stricture includes the insidious and sometimes sudden occurrence of dysphagia to solid food with antecedent pyrosis. However, in up to 25% of cases there is no prior history of heartburn and other acid-related symptoms. In fact, some patients present a history in which reflux-related symptoms might even resolve over time secondary to progression of fibrosis and esophageal narrowing, only to return after therapeutic dilation. | ||
*If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration. | *If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration. | ||
*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). | *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). | ||
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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].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
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] Sometimes there is no history of heartburn and reflux symtoms before diagnosis of esophageal stricture because of progression of fibrosis.
- e typical presentation of esophageal stricture includes the insidious and sometimes sudden occurrence of dysphagia to solid food with antecedent pyrosis. However, in up to 25% of cases there is no prior history of heartburn and other acid-related symptoms. In fact, some patients present a history in which reflux-related symptoms might even resolve over time secondary to progression of fibrosis and esophageal narrowing, only to return after therapeutic dilation.
- If left untreated, patients with esophageal stricture may progress to develop pulmonary aspiration, weight loss, and dehydration.
- 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
Prognosis
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of weight loss is associated with a particularly poor prognosis among patients with esophageal stricture.
- Loss of previous heartburn is associated with more esophageal stricture
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
References
- ↑ 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.
- ↑ 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.
- ↑ 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.