Esophageal stricture natural history, complications and prognosis
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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 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
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] , and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.Most strictures can be treated successfully with endoscopic dilation using bougies or balloons, with only a few complications. Nonetheless, approximately one third of patients develop recurrent symptoms after dilation within the first year.[6]
- Our multicenter series showed a disappointing long-term outcome for RBES, with only 1 of 3 achieving clinical resolution. The dysphagia-free period was relatively short, affecting the quality of life. Endoprosthetics did not appear to affect the natural history of RBES.[7]
- 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.
- Weight loss is associated with poor prognosis among patients with esophageal stricture.[8]
- Loss of previous heartburn is related to more esophageal stricture[2]
- [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.
- ↑ 2.0 2.1 Lundell, M.D., Ph.D., Lars. "Reflux esophagitis and peptic strictures". GI Motility online.
- ↑ 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.
- ↑ 4.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.