Plummer-Vinson syndrome medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
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
The mainstay of treatment for [disease name] is [therapy].
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
An important aspect in treating Plummer-Vinson syndrome is to identify the cause of iron deficiency in order to exclude active hemorrhage, malignancy or celiac disease. The treatment of Plummer-Vinson syndrome is primarily aimed at correcting iron deficiency anemia.
- Patients with mild dysphagia may improve with iron replacement alone, if esophageal webs are not significantly obstructive.
- Patients with persistent and significant dysphagia (for solids) require mechanical dilation for esophageal web(s).
- Mechanical dilatation with an endoscope can be used to disrupt esophageal web/stricture.
- In addition, needle-knife electro incision may be used as an alternative to endoscopic dilation.
Treatment is primarily aimed at correcting the iron-deficiency anemia. Patients with Plummer-Vinson syndrome should receive iron supplementation in their diet. This may improve dysphagia and pain.
Iron deficiency anemia
- 1.1 Ferrous sulphate
- Preferred regimen (1): Ferrous sulphate 100-200 mg PO divided q12hr; may administer extended release form once daily
Food Sources of Iron
- Iron deficiency can have serious health consequences that regular diet may not be able to quickly correct. Hence, iron supplementation is necessary in patients with Plummer-Vinson syndrome.
- Iron supplementation is often necessary if iron deficiency is symptomatic. However, mild iron deficiency can be corrected, and prevented, by eating iron-rich foods.
- Iron rich foods from plants and animals are absorbed and processed differently by the body.
- Iron from meat (heme iron source) is more easily broken down and absorbed than iron in grains (nonheme iron source).
- Minerals and chemicals in one type of food may inhibit absorption of iron from another type of food eaten at the same time.[2]
- Heme-bound iron from animal source is readily absorbed as compared to iron from plant sources.
- Thus, vegetarians and vegans should have a higher total daily iron intake than those who consume meat, fish or poultry.[3]
- Legumes and dark-green leafy vegetables like broccoli, kale and oriental greens are especially good sources of iron for vegetarians and vegans. However, spinach and swiss chard contain oxalates which bind iron making it largely unavailable for absorption.
- Iron from nonheme sources (foodgrains) is more readily absorbed if consumed with foods that contain either heme-bound iron or vitamin C.
| Food | Serving size |
Miligrams per serving |
% DV* |
|---|---|---|---|
| Chicken liver (cooked) | 3˝ ounces | 12.8 | 70 |
| Oysters(breaded and fried) | 6 pieces | 4.5 | 25 |
| Beef, chuck (lean, braised) | 3 ounces | 3.2 | 20 |
| Clams (breaded, fried) | 1 cup | 3.0 | 15 |
| Beef tenderloin (roasted) | 3 ounces | 3.0 | 15 |
| Turkey ( dark meat, roasted) | 3˝ ounces | 2.3 | 10 |
| Beef, eye of round (roasted) | 3 ounces | 2.2 | 10 |
| Turkey, light meat (roasted) | 3˝ ounces | 1.6 | 8 |
| Chicken, leg, meat only (roasted) | 3˝ ounces | 1.3 | 6 |
| Tuna, fresh bluefin (cooked) | 3 ounces | 1.1 | 6 |
| Chicken breast (roasted) | 3 ounces | 1.1 | 6 |
| Halibut (cooked) | 3 ounces | 0.9 | 6 |
| Blue crab (cooked) | 3 ounces | 0.8 | 4 |
| Pork loin (broiled) | 3 ounces | 0.8 | 4 |
| Tuna white (canned in water) | 3 ounces | 0.8 | 4 |
| Shrimp (mixed species, cooked) | 4 large | 0.7 | 4 |
| Food | Serving size |
Miligrams per serving |
% DV* |
|---|---|---|---|
| Ready-to-eat cereal (100% iron fortified | cup | 18.0 | 100 |
| Oatmeal, instant, fortified (prepared with water | 1 cup | 10.0 | 60 |
| Soybeans, mature (boiled) | 1 cup | 8.8 | 50 |
| Lentils (boiled) | 1 cup | 6.6 | 35 |
| Kidney beans mature (boiled) | 1 cup | 5.2 | 25 |
| Lima beans large, mature (boiled) | 1 cup | 4.5 | 25 |
| Navy beans mature (boiled) | 1 cup | 4.5 | 25 |
| Ready-to-eat cereal (25% iron fortified) | 1 cup | 4.5 | 25 |
| Black beans mature (boiled) | 1 cup | 3.6 | 20 |
| Pinto beans mature (boiled) | 1 cup | 3.6 | 20 |
| Molasses (blackstrap) | 1 tablespoon | 3.5 | 20 |
| Tofu (raw, firm) | ˝ cup | 3.4 | 20 |
| Spinach (boiled, drained) | ˝ cup | 3.2 | 20 |
| Spinach (canned, drained solids) | ˝ cup | 2.5 | 10 |
| Black-eyed peas (cowpeas) (boiled) | ˝ cup | 1.8 | 10 |
| Spinach (frozen, chopped, boiled) | ˝ cup | 1.9 | 10 |
| Grits (white, enriched | 1 cup | 1.5 | 8 |
| Raisins (seedless, packed) | ˝ cup | 1.5 | 8 |
| Whole wheat bread | 1 slice | 0.9 | 6 |
| White bread (enriched) | 1 slice | 0.9 | 6 |