Esophagus stricture

Long-term maintenance therapy should be considered to prevent complications and worsening of esophageal function in patients who have symptomatic relapse after discontinuation of therapy or dosage reduction, including patients with complications such as Barrett s esophagus, strictures, or hemorrhage. 

These symptoms may be indicative of complications of GERD such as Barrett s esophagus, esophageal strictures, or esophageal cancer. 

The PPIs are superior to H2RAs in patients with moderate to severe GERD. This includes not only patients with erosive esophagitis or complicated symptoms (Barrett s esophagus or strictures), but also those with non-erosive reflux disease who have moderate to severe symptoms. Symptomatic relief is seen in approximately 83% of patients and healing rates at 8 weeks as judged by endoscopy are 78%.1... 

Many patients with GERD relapse if medication is withdrawn, and long-term maintenance treatment is required in such patients.1 Candidates for maintenance therapy include patients whose symptoms return once therapy is discontinued or decreased, patients with complications such as Barrett s esophagus or strictures, and perhaps patients with atypical symptoms. 

CV RRR, normal S, S2 no murmurs, rubs, or gallops Abdomen Soft, non-tender, non-distended (+) bowel sounds, (-) hepatosplenomegaly, heme (-) stool Endoscopy Diffuse erythema and several isolated erosions in the distal esophagus no evidence of ulceration, obstruction, or stricture... 

Most infants have physiologic reflux with no clinical consequence.26 Complications, although rare, include distal esophagitis, failure to thrive, esophageal strictures, and Barrett s esophagus.27... 

Esophageal stricture Narrowing of the esophageal lumen. Esophageal strictures are usually benign and caused by acid refluxing into the lower esophagus. 

The explosion of a cylinder of lithium hydride led to eye contact and swallowing of a small amount of the dust by a technician. The resulting burns caused scarring of both corneas and strictures of the larynx, trachea, bronchi, and esophagus death occurred 10 months later. 

Hypersensitivity to bisphosphonates or any component of the products hypocalcemia (alendronate, risedronate, see Precautions) abnormalities of the esophagus that delay esophageal emptying such as stricture or achalasia (alendronate) inability to stand or sit upright for at least 30 minutes (alendronate, risedronate) clinically overt osteomalacia (etidronate). 

Proton pump inhibitors are the most effective agents for the treatment of nonerosive and erosive reflux disease, esophageal complications of reflux disease (peptic stricture or Barrett s esophagus), and extraesophageal manifestations of reflux disease. Once-daily dosing provides effective symptom relief and tissue healing in 85-90% of patients up to 15% of patients require twice-daily dosing. 

As lewisite is a vesicant, emesis is not recommended in those species that can vomit (dogs, cats, swine, and ferrets). Dilution with milk or water is recommended. Activated charcoal is not recommended as severe irritation/vesication of the esophagus or gastrointestinal tract is likely to occur. Endoscopy can be performed very carefully to determine the extent of injury. Esophageal perforation and/or stricture formation may occur. 

An esophageal stricture, with ulceration, inflammation, and fibrosis, has been reported in an elderly patient who had taken ascorbic acid for 2 months (37). A 500 mg tablet of ascorbic acid dissolves only slowly and is in vitro associated with a shift in saliva pH from 6.2 to 2.8. Since elderly individuals usually have less frequent esophageal contractions, it is not uncommon for this group to have a capsule lodged for a time in the esophagus (SEDA-13, 348) and it is entirely possible that cases like the above are more frequent than previously thought. 

Quinidine sometimes causes esophagitis (39,40), especially when there is some abnormality of the esophagus or cardiomegaly. This sometimes results in esophageal stricture (41). 

Benedict EB (1941) Carcinoma of the esophagus developing in benign stricture. New England Journal of Medicine 224 408-412. 

Radiographic evaluation of the GI tract often starts with plain films of the abdomen, which are straightforward, uncontrasted radiographs. Specific abdominal structures that may be identified include the kidney, ureters, and bladder (KUB) esophagus stomach intestine stones and vessels. Plain films are often used to evaluate abdominal pain. Clinicians frequently employ plain radiographic fluoroscopy to guide and position other instruments that are used to evaluate and treat GI disorders an example is the manipulation of dilation devices to treat esophageal strictures. Bowel obstruction and perforation are especially well identified by this technique. 

Barrett esophagus—Inflammatory changes in the esophagus resulting in replacement of epithelial lining by columnar-type cells that can lead to stricture or adenocarcinoma. 

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