Stricture oesophageal

More alkaline reflux in the oesophagus of Barrett s patients or patients with oesophagitis or stricture, compared to controls (uncomplicated GORD, volunteers or no GORD)... 

C. Visible oesophageal inflammation, ulcer or stricture Proton pump inhibitors e.g., omeprazole 20-40 mg daily, lansoprazole 30 mg daily, pantoprazole 40 mg daily, rabeprazole 20 mg daily... 

Direct treatment of varices by endoscopy is preferred. Band ligation, in which the varices are strangulated by application of small elastic bands has fewer complications than sclerotherapy, which involves injecting sclerosant into and around the varices but may lead to oesophagitis, stricture or embolisation of sclerosant. Either technique can control bleeding in about 90% of patients, and rebleeding is reduced if this direct treatment is combined with reduction of portal pressure (see below). 

Carbolic acid. Toxic by ingestion or through skin. Corrosive. Death generally due to respiratory depression. Renal damage can occur. Oesophageal stricture may be produced by drinking. Lethal dose adult 10-30 g. 

Fasulakis S, Andronikou S (2003) Balloon dilatation in children for esophageal strictures other than those due to primary repair of oesophageal atresia, interposition or restrictive fundoplication. Pediatr Radiol 33 682-687 Fernbach SK, Glass RBJ (1988) The expanded spectrum of limb anomalies in the VATER association. Pediatr Radiol 18 215-220... 

Oesophageal strictures in childhood can be the result of oesophageal surgery performed in the case of congenital oesophageal atresia (with strictures occurring in up to 70% of patients), or as a... 

London RL, Trotman RW, DiMarino AJJr, Oleaga JA, Frei-man DB, Ring EJ et al (1981) Dilatation severe oesophageal strictures by an inflatable balloon catheter. Gastroenterology 80 173-175... 

Said M, Mekki M, Golli M, Memmi F, Hafsa C, Braham R et al (2003) Balloon dilatation of anastomotic strictures secondary to surgical repair of oesophageal atresia. Br J Radiol 76 26-31... 

Swarbrick ET, Gough AL, Foster CS et al (1996) Prevention of recurrence of oesophageal stricture, a comparison of lansoprazole and high-dose ranitidine. Eur J Gastroenterol Hepatol 8 431-438... 

Irregularities of the oesophageal lumen secondary to ulcer deformities and scars are accurately depicted by high-quality contrast studies. Conversely erosions and shallow ulcers are easily overlooked therefore patients with GORD should be evaluated by endoscopy. Complicating strictures are readily managed at endoscopy by the use of hydrostatic balloons. 

This is mainly a classification of active disease and does not take complications of gastro-oesophageal reflux disease into account, i.e. scar formation and strictures. In dysphagic patients with no other symptom or sign of reflux oesophagitis, carcinoma of the oesophagus must be excluded. 

Submucosal lesions in the oesophagus are also encountered, a relatively rare one being intramural pseudodiverticulosis (Flora et al. 1997) (Fig. 4.26). This is a condition of unknown aetiology, but which has an association with diabetes, alcohol abuse, reflux disease, and oesophageal strictures. It is more commonly seen in patients with oesophageal carcinomas than in matched controls, and there... 

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