Advertisement

Digestive Diseases and Sciences

, Volume 37, Issue 5, pp 733–736 | Cite as

Study of 47 consecutive patients with peptic esophageal stricture compared with 3880 cases of reflux esophagitis

  • M. Ben Rejeb
  • O. Bouché
  • P. Zeitoun
Original Articles

Abstract

The purpose of this study, making use of systematic records on computer over a period of 12 years, was to compare the prevalence and the demographic characteristics of patients with peptic stricture with those having a reflux esophagitis. As compared with 3880 cases of erosive and/or ulcerative esophagitis, the percentage of peptic stricture patients was 1.21%. The latter were on average nine years older and more frequently had a hiatus hernia. Ten patients with peptic stricture had had severe esophagitis previously recorded in our department. Thirty-four peptic stricture patients (72.3%) had at least one condition reported as possibly provocative of stricture. This study stresses the point that the incidence of peptic esophageal stricture is probably far lower than had been reported previously. Consequently, management of low-grade reflux esophagitis should be aimed primarily at relieving symptoms rather than healing esophageal lesions to prevent stricture.

Key Words

esophageal stenosis epidemiology esophagitis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Baldi F, Ferrarini F, Morselli Labarte AM, Barbara L: Prevalence of esophagitis in patients undergoing routine upper endoscopy: A multicenter survey in Italy.In Esophageal Disorders, Pathophysiology and Therapy. TR De Meester, DB Skinner (eds). New York, Raven Press, 1985, pp 213–219Google Scholar
  2. 2.
    Dedieu P, Gaillard F, Lavignolle A, Sugier H, Gibon M, Davely P, Perrin D, Miniconi P: Oesophagites par reflux: Aspects épidémiologiques, anatomopathologiques et évolutifs (123 cas). Gastroenterol Clin Biol 5:266–274, 1981Google Scholar
  3. 3.
    Henrion J, Heller F: Endobrachyoesophage (oesophage de Barrett). Etude clinique et endoscopique de 22 cas. Acta Gastroenterol Belg 46:207–219, 1983Google Scholar
  4. 4.
    Maxton DG, Ainley CC, Grainger SL, Morris RW, Thompson RPH: Teeth and benign oesophageal stricture. Gut 28:61–63, 1987Google Scholar
  5. 5.
    Savary M, Ollyo JB, Monnier P: L'oesophagite sténosante par reflux.In Troubles de la motricité de l'oesophage. Reflux gastro-oesophagien. JP Galmiche, R Colin (eds). Paris, Doin, 1987, pp 193–229Google Scholar
  6. 6.
    Stoker DL, Williams JG, Leicester RG, Colin-Jones DG: Oesophagitis—a five year review. Gut 29:1450, 1988 (abstract)Google Scholar
  7. 7.
    Lanza FL, Graham DY: Bougienage is effective therapy for most benign esophageal strictures. JAMA 240:844–847, 1978Google Scholar
  8. 8.
    Maratka Z: Terminology, definitions and diagnostic criteria in digestive endoscopy. Scand J Gastroenterol 19(suppl 103):27, 1984Google Scholar
  9. 9.
    Kaul B, Pettersen H, Myrvold HE, Grette K, Roysland P, Halvorsen T: Hiatus hernia in gastroesophageal reflux disease. Scand J Gastroenterol 21:31–34, 1986Google Scholar
  10. 10.
    Ollyo JB, Savary M, Hofstetter JR, Mosimann R, Gonvers JJ: Incidence endoscopique de l'oesophagite par reflux dans un collectif de 20467 patients. Schweiz Rundschau Med 73:1088–1089, 1984Google Scholar
  11. 11.
    Rago E, Boesby S, Spencer J: Results of Eder-Puestow dilatation in the management of esophageal peptic strictures. Am J Gastroenterol 78:6–8, 1983Google Scholar
  12. 12.
    Salo JA, Ala-Kulju K, Kalima T: Fibre-endoscopic dilatation of peptic oesophageal strictures. Acta Chir Scand 153:365–367, 1987Google Scholar
  13. 13.
    Watson A: The role of antireflux surgery combined with fiberoptic endoscopic dilatation in peptic esophageal stricture. Am J Surg 148:346–349, 1984Google Scholar
  14. 14.
    Wesdorp ICE, Bartelsman JFWM, Den Hartog Jager FCA, Huibregtse K, Tytgat GN: Results of conservative treatment of benign esophageal strictures: A follow-up study in 100 patients. Gastroenterology 82:487–493, 1982Google Scholar
  15. 15.
    Moghissi K: Intrathoracic fundoplication for reflux stricture associated with short esophagus. Thorax 38:36–40, 1983Google Scholar
  16. 16.
    Ogilvie AL, Ferguson R, Atkinson M: Outlook with conservative treatment of peptic oesophageal stricture. Gut 21:23–25, 1980Google Scholar
  17. 17.
    Mercer CD, Hill D: Surgical management of peptic esophageal stricture. Twenty-year experience. J Thor Cardiovasc Surg 91:371–378, 1986Google Scholar
  18. 18.
    Spechler S, Sperber H, Doos WG, Schimmel EM: The prevalence of Barrett's esophagus in patients with chronic peptic esophageal strictures. Dig Dis Sci 28:769–773, 1983Google Scholar
  19. 19.
    Ahtaridis G, Snape WJ, Cohen S: Clinical and manometric findings in benign peptic strictures of the esophagus. Dig Dis Sci 24:858–861, 1979Google Scholar
  20. 20.
    Zeitoun P, Carteret E: Natural history of reflux esophagitis in adults.In Control of Acid Secretion. M Mignon, JP Galmiche (eds). Paris, John Libbey, 1988, pp 225–238Google Scholar
  21. 21.
    Carteret E, Renard P, Aucouturier JP, Bouché O, Zeitoun P: Hiatus hernia and esophagitis: coincidence or necessity? Gastroenterology 98:28, 1990 (abstract)Google Scholar
  22. 22.
    Ball CS, Watson A: Acid sensitivity in reflux oesophagitis with and without complications. Gut 29:728, 1988 (abstract)Google Scholar
  23. 23.
    Volpicelli NA, Bedine MS, Hendrix TR: Absence of acid sensitivity in patients with benign esophageal stricture. Gastroenterology 68:1007, 1975 (abstract)Google Scholar
  24. 24.
    Pujol P, Galmiche JP, Poynard T, Barré P: Age et reflux gastro-oesophagien: Analyse uni- et multi-factorielle des données cliniques, endoscopiques et pHmétriques chez 274 patients. Gastroenterol Clin Biol 13:71, 1989 (abstract)Google Scholar
  25. 25.
    Zaninotto G, Bonavina L, Pianalto S, Fassina A, Ancona E: Esophageal strictures following nasogastric intubation. Int Surg 71:100–103, 1986Google Scholar
  26. 26.
    Heller SR, Fellows IW, Ogilvie AL, Atkinson M: Nonsteroidal anti-inflammatory drugs and benign oesophageal stricture. Br Med J 285:167–168, 1982Google Scholar
  27. 27.
    Wilkins WE, Ridley MG, Pozniak AL: Benign stricture of the oesophagus: Role of non steroidal anti-inflammatory drugs. Gut 25:478–480, 1984Google Scholar
  28. 28.
    Ollyo J, Gonvers JJ, Levi F, Wellinger J, Savary M: Barrett's oesophagus, reflux induced stricture and malignancies other than adenocarcinoma of the columnar lined lower esophagus. Gastroenterology 92:1560, 1987 (abstract)Google Scholar
  29. 29.
    Dodds WJ, Hogan WJ, Helm JF, Dent J: Pathogenesis of reflux esophagitis. Gastroenterology 81:276–294, 1981Google Scholar
  30. 30.
    Castell DO: Introduction to pathophysiology of gastroesophageal reflux.In Gastroesophageal Reflux Disease: Pathogenesis, Diagnosis, Therapy. DO Castell, WC Wu, DJ Ott (eds). Mt. Kisco, New York, Futura Publishing, 1985, pp 3–9Google Scholar

Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • M. Ben Rejeb
    • 1
  • O. Bouché
    • 1
  • P. Zeitoun
    • 1
  1. 1.Department of Hepato-gastroenterologyHôpital Robert DebréF-Reims CedexFrance

Personalised recommendations