Abstract
Purpose of Review
This paper presents the author’s approach to esophageal dilation. It offers a tailored approach to the application of dilation to specific types of esophageal stenotic lesions.
Recent Findings
In patients with inflammatory stricture, recent studies confirm the importance of treating the underlying inflammatory condition in order to decrease the rate of recurrence. The paper reviews some of the novel techniques that have been suggested for the treatment of refractory benign esophageal strictures, including incisional therapy, stenting, or the injection steroids or antifibrotic agents.
Summary
The endoscopist who treats esophageal strictures must be familiar with the tools of the dilation and how they are best applied to specific types of stenotic lesions. If inflammation is present, effective management requires treatment of the inflammatory process in addition to mechanical dilation of the stenotic lesion. Controlled trials of novel approaches to treatment of refractory benign esophageal strictures are limited and will be necessary to determine efficacy.
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Notes
Atypical esophagitis associated with lymphocytic esophagitis and mucous membrane disorders (e.g., pemphigoid and lichen planus) can respond to dilatation in a manner similar to that of EoE, and I approach them in the same manner as I used for EoE.
References
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Ravich, W.J. Endoscopic Management of Benign Esophageal Strictures. Curr Gastroenterol Rep 19, 50 (2017). https://doi.org/10.1007/s11894-017-0591-8
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DOI: https://doi.org/10.1007/s11894-017-0591-8