Esophageal Stricture Medication

  • Author: Sandeep Mukherjee, MB, BCh, MPH, FRCPC; Chief Editor: Julian Katz, MD   more...
 
Updated: Jan 4, 2012
 

Medication Summary

Antisecretory medications are generally used for the treatment of acid-peptic stricture of the esophagus. PPIs are the most efficacious drugs, and the class is usually used routinely.

Next

Proton pump inhibitors

Class Summary

PPIs specifically inhibit the H+/K+ -ATPase enzyme system at the secretory surface of the gastric parietal cell, resulting in a potent antisecretory effect.

View full drug information

Omeprazole (Prilosec)

 

Decreases gastric acid secretion by inhibiting the parietal cell H+/K+ -ATP pump.

View full drug information

Lansoprazole (Prevacid)

 

Suppresses gastric acid secretion by specifically inhibiting H+/K+-ATPase enzyme system at the secretory surface of gastric parietal cells.

View full drug information

Rabeprazole (Aciphex)

 

Decreases gastric acid secretion by inhibiting the parietal cell H+/K+ ATP pump.

View full drug information

Pantoprazole (Protonix)

 

Decreases gastric acid secretion by inhibiting the parietal cell H+/K+ ATP pump.

View full drug information

Esomeprazole magnesium (Nexium)

 

S-isomer of omeprazole. Inhibits gastric acid secretion by inhibiting H+/K+ -ATPase enzyme system at secretory surface of gastric parietal cells.

Previous
Proceed to Follow-up
 
 
Contributor Information and Disclosures
Author

Sandeep Mukherjee, MB, BCh, MPH, FRCPC  Associate Professor, Department of Internal Medicine, Section of Gastroenterology and Hepatology, University of Nebraska Medical Center; Consulting Staff, Section of Gastroenterology and Hepatology, Veteran Affairs Medical Center

Sandeep Mukherjee, MB, BCh, MPH, FRCPC is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Merck Honoraria Speaking and teaching; Ikaria Pharmaceuticals Honoraria Board membership

Coauthor(s)

Rajeev Vasudeva, MD, FACG  Clinical Professor of Medicine, Consultants in Gastroenterology, University of South Carolina School of Medicine

Rajeev Vasudeva, MD, FACG is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, Columbia Medical Society, South Carolina Gastroenterology Association, and South Carolina Medical Association

Disclosure: Pricara Honoraria Speaking and teaching; UCB Consulting fee Consulting

Specialty Editor Board

Maurice A Cerulli, MD, FACP, FACG, FASGE, AGAF  Associate Professor of Clinical Medicine, Albert Einstein College of Medicine of Yeshiva University; Associate Professor of Clinical Medicine, Hofstra Medical School

Maurice A Cerulli, MD, FACP, FACG, FASGE, AGAF is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Medical Association, American Society for Gastrointestinal Endoscopy, and New York Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Simmy Bank, MD  Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

  1. Ahtaridis G, Snape WJ, Cohen S. Clinical and manometric findings in benign peptic strictures of the esophagus. Dig Dis Sci. Nov 1979;24(11):858-61. [Medline].

  2. Vega KJ, Chisholm S, Jamal MM. Comparison of reflux esophagitis and its complications between African Americans and non-Hispanic whites. World J Gastroenterol. Jun 21 2009;15(23):2878-81. [Medline].

  3. Lawson JD, Otto K, Grist W, Johnstone PA. Frequency of esophageal stenosis after simultaneous modulated accelerated radiation therapy and chemotherapy for head and neck cancer. Am J Otolaryngol. Jan-Feb 2008;29(1):13-9. [Medline].

  4. Chen AM, Li BQ, Jennelle RL, et al. Late esophageal toxicity after radiation therapy for head and neck cancer. Head Neck. Jun 17 2009;epub ahead of print. [Medline].

  5. Pace F, Antinori S, Repici A. What is new in esophageal injury (infection, drug-induced, caustic, stricture, perforation)?. Curr Opin Gastroenterol. Jul 2009;25(4):372-9. [Medline].

  6. Zografos GN, Georgiadou D, Thomas D, Kaltsas G, Digalakis M. Drug-induced esophagitis. Dis Esophagus. Apr 15 2009;[Medline].

  7. Ono S, Fujishiro M, Niimi K, Goto O, Kodashima S, Yamamichi N, et al. Predictors of postoperative stricture after esophageal endoscopic submucosal dissection for superficial squamous cell neoplasms. Endoscopy. Jun 29 2009;[Medline].

  8. Dakkak M, Hoare RC, Maslin SC. Oesophagitis is as important as oesophageal stricture diameter in determining dysphagia. Gut. Feb 1993;34(2):152-5. [Medline].

  9. Smith PM, Kerr GD, Cockel R. A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group. Gastroenterology. Nov 1994;107(5):1312-8. [Medline].

  10. Marks RD, Richter JE, Rizzo J. Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis. Gastroenterology. Apr 1994;106(4):907-15. [Medline].

  11. Swarbrick ET, Gough AL, Foster CS. Prevention of recurrence of oesophageal stricture, a comparison of lansoprazole and high-dose ranitidine. Eur J Gastroenterol Hepatol. May 1996;8(5):431-8. [Medline].

  12. Silvis SE, Farahmand M, Johnson JA. A randomized blinded comparison of omeprazole and ranitidine in the treatment of chronic esophageal stricture secondary to acid peptic esophagitis. Gastrointest Endosc. Mar 1996;43(3):216-21. [Medline].

  13. de Wijkerslooth LR, Vleggaar FP, Siersema PD. Endoscopic management of difficult or recurrent esophageal strictures. Am J Gastroenterol. Dec 2011;106(12):2080-91. [Medline].

  14. Fan Y, Song HY, Kim JH, Park JH, Ponnuswamy I, Jung HY, et al. Fluoroscopically guided balloon dilation of benign esophageal strictures: incidence of esophageal rupture and its management in 589 patients. AJR Am J Roentgenol. Dec 2011;197(6):1481-6. [Medline].

  15. Saeed ZA, Winchester CB, Ferro PS. Prospective randomized comparison of polyvinyl bougies and through-the- scope balloons for dilation of peptic strictures of the esophagus. Gastrointest Endosc. Mar 1995;41(3):189-95. [Medline].

  16. Scolapio JS, Pasha TM, Gostout CJ. A randomized prospective study comparing rigid to balloon dilators for benign esophageal strictures and rings. Gastrointest Endosc. Jul 1999;50(1):13-7. [Medline].

  17. Kozarek RA, Patterson DJ, Ball TJ. Esophageal dilation can be done safely using selective fluoroscopy and single dilating sessions. J Clin Gastroenterol. Apr 1995;20(3):184-8. [Medline].

  18. Pregun I, Hritz I, Tulassay Z, Herszenyi L. Peptic esophageal stricture: medical treatment. Dig Dis. 2009;27(1):31-7. [Medline].

  19. Kirsch M, Blue M, Desai RK. Intralesional steroid injections for peptic esophageal strictures. Gastrointest Endosc. Mar-Apr 1991;37(2):180-2. [Medline].

  20. Lee M, Kubik CM, Polhamus CD. Preliminary experience with endoscopic intralesional steroid injection therapy for refractory upper gastrointestinal strictures. Gastrointest Endosc. Jun 1995;41(6):598-601. [Medline].

  21. Kochhar R, Makharia GK. Usefulness of intralesional triamcinolone in treatment of benign esophageal strictures. Gastrointest Endosc. Dec 2002;56(6):829-34. [Medline].

  22. Dunne DP, Rupp T, Rex DK, Lehman GA. Five year follow-up of prospective randomized trial of Savary dilation with or without intra-lesional steroids for benign gastroesophageal reflux strictures [abstract]. Gastroenterology. 1999;116:A152.

  23. Ramage JI Jr, Rumalla A, Baron TH, et al. A prospective, randomized, double-blind, placebo-controlled trial of endoscopic steroid injection therapy for recalcitrant esophageal peptic strictures. Am J Gastroenterol. Nov 2005;100(11):2419-25. [Medline].

  24. Hishiki T, Kouchi K, Saito T, Terui K, Sato Y, Mitsunaga T, et al. Successful treatment of severe refractory anastomotic stricture in an infant after esophageal atresia repair by endoscopic balloon dilation combined with systemic administration of dexamethasone. Pediatr Surg Int. Jun 2009;25(6):531-3. [Medline].

  25. Raijman I, Siddique I, Rachal LT. Endoscopic stricturoplasty in the management of recurrent benign esophageal strictures. Gastrointest Endosc. 1999;49:AB172.

  26. Hagiwara A, Togawa T, Yamasaki J. Endoscopic incision and balloon dilatation for cicatricial anastomotic strictures. Hepatogastroenterology. Mar-Apr 1999;46(26):997-9. [Medline].

  27. Tang SJ, Singh S, Truelson JM. Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos). Surg Endosc. Jun 11 2009;[Medline].

  28. Repici A, Conio M, De Angelis C, et al. Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures. Gastrointest Endosc. Oct 2004;60(4):513-9. [Medline].

  29. Siersema PD. Stenting for benign esophageal strictures. Endoscopy. Apr 2009;41(4):363-73. [Medline].

  30. Han Y, Liu K, Li X, Wang X, Zhou Y, Gu Z, et al. Repair of massive stent-induced tracheoesophageal fistula. J Thorac Cardiovasc Surg. Apr 2009;137(4):813-7. [Medline].

  31. Thomson A, Baron TH. Esophageal stents: One size does not fit all. J Gastroenterol Hepatol. Jan 2009;24(1):2-4. [Medline].

  32. Vandenplas Y, Hauser B, Devreker T, Urbain D, Reynaert H. A biodegradable esophageal stent in the treatment of a corrosive esophageal stenosis in a child. J Pediatr Gastroenterol Nutr. Aug 2009;49(2):254-7. [Medline].

  33. Dunne D, Mercer D, Paterson WG. Decreasing frequency of esophageal dilation for peptic stricture correlates with omeprazole use. Can J Gastroenterol. 1997;11(suppl A):43A.

  34. Guda NM, Vakil N. Proton pump inhibitors and the time trends for esophageal dilation. Am J Gastroenterol. May 2004;99(5):797-800. [Medline].

  35. Agnew SR, Pandya SP, Reynolds RP. Predictors for frequent esophageal dilations of benign peptic strictures. Dig Dis Sci. May 1996;41(5):931-6. [Medline].

  36. American Society for Gastrointestinal Endoscopy. Antibiotic prophylaxis for gastrointestinal endoscopy. Gastrointest Endosc. Dec 1995;42(6):630-5. [Medline].

  37. Attwood SE, DeMeester TR, Bremner CG. Alkaline gastroesophageal reflux: implications in the development of complications in Barrett's columnar-lined lower esophagus. Surgery. Oct 1989;106(4):764-70. [Medline].

  38. Bell NJ, Burget D, Howden CW. Appropriate acid suppression for the management of gastro-oesophageal reflux disease. Digestion. 1992;51 Suppl 1:59-67. [Medline].

  39. Berenson GA, Wyllie R, Caulfield M. Intralesional steroids in the treatment of refractory esophageal strictures. J Pediatr Gastroenterol Nutr. Feb 1994;18(2):250-2. [Medline].

  40. Botoman VA, Surawicz CM. Bacteremia with gastrointestinal endoscopic procedures. Gastrointest Endosc. Oct 1986;32(5):342-6. [Medline].

  41. Cox JG, Winter RK, Maslin SC. Balloon or bougie for dilatation of benign oesophageal stricture? An interim report of a randomised controlled trial. Gut. Dec 1988;29(12):1741-7. [Medline].

  42. Dajani AS, Taubert KA, Wilson W. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. JAMA. Jun 11 1997;277(22):1794-801. [Medline].

  43. Graham DY, Saeed ZA. Guidewire-assisted esophageal dilation. Gastrointest Endosc. Nov-Dec 1991;37(6):650-1. [Medline].

  44. Heller SR, Fellows IW, Ogilvie AL. Non-steroidal anti-inflammatory drugs and benign oesophageal stricture. Br Med J (Clin Res Ed). Jul 17 1982;285(6336):167-8. [Medline].

  45. Kadakia SC, Parker A, Carrougher JG. Esophageal dilation with polyvinyl bougies, using a marked guidewire without the aid of fluoroscopy: an update. Am J Gastroenterol. Sep 1993;88(9):1381-6. [Medline].

  46. Kuo WH, Kalloo AN. Reflux strictures of the esophagus. Gastrointest Endosc Clin N Am. Apr 1998;8(2):273-81. [Medline].

  47. Mamazza J, Schlachta CM, Poulin EC. Surgery for peptic strictures. Gastrointest Endosc Clin N Am. Apr 1998;8(2):399-413. [Medline].

  48. Marks RD, Richter JE. Peptic strictures of the esophagus. Am J Gastroenterol. Aug 1993;88(8):1160-73. [Medline].

  49. Marks RD, Shukla M. Diagnosis and management of peptic esophageal strictures. Gastroenterologist. Dec 1996;4(4):223-37. [Medline].

  50. Meyer GW. Endocarditis prophylaxis for esophageal dilation: a confusing issue?. Gastrointest Endosc. Dec 1998;48(6):641-3. [Medline].

  51. Ott DJ, Gelfand DW, Lane TG. Radiologic detection and spectrum of appearances of peptic esophageal strictures. J Clin Gastroenterol. Feb 1982;4(1):11-5. [Medline].

  52. Patterson DJ, Graham DY, Smith JL. Natural history of benign esophageal stricture treated by dilatation. Gastroenterology. Aug 1983;85(2):346-50. [Medline].

  53. Pungpapong S, Raimondo M, Wallace MB, Woodward TA. Problematic esophageal stricture: an emerging indication for self-expandable silicone stents. Gastrointest Endosc. Nov 2004;60(5):842-5. [Medline].

  54. Richter JE. Peptic strictures of the esophagus. Gastroenterol Clin North Am. Dec 1999;28(4):875-91, vi. [Medline].

  55. Spechler SJ. AGA technical review on treatment of patients with dysphagia caused by benign disorders of the distal esophagus. Gastroenterology. Jul 1999;117(1):233-54. [Medline].

  56. Spechler SJ. American gastroenterological association medical position statement on treatment of patients with dysphagia caused by benign disorders of the distal esophagus. Gastroenterology. Jul 1999;117(1):229-33. [Medline].

  57. Spechler SJ. Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. The Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group. N Engl J Med. Mar 19 1992;326(12):786-92. [Medline].

  58. Vandenplas Y, Hauser B, Devreker T, Urbain D, Reynaert H. A degradable esophageal stent in the treatment of a corrosive esophageal stenosis in a child. Endoscopy. 2009;41 Suppl 2:E73. [Medline].

  59. Vollan G, Stangeland L, Soreide JA. Long term results after Nissen fundoplication and Belsey Mark IV operation in patients with reflux oesophagitis and stricture. Eur J Surg. Jun-Jul 1992;158(6-7):357-60. [Medline].

  60. Wilcox CM, Alexander LN, Clark WS. Localization of an obstructing esophageal lesion. Is the patient accurate?. Dig Dis Sci. Oct 1995;40(10):2192-6. [Medline].

  61. Wilkins WE, Ridley MG, Pozniak AL. Benign stricture of the oesophagus: role of non-steroidal anti- inflammatory drugs. Gut. May 1984;25(5):478-80. [Medline].

  62. Zein NN, Greseth JM, Perrault J. Endoscopic intralesional steroid injections in the management of refractory esophageal strictures. Gastrointest Endosc. Jun 1995;41(6):596-8. [Medline].

 
Previous
Next
 
Esophageal stricture. Endoscopic appearance of the distal esophagus showing a smooth stricture with a benign appearance.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.