Benign esophageal strictures are believed to develop as a result of chronic inflammation causing fibrous tissue formation and collagen deposition (Spechler, 1995). It is estimated that 65 to 70% of all benign strictures are peptic in origin and a result of chronic uncontrolled gastroesophageal reflux (a full list of other etiologies of esophageal strictures is listed in Table 17-1). Strictures become clinically apparent when patients complain of progressive dysphagia to solids. Heartburn, present in 75% of patients with peptic strictures, and chronic cough, regurgitation, and asthma can also be present. Symptoms may be subtle in which the patient slowly changes their eating habits or overt with recurrent food impactions.
Modern esophageal dilatation techniques can effectively eliminate symptoms of dysphagia in nearly all patients without the need for surgical intervention. An effective management strategy of esophageal strictures includes the use of optimal dilatation techniques and the appropriate management of the underlying causes.
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