Does aspirin or nsaid use influence the success of esophageal dilation in patients with gerd strictures?

J. P. Waring, S. L. Kim, L. P. Davis, J. M. Wo, W. K. Fackler, J. G. Hunter

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Abstract

Several studies suggest that approximately 60% of patients with strictures due to gastroesophageal reflux disease (GERD) regularly take aspirin or a non-steroidal anti-inflammatory agent (ASA/NSAID). It is unknown if these medications interfere with medical/endoscopic treatment. AIM: To determine if continued ASA/NSAID use portends a poor prognosis in patients with GERD strictures. METHODS: We collected pre and post dilation symptom scores in 50 patients (18F, 32M) with distal esophageal strictures. The dysphagia score was obtained by adding the dysphagia frequency (never=0, intermittently=1, weekly=2, daily=3) to the diet score (no problems=0, problems with selected solids-1, all solids=2, liquids=3). GERD was treated with aggressive medical therapy. Patients were gradually dilated to 45-48 F during repeated dilation sessions. Once achieving this goal, dilations were performed on a PRN basis. Patients not responding to initial dilation sessions received intralesional steroid injection. RESULTS: Prior to dilation, 30 patients (60%) were taking ASA/NSAID and 30 (60%) had poorly controlled heartburn. During the dilation period, 22 patients continued ASA/NSAID. Heartburn was well controlled in 45 of the 50 patients. The patients had a mean of 2.3 dilations. Only 3 patients were treated with intralesional steroids. Table displays mean dysphagia scores: Age Pre-dilation Post-dilation All Patients 60.5 4.24 1.34* No ASA/NSAID 57.1 4.42 1.39* Continued ASA/NSAID 67.2 4.18 1.27* *p< 0.001 in all groups comparing pre and post scores. Patients continuing ASA/NSAID were older; otherwise there were no significant differences. Once the dilation goal was achieved and heartburn was under good control, only 12 patients required 38 dilations with a mean follow-up of 15 months. CONCLUSIONS: 1) GERD strictures usually respond to aggressive medical/endoscopic therapy. 2) Discontinuation of ASA/NSAID does not appear to be necessary for a successful outcome.

Original languageEnglish (US)
Pages (from-to)AB86
JournalGastrointestinal endoscopy
Volume45
Issue number4
DOIs
StatePublished - Jan 1 1997

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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