Esophageal Stricture Refractory to Weekly Dilations: What to Do When Target Diameter Is Not Achieved

This protocol covers the clinical scenario in which esophageal stricture has not responded sufficiently to a standard program of weekly endoscopic dilations — specifically, when the target esophageal diameter cannot be achieved or maintained despite repeated sessions.

Prior Treatment Line — Failure Condition

The previous approach consisted of weekly endoscopic dilations, continued with the goal of achieving and sustaining the target esophageal diameter. Progression to this protocol is indicated when that goal has not been met.

Next-Line Approach (overview — partial)

For strictures that remain refractory after repeated dilation, adjunctive endoscopic interventions are the next consideration. The full protocol specifies which approach is appropriate and how it is applied — details are available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.giec.2025.02.002

For refractory strictures, there may also be benefit in using adjunctive therapies, such as steroid injections or even stent placement.

Endoscopic intralesional injection therapy with corticosteroids can be done at the time of dilation for complex strictures.

Esophageal stent placement can be considered for refractory esophageal strictures, particularly when other measures including repeated weekly dilations have failed.

View source ↗