Treatment of Esophageal Stricture in Gastroesophageal Reflux Disease

This protocol addresses peptic esophageal stricture located in the distal third of the esophagus, arising in the context of gastroesophageal reflux disease (GERD).

Clinical Scenario

GERD can cause chronic inflammation, ulceration, and fibrosis of the distal esophagus, leading to the formation of peptic strictures. The presence of a peptic stricture is itself considered conclusive evidence for a diagnosis of GERD. Patients typically present with dysphagia related to luminal narrowing in the distal esophagus.

Treatment Approach

Management combines endoscopic mechanical dilation of the stricture with indefinite acid suppressive therapy to address the underlying reflux-driven injury.

The complete regimen — including choice of dilation technique, specific acid suppressive agent, and follow-up algorithm — is detailed in the full protocol.

Treatment Goals

Resolution of the stricture and relief of dysphagia, typically achieved after fewer than 5 dilations, with ongoing acid suppression to prevent recurrence.

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References

DOI: 10.1016/j.giec.2025.02.002

Gastroesophageal reflux disease (GERD) can cause inflammation, ulceration, and fibrosis of the distal esophagus, leading to the development of peptic strictures.

Peptic strictures are conclusive evidence for a diagnosis of GERD.

They can be treated effectively with either balloon or bougie dilation, and usually resolve after less than 5 dilations.

Patients with this endoscopic finding should be kept on acid suppressive therapy indefinitely to help heal esophagitis and prevent stricture recurrence.

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