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yashmakca
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Quote yashmakca Replybullet Calendar Event: Strictures
    Posted: 16áSepá2017 at 6:53pm
Hi I am interested in this site, hoping to get some information and read others experiences. I am a 54 year old female who was diagnosed over 15 years ago with GERD and a hiatal hernia. I was symptomatic and was originally put on Prevacid but eventually changed to pariet 20mg twice a day and have been since. I have had several endos since and my GERD is chronic. I know my triggers and haven't been the most compliant patient. Now I'm showing symptoms of possible strictures and am scheduled for another endo. My last scope was 2 1/2 years ago and I'm a little worried wondering how advanced anything would be with possible progression and wondering if anyone has advice on strictures. Can strictures increase your chances of esophageal cancer and how often would I need to be checked after he first one is diagnosed?
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chrisrob
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Quote chrisrob Replybullet Posted: 16áSepá2017 at 7:13pm
Hi Yashmikca and welcome to the forum.

Strictures are not uncommon in those of us with acid reflux.
They may occur due to the inflammation of oesophagitis or they may occur as a body's response to reflux.

The body attempts to protect itself from the possible damage acid and reflux can cause. Hence It can produce Barrett's columnar cells to protect the oesophagus from erosion but,as this recent paper suggests, "motility disorders (hypertensive lower esophageal sphincter, achalasia, cricopharyngeal achalasia) and structural changes (Schatzki's ring, esophageal stricture, subglottic trachea stenosis), which develop as a complication of reflux may help to prevent aspiration that can cause new complaints and may lead to further complications."

Strictures can usually be dealt with fairly easily with dilation. There are some on here who have had it. Sometimes further dilation may be needed a few years further down the line, too.

All swallowing difficulties need to be investigated. There is always a very slight chance they could be from a tomour but that is very unlikely - and there is no evidence that strictures can be associated with an increased risk of progression towards the cancer.

Your PPIs (Prevacid = lansoprazole and Pariet = pantoprazole) reduce acid (and may protect against progression to cancer by 71% according to this meta-analysis) but they do not reduce reflux which has to be managed by lifestyle or surgery.
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yashmakca
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Quote yashmakca Replybullet Posted: 16áSepá2017 at 7:23pm
Thank you for your response and information. I'm very new to this site so it will take awhile for me to figure out how to use it exactly as I couldn't find your name to address you lol.
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yashmakca
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Quote yashmakca Replybullet Posted: 16áSepá2017 at 7:25pm
Thank you chrisrob for posting that information.
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Suzy
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Quote Suzy Replybullet Posted: 06áOctá2017 at 5:08pm
Hi Yashmakca

I hope all goes well for your next scope to investigate possible strictures.

I had this problem earlier in the year and was quite surprised when the Consultant couldn't get the scope down due to a stricture. He tried twice then aborted. I had a large stricture which was inflamed plus general Grade D oesophagitis. I was put on 80mg ppi for six weeks to try and reduce the oesophagitis and then they had another go but still couldn't get passed the stricture so did a balloon dilation. It's nothing to worry about, you will be knocked out and won't know a thing about it. You'll be given advice on what to eat and drink for the following 24 hrs. I was told I could carry on as normal on the day after the procedure. However I was quite uncomfortable the following day feeling generally rather fragile and sore. If I have to do it again I'll cancel plans for the day after the procedure and have a quiet day at home.

I don't know if strictures increase the chance of oesophageal cancer or not. I didn't ask. My Consultant did say he thought it was time to consider a fundoplication and that I could expect to be back for another dilation within a year. I'm six months on and all's still ok. I'm thinking about the op but haven't made a decision yet.     

On the plus side the dilation has eliminated all of the problems of food sticking, swallowing difficulties, pain and sickness. It's fantastic however on the minus side I have far more reflux problems as the oesophagus is now open and I'm still on 80mg ppi's a day. Not happy about that but you can't have everything!

Good luck. Keep us posted. I'd like to know how you get on and what they tell you about strictures.

Best wishes
Suzy
(Fellow Canadian living in UK)
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