EGD Masterclass: EoE, Strictures, and Pre-malignant Gastric Conditions (Virtual Only) | January 2023-Dayna Early

Dayna Early_Diagnostic Approach to Strictures

Pdf Summary

In this document, Dr. Dayna Early discusses the diagnostic approach to esophageal strictures. She first lists the different types of esophageal strictures, including erosive esophagitis, peptic, rings or webs, eosinophilic esophagitis, radiation induced, malignant, caustic ingestion, and post surgical/anastamotic. She emphasizes the importance of taking a thorough patient history, paying attention to symptoms such as heartburn, intermittent episodes, progressive nature, food impaction, prior surgery or radiation, and "warning signs" like weight loss or hematemesis.<br /><br />Dr. Early then outlines the diagnostic approach, which involves imaging and endoscopy. Imaging, such as radiography, is helpful for subtle findings like rings or webs, as well as visualization of proximal and complex strictures. However, endoscopy is preferred as it allows for diagnosis (imaging and biopsies) and management (dilation) in the same setting.<br /><br />The document includes two patient stories to illustrate the diagnostic process. The first is an 80-year-old female who experienced choking and difficulty swallowing after a Father's Day dinner. The second is a 39-year-old male with intermittent dysphagia and two episodes of food impaction.<br /><br />Finally, Dr. Early provides some key take-home points. She highlights the importance of symptom characteristics and patient history in diagnosing the cause of esophageal strictures. She also emphasizes that imaging and endoscopy are usually necessary for diagnosis, with endoscopy being the preferred method.

Keywords

esophageal strictures

diagnostic approach

types of esophageal strictures

patient history

warning signs

imaging

endoscopy

radiography

dilation

key take-home points