The natural history of peptic oesophageal strictures treated by dilatation and antireflux therapy alone.

A total of 195 patients with benign peptic oesophageal strictures treated by endoscopic dilatation and antireflux medication between July 1977 and July 1986 were studied prospectively to determine the effect of such treatment on the subsequent course of this disease. Of the patients, 58% were female and they were significantly older than the males at the time of initial presentation (75 years vs 68 years, P less than 0.0001). 46% of both sexes required only one dilatation but the men required more dilatations over a longer period: 31% males vs 19% females required more than 3 dilatations (P less than 0.05) and 40% males vs 27% females were being dilated 2 years or more after the initial dilatation (P less than 0.05). Dilatation combined with antireflux medication is clearly an effective method of management for most patients with peptic oesophageal strictures. The value of antireflux surgery requires evaluation for that subset of patients, predominantly males, who require long-term and repeated dilatation.