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Chirurgie 6. August 2015

Diagnosis and treatment of benign inflammatory esophageal diseases

Background: Nowadays, benign inflammatory esophageal diseases represent a rising socioeconomic burden. Recently, novel therapeutic approaches have been introduced to enrich personalized surgical options.

Methods: A PubMed research was conducted and merged with institutional guidelines and data.

Results: Magnetic sphincter augmentation strengthens the lower esophageal sphincter and therefore recreates the natural reflux barrier. Electrical sphincter stimulation offers the possibility to personalize minimal invasive treatment and considers even changing lifestyles. Endoscopic antireflux procedures try to mimic the outcome of laparoscopic fundoplication and aim to improve the angle of His. However, laparoscopic fundoplication remains the surgical treatment of choice in advanced reflux disease.

Reflux can also cause eosinophilic infiltration and therefore hinders diagnosis of eosinophilic esophagitis. Once diagnosis is established, dietary modifications and topical steroids offer relevant relief. Reflux produces Barrett’s esophagus, a neoplastic progression, which is commonly treated with radiofrequency ablation.

Conclusion: Novel therapeutic options are facing the rising incidence of benign inflammatory diseases.

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