Authors: Jeffrey S Olson David A Lieberman Amnon Sonnenberg
Publish Date: 2007/10/12
Volume: 53, Issue: 5, Pages: 1192-1197
Abstract
Aims To study practice patterns in the management of nonobstructive dysphagia among US gastroenterologists Data source Endoscopic data repository from 100 US gastroenterology practices during 1998–2003 Clinical Outcomes Research Initiative CORI Methods All initial esophagogastroduodenoscopies EGDs performed in adult patients between 1998 and 2003 n = 181261 were evaluated for demographic data endoscopic findings and the occurrence of esophageal dilation A case population of 7256 patients receiving empiric dilation for dysphagia for nonobstructive dysphagia was compared to a control population of 5764 patients with dilation for peptic strictures Results The group of patients with empiric dilation was younger than the group of patients with peptic strictures and contained more women Reflux symptoms and erosive esophagitis were less frequent in the empiric dilation group than in the strictures group Empiric dilations were mostly performed using rubber bougies whereas strictures were most frequently dilated over a guidewire For all types of dilators the diameters were significantly larger in empiric than stricture dilation Repeat dilations within 1 year after the initial procedure occurred in 4 of the empiric and 13 of the stricture dilations Conclusions Compared with the dilation of peptic strictures empiric dilation of nonobstructive dysphagia is a more common clinical practice that is performed in a different patient population and utilizes different techniquesThe Clinical Outcomes Research Initiative is supported with funding from the NIDDK grant U01DK05713206A1 In addition CORI has received support from the following entities to subsidize the infrastructure of its practicebased network AstraZeneca Novartis Bard International Pentax USA ProVation Endosoft GIVEN Imaging and Ethicon
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