Article Text

Download PDFPDF

UK guidelines on oesophageal dilatation in clinical practice
  1. Sarmed S Sami1,
  2. Hasan N Haboubi2,
  3. Yeng Ang3,4,
  4. Philip Boger5,
  5. Pradeep Bhandari6,
  6. John de Caestecker7,
  7. Helen Griffiths8,
  8. Rehan Haidry9,
  9. Hans-Ulrich Laasch10,
  10. Praful Patel5,
  11. Stuart Paterson11,
  12. Krish Ragunath12,
  13. Peter Watson13,
  14. Peter D Siersema14,
  15. Stephen E Attwood15
  1. 1 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Cancer Biomarker Group, Swansea Medical School, Swansea University, Swansea, UK
  3. 3 Department of GI Sciences, University of Manchester, Manchester, UK
  4. 4 Salford Royal NHS Foundation Trust, Salford, UK
  5. 5 Department of Gastroenterology, Southampton University Hospital, Southampton, UK
  6. 6 Department of Gastroenterology, Portsmouth University Hospitals NHS Trust, Portsmouth, UK
  7. 7 Digestive Diseases Centre, University Hospitals of Leicester, Leicester, UK
  8. 8 Department of Gastroenterology, Wye Valley NHS Trust, Wye Valley, UK
  9. 9 Department of Gastroenterology, University College Hospital, London, UK
  10. 10 Department of Radiology, The Christie NHS Foundation Trust, Manchester, UK
  11. 11 Department of Gastroenterology, NHS Forth Valley, Stirling, UK
  12. 12 NIHR Nottingham Digestive Diseases Biomedical Research Centre, Queens Medical Centre, Belfast, UK
  13. 13 Faculty of Medicine Health and Life Sciences, Queen’s University Belfast, Belfast, UK
  14. 14 Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands
  15. 15 Department of Surgery, Durham University, Durham, UK
  1. Correspondence to Professor Stephen E Attwood, Department of Surgery, Durham University, Durham DH13HP, UK; seaattwood{at}gmail.com

Abstract

These are updated guidelines which supersede the original version published in 2004. This work has been endorsed by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the oesophageal section of the BSG. The original guidelines have undergone extensive revision by the 16 members of the Guideline Development Group with representation from individuals across all relevant disciplines, including the Heartburn Cancer UK charity, a nursing representative and a patient representative. The methodological rigour and transparency of the guideline development processes were appraised using the revised Appraisal of Guidelines for Research and Evaluation (AGREE II) tool.

Dilatation of the oesophagus is a relatively high-risk intervention, and is required by an increasing range of disease states. Moreover, there is scarcity of evidence in the literature to guide clinicians on how to safely perform this procedure. These guidelines deal specifically with the dilatation procedure using balloon or bougie devices as a primary treatment strategy for non-malignant narrowing of the oesophagus. The use of stents is outside the remit of this paper; however, for cases of dilatation failure, alternative techniques—including stents—will be listed. The guideline is divided into the following subheadings: (1) patient preparation; (2) the dilatation procedure; (3) aftercare and (4) disease-specific considerations. A systematic literature search was performed. The Grading of Recommendations Assessment, Develop­ment and Evaluation (GRADE) tool was used to evaluate the quality of evidence and decide on the strength of recommendations made.

  • oesophageal strictures
  • oesophagitis
  • achalasia
  • dysphagia

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Contributors All authors contributed equally to the development of this guideline.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests PDS received research support from Boston Scientific and Cook Medical. YA received research support from Medtronic and is a member of the Clinical Services and Standards Committee of the British Society of Gastroenterology and the UK and Ireland RFA user group. SEA received consultancy fees from Dr Falk Pharma.

  • Provenance and peer review Not commissioned; externally peer reviewed.