Article Text
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
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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.