Prevention of stenoses following ingestion of caustic substances is not an indication for corticosteroids.

Overview

Afrequent complication on ingestion of acids or lye is the formation of esophageal strictures. There are conflicting views on the administration of corticosteroids for their prevention. Therefore the aim of the present

study was to compare present-day data in the literature and to assess corticosteroid therapy. Articles dealing with corrosive injury to the esophagus over the years 1991 – 2003 were researched on Medline and Scirus. The criterion for inclusion in the study was an endoscopically documented 2nd or 3rd degree of esophageal injury and at least 8-day therapy with corticosteroids or without corticosteroids. The data have been evaluated by the Pearson chi-square test at the 0.01 level of significance. There have been found six studies including 211 patients, of which four studies included the application of corticosteroids and two treated the patients without corticosteroids. Esophageal stenosis in 2nd degree injury was found in 15.4% of cases under corticosteroid therapy and in 6.3% of cases treated without corticosteroids, the difference not being statistically significant. In studies dealing with 3rd degree injury the incidence of strictures was significantly higher, namely 92.3%, in studies without corticosteroid therapy was only 23.1%.

A summary of the results of three overview studies in the years 1990 – 2004 including 505 patients only confirmed the following conclusion:

The analysis of studies has not demonstrated any favorable effect of corticosteroid therapy in 2nd and 3rd degree corrosive lesions of the esophagus. In 3rd degree injuries the results were even worse significantly. Corticosteroid therapy is not indicated in corrosive esophageal injury; even the worsening of healing and an increase in the number of esophageal strictures cannot be ruled out.

Key words:
corrosives – corticosteroids – esophagus – strictures