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Temporal trends in new and recurrent oesophageal strictures in a Medicare population
Author(s) -
ELSERAG H. B.,
LAU M.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03310.x
Subject(s) - medicine , reflux , incidence (geometry) , population , esophageal disease , gastroenterology , disease , esophagus , surgery , physics , environmental health , optics
SUMMARY Background The widespread use of proton pump inhibitors for gastro‐oesophageal reflux disease could result in a decline in new as well as recurrent gastro‐oesophageal reflux disease‐related oesophageal strictures. The temporal trends of strictures have not been examined in population‐based studies. Methods To examine the temporal trends in strictures, we calculated the age‐adjusted incidence rates of new oesophageal strictures with or without oesophageal dilation in a sample of Medicare beneficiaries between 1992 and 2000. We also examined recurrent dilations recorded at least 3 months after a new stricture or the preceding recurrent stricture. Results The age‐adjusted rates for strictures accompanied with dilation declined by approximately 11% from 215 per million to 192 per million. New oesophageal strictures with dilation declined as a proportion of all upper endoscopies procedures (from 2.6% to 1.9%). Recurrent dilation within 1 year declined dramatically from 16% (9.5% CI: 12.5–20.3) in 1992 to 8% (95% CI: 4.43–10.62) in 2000. In multivariable proportional hazards model, there was a 30% risk reduction of recurrent oesophageal strictures. Conclusions This population‐based study indicates that the incidence of new as well as recurrent oesophageal strictures has been declining. In the face of rising incidence of other gastro‐oesophageal reflux disease‐related complications, it is important to understand the explanation of the present observations.