Esophagitis, peptic ulcer and early stricture; non-surgical management.

In the management of esophagitis, peptic ulcer and early stricture, a basic medical program, including correction of dietary abuse, administration of antispasmodics and antacids, and treatment of existing oral infections, should be started promptly. Elevation of the head of the bed approximately six to eight inches helps to prevent acid regurgitation from the stomach, especially at night. In cases of early organic stricture of the lower esophageal segment, gentle, gradual and frequent dilatation of the esophagus may prove helpful. The dilatation should be carried out gradually over a period of weeks. One of the methods for this procedure is the use of bougies graduating in size. By following such a program of medical management and gentle dilatation until the disease entity remains quiescent and stationary, satisfactory results are obtained in a majority of cases and radical (and often disappointing) surgical procedures can be avoided.