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- W1968059448 abstract "Gastric outlet obstruction (GOO) secondary to active peptic ulcer disease is generally associated with mucosal edema at the pyloro-duodenal channel and, to that end, should be improved, to an extent, by antisecretory therapy and food/fluid restriction.1Shabbir J. Durrani S. Ridgway P.F. et al.Proton pump inhibition is a feasible primary alternative to surgery and balloon dilatation in adult peptic pyloric stenosis (APS): report of six consecutive cases.Ann R Coll Surg Engl. 2006; 88: 174-175Crossref PubMed Scopus (2) Google Scholar What is unclear from the article by Cherian et al2Cherian P.T. Cherian S. Singh P. Long-term follow-up of patients with gastric outlet obstruction related to peptic ulcer disease treated with endoscopic balloon dilatation and drug therapy.Gastrointest Endosc. 2007; 66: 491-497Abstract Full Text Full Text PDF PubMed Scopus (65) Google Scholar is the extent to which only eradicating the cause of peptic ulcer disease could have improved the patient's symptoms, without the use of endoscopic balloon dilatation (EBD) at the outset. They note that 6 of 23 patients were on a proton pump inhibitor (PPI) at the time of endoscopic intervention. Could these patients have improved with balloon dilatation alone, without the need for maintaining antisecretory therapy, as these could have been pyloric strictures from inactive peptic ulcer disease? Chronic peptic strictures due to previous peptic ulcer disease require multiple EBD sessions, and antisecretory therapy carries little or no value in this setting. Did this cohort need more procedures than the other groups (Helicobacter pylori associated, idiopathic)? Moreover, the improvement in 16 of 23 patients who were on a higher dose of PPI could have been due to the effect of the PPI rather than the balloon dilatation (systematic bias), and the lack of a control group makes it difficult to make accurate assumptions. The observational nature of the study does little more than reinforce the value of treating the underlying cause for GOO and selecting patients for EBD who do not respond to drug therapy." @default.
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- W1968059448 date "2008-03-01" @default.
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- W1968059448 title "Benign pyloro-duodenal stenosis" @default.
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- W1968059448 doi "https://doi.org/10.1016/j.gie.2007.09.051" @default.
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