Current management of benign GOO begins with conservative measures such as IV PPIs, sucralfate, cessation of NSAIDs use, treatment of H. pylori when applicable, and gastric decompression. Recent research has shown the use of endoscopic balloon dilation and medical therapy to be associated with favorable long-term outcomes and is considered to be first-line treatment of benign GOO but one-third of patients may ultimately require surgical intervention.

 Still these strictures are difficult to manage conservatively and they usually require intervention to treat the stricture related complications. Although the surgical procedures are potentially curative, they are associated with high rates of morbidity and mortality.

Several non-surgical, minimally invasive options are available to treat benign strictures of the gastric outlet. These procedures, which can be performed endoscopically or fluoroscopically, include balloon dilation, temporary stent placement, intralesional steroid injection and incisional therapy with proton pump inhibitor. There is high prevelence of recurrence after treatment with PPI and CRE dilatation with unsatisfactory results.

Objective of the study- To assess the novel non surgical treatment modality for gastroduodenal ulcerative stricture

. Inclusion criteria -Patients aged more than 18 years, with benign gastroduodenal stricture related to NSAIDs, opiods, caustic and peptic.

Study methodology - Patients of benign ulcerated gastrotroduodenal stricture will be randomized (1:1) to PPI( Pantoprazole 40 mg BD) with CRE dilatation and misoprostol (400 mg TDS) plus pantoprazole 40 mg BD with CRE dilatation for 14 weeks.

 Outcome - Symptoms resolution ( heart burn, vomiting, abdomen pain and post prandial fullness), Need for CRE dilatataion( number of CRE dilatation session), Need for surgery, Improvement in nutritional status.