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achalasia review

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https://www.readbyqxmd.com/read/28617027/efficacy-of-peroral-endoscopic-myotomy-compared-with-other-invasive-treatment-options-for-the-different-esophageal-motor-disorders
#1
Fermín Estremera-Arévalo, Eduardo Albéniz, María Rullán, Irene Areste, Rosa Iglesias, Juan José Vila
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. METHODS: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined...
June 15, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28575249/esophageal-distensibility-measurement-impact-on-clinical-management-and-procedure-length
#2
N K Ahuja, A Agnihotri, K L Lynch, D Hoo-Fatt, F Onyimba, M McKnight, F C Okeke, P Garcia, S Dhalla, E Stein, P J Pasricha, J O Clarke
Luminal distensibility measurement has demonstrated relevance to various disease processes, though its effects on clinical decision-making have been less well understood. This study aims to characterize the clinical impact of impedance planimetry measurement as well as the learning curve associated with its use in the esophagus. A single provider performed distensibility measurement in conjunction with upper endoscopy for a variety of clinical indications with the functional lumen imaging probe (FLIP) over a period of 21 months...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28566891/ling-classification-describes-endoscopic-progressive-process-of-achalasia-and-successful-peroral-endoscopy-myotomy-prevents-endoscopic-progression-of-achalasia
#3
Wen-Gang Zhang, En-Qiang Linghu, Ning-Li Chai, Hui-Kai Li
AIM: To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. METHODS: We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28549006/laparoscopic-heller-myotomy-versus-peroral-endoscopic-myotomy-poem-for-achalasia-a-systematic-review-and-meta-analysis
#4
Francisco Schlottmann, Daniel J Luckett, Jason Fine, Nicholas J Shaheen, Marco G Patti
OBJECTIVE: To compare the outcome of per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia. BACKGROUND: Over the last 2 decades, LHM has become the primary form of treatment in many centers. However, since the first description of POEM in 2010, this technique has widely disseminated, despite the absence of long-term results and randomized trials. METHODS: A systematic Medline literature search of articles on LHM and POEM for the treatment of achalasia was performed...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28536813/long-term-outcomes-of-heller-s-myotomy-and-balloon-dilatation-in-childhood-achalasia
#5
Efstratios Saliakellis, Nikhil Thapar, Derek Roebuck, Fernanda Cristofori, Kate Cross, Edward Kiely, Joseph Curry, Keith Lindley, Osvaldo Borrelli
Achalasia is a rare esophageal motility disorder: its optimal treatment in children is still a matter of debate. Records of children treated for achalasia, over an 18-year period, were reviewed.Forty-eight children (median age at diagnosis 10 years; range 3-17 years) were identified. Twenty-eight patients were initially treated with Heller's myotomy (HM) and 20 with balloon dilatation (BD). At last follow-up (median 3 years; range 1-5.5 years), 43.8% (21/48) of children were symptom free. The number of asymptomatic children was significantly higher among those treated initially with HM compared to BD (HM 15/28, 53...
May 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28529168/opioids-in-gastroenterology-treating-adverse-effects-and-creating-therapeutic-benefits
#6
Michael Camilleri, Anthony Lembo, David A Katzka
The use of opioid medications on both an acute and chronic basis is ubiquitous in the U.S. As opioid receptors densely populate the gastrointestinal tract, symptoms and side effects can be expected in these patients. In the esophagus, dysmotility may result manifesting with dysphagia and a syndrome indistinguishable from primary achalasia. In the stomach, a marked delay in gastric emptying may ensue with postprandial nausea and early satiety. Postoperatively, particularly with abdominal surgery, opioid induced ileus may ensue...
May 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28485000/simultaneous-diagnosis-of-familial-achalasia-report-of-two-cases
#7
Masato Hoshino, Nobuo Omura, Fumiaki Yano, Se Ryung Yamamoto, Minoru Matsuda, Katsuhiko Yanaga
BACKGROUND: Achalasia is a rare disease with a morbidity of 1 in 100,000, for which the exact mechanism of pathogenesis has not been clarified due to the small total number of patients. We herein report on our experience with two cases of familial achalasia in which the involvement of genetic inheritance was suspected. CASE PRESENTATION: These cases consist of a man in his thirties and his mother in her sixties. The son consulted the Department of Gastrointestinal Medicine at our institute with dysphagia, and an upper gastrointestinal endoscopy revealed a gastric submucosal tumor with a maximal diameter of approximately 50 mm...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28475741/clinical-presentation-and-disease-course-of-patients-with-esophagogastric-junction-outflow-obstruction
#8
K L Lynch, Y-X Yang, D C Metz, G W Falk
Esophagogastric junction outflow obstruction, characterized by preserved peristalsis in conjunction with an elevated integrated relaxation pressure, can result from specific anatomic variants or may represent achalasia in evolution. There is limited information on the clinical significance of this diagnosis. The aim of this study is to describe the clinical characteristics and outcomes in our cohort of patients with esophagogastric junction outflow obstruction.Consecutive adult patients who had undergone high-resolution esophageal manometry between February 2013 and November 2015 with a diagnosis of esophagogastric junction outflow obstruction were identified...
June 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28472017/systematic-review-and-meta-analysis-of-perioperative-outcomes-of-peroral-endoscopic-myotomy-poem-and-laparoscopic-heller-myotomy-lhm-for-achalasia
#9
Aiman Awaiz, Rossita M Yunus, Shahjahan Khan, Breda Memon, Muhammed A Memon
AIMS AND OBJECTIVES: Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM. MATERIALS AND METHODS: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed...
June 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28429200/achalasia-it-is-not-all-black-and-white
#10
REVIEW
Santosh Sanagapalli, Rami Sweis
PURPOSE OF REVIEW: This review aims to shed light on subtleties of achalasia diagnosis, including potential pitfalls that may lead to errors. Optimal methods for assessment of disease severity and the relationship between achalasia and other motility disorders will also be reviewed with an emphasis on recent findings from the literature. RECENT FINDINGS: Adjunctive testing with viscous substances or larger water volumes should be used routinely as it improves the accuracy of achalasia diagnosis...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#11
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
July 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28375450/patient-reported-outcome-measures-in-dysphagia-a-systematic-review-of-instrument-development-and-validation
#12
D A Patel, R Sharda, K L Hovis, E E Nichols, N Sathe, D F Penson, I D Feurer, M L McPheeters, M F Vaezi, David O Francis
OBJECTIVE: Patient-reported outcome (PRO) measures are commonly used to capture patient experience with dysphagia and to evaluate treatment effectiveness. Inappropriate application can lead to distorted results in clinical studies. A systematic review of the literature on dysphagia-related PRO measures was performed to (1) identify all currently available measures and (2) to evaluate each for the presence of important measurement properties that would affect their applicability. DESIGN: MEDLINE via the PubMed interface, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument database were searched using relevant vocabulary terms and key terms related to PRO measures and dysphagia...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28361839/peroral-endoscopic-myotomy-achieves-similar-clinical-response-but-incurs-lesser-charges-compared-to-robotic-heller-myotomy
#13
COMPARATIVE STUDY
Mouen A Khashab, Vivek Kumbhari, Alan H Tieu, Mohamad H El Zein, Amr Ismail, Saowanee Ngamruengphong, Vikesh K Singh, Anthony N Kalloo, John O Clarke, Ellen M Stein
BACKGROUND/AIM: Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. PATIENTS AND METHODS: A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28351117/clinical-characteristics-of-patients-with-untreated-achalasia
#14
Han Ho Jeon, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park, Jeffrey L Conklin
Background/Aims: Patients with untreated achalasia frequently complain of heartburn and regurgitation. The diagnosis of achalasia might be delayed because these symptoms are misinterpreted as gastroesophageal reflux. We aim to evaluate the clinical presentation, radiologic, and manometric findings in patient untreated achalasia. Methods: The records of patients diagnosed with primary achalasia between July 2004 and January 2012 at Gangnam Severance Hospital, Seoul, Korea were evaluated...
March 28, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/28350752/the-yield-of-endoscopic-investigation-for-unintentional-weight-loss
#15
Naim Abu-Freha, Yotam Lior, Shira Shoher, Victor Novack, Alexander Fich, Alexander Rosenthal, Ohad Etzion
AIM: The aim of this study was to assess the yield of endoscopic evaluation in isolated unintentional weight loss (UWL) patients compared with patients with weight loss and additional symptoms or signs. PATIENTS AND METHODS: A retrospective review of all patients who underwent an endoscopic evaluation for the investigation of UWL at Soroka University Medical Center between 2006 and 2012. Data on clinical indication, endoscopic, and laboratory finding were retrieved...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28319561/pediatric-enteric-neuropathies-diagnosis-and-current-management
#16
Maggie L Westfal, Allan M Goldstein
PURPOSE OF REVIEW: Neurointestinal diseases are increasingly recognized as causes of significant gastrointestinal morbidity in children. This review highlights the most common pediatric enteric neuropathies and their diagnosis and management, emphasizing insights and discoveries from the most recent literature available. RECENT FINDINGS: The embryologic and histopathologic causes of enteric neuropathies are varied. They range from congenital aganglionosis in Hirschsprung disease, to autoimmune-mediated loss of neuronal subtypes in esophageal achalasia and Chagas disease, to degenerative neuropathies in some cases of chronic intestinal pseudo-obstruction and gastroparesis...
June 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28300325/the-case-of-self-resolving-type-iii-achalasia-after-bilateral-lung-transplant
#17
P Aggarwal, V Bansal, N Aggarwal, Z Arora, S Murthy, S Gabbard
BACKGROUND: Post-surgical achalasia has been previously described in large case series but there are limited data on the natural progression of the disease process. In general, achalasia is considered an "incurable" disease as per published guidelines. We present here, the first report of a patient with post-surgical achalasia which resolved spontaneously. METHODS: This is a retrospective chart review. KEY RESULTS: A 60-year-old male presented for dysphagia 3 months status post-bilateral lung transplant and was diagnosed with achalasia following positive manometry...
March 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28275309/esophagogastric-junction-distensibility-assessed-using-the-functional-lumen-imaging-probe
#18
Joan W Chen, Joel H Rubenstein
AIM: To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP). METHODS: Systematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28265971/application-of-the-functional-lumen-imaging-probe-to-esophageal-disorders
#19
REVIEW
Dustin A Carlson, Ikuo Hirano
The functional luminal imaging probe (FLIP) provides a novel method to evaluate esophageal physiology and function in both health and disease. FLIP enables assessment of a previously underexplored component of esophageal function, distensibility, by utilizing high-resolution impedance planimetry to evaluate the relationship of the esophageal luminal geometry with pressure during controlled volumetric distension. Recent studies have described the potential utility of FLIP to evaluate the severity and effectiveness of therapy for esophageal diseases including achalasia, gastroesophageal reflux disease, and eosinophilic esophagitis...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28260955/peroral-endoscopic-myotomy-procedural-complications-and-pain-management-for-the-perioperative-clinician
#20
Lopa Misra, Norio Fukami, Katarina Nikolic, Terrence L Trentman
Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus...
2017: Medical Devices: Evidence and Research
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