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Nesreen Khidir, Luigi Angrisani, Jowhara Al-Qahtani, Sheraz Abayazeed, Moataz Bashah
BACKGROUND: Gastroesophageal reflux disease (GERD) occurs de novo or intensifies after sleeve gastrectomy (LSG). Endoscopic radiofrequency (Stretta) is a minimally invasive, effective tool to treat GERD. However, Stretta safety and efficacy are unknown in patients with GERD after LSG. To evaluate the safety and efficacy of Stretta treatment post-LSG GERD, quality of life, and PPI dose up to 6 months. METHODS: A retrospective review of all patients' data who underwent Stretta procedure in our center...
June 15, 2018: Obesity Surgery
Magnus Halland, John Pandolfino, Elizabeth Barba
Rumination syndrome is a functional gastrointestinal disorder characterized by effortless post-prandial regurgitation. The disorder appears uncommon, although only limited epidemiological data are available. Awareness of the characteristic symptoms is essential for recognizing the disorder, and thus avoiding the long delay in diagnosis which many patients experience. Whilst objective testing by post-prandial esophageal high resolution impedance manometry is available in select referral centers, a clinical diagnosis can be made in most patients...
June 11, 2018: Clinical Gastroenterology and Hepatology
Bengi Balci, Gizem Kilinc, Bülent Calik, Gökhan Akbulut
Introduction: Esophageal diverticulum is a rare entity with symptoms that include dysphagia, halitosis, chest pain, and regurgitation. Indications for surgery include the presence of any of these symptoms and a diverticulum larger than 3 cm because of the increased risk of malignancy and aspiration. Treatment is open or minimally invasive surgery performed from the transhiatal or transthoracic approach. Case Description: Three patients were investigated by esophagogastroduodenoscopy, esophageal manometry, and computed tomography and were given the diagnosis of epiphrenic diverticulum of the esophagus...
April 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Jan Kobal, Kolenc Matej, Matic Koželj, Simon Podnar
BACKGROUND: Huntington's disease (HD) patients often report anorectal dysfunction; however, in HD research no detailed analysis of these complaints has been published. OBJECTIVE: To report anorectal dysfunction in a systematically studied cohort of HD subjects. METHODS: In 54 HD patients (24 men) and 10 presymptomatic HD mutation carriers (2 men) and in 99 controls (44 men) a history of anal incontinence and constipation was obtained and data was compared accordingly...
June 4, 2018: Journal of Huntington's Disease
Henriette Heinrich, Benjamin Misselwitz
Functional anorectal disorders such as faecal incontinence (FI), functional anorectal pain, and functional defecation disorders (FDD) are highly prevalent and represent a high socioeconomic burden. Several tests of anorectal function exist in this setting; however, high-resolution anorectal manometry (HR-ARM) is a new tool that depicts pressure all along the anal canal and can assess rectoanal coordination. HR-ARM is used in the diagnosis of FI and especially FDD although data in health is still sparse, and pressure phenomena seen during simulated defecation, such as dyssynergia, are highly prevalent in health...
April 2018: Visceral Medicine
Maria Witte, Frank Schwandner, Ernst Klar
Background: Anorectal surgery covers a wide spectrum of surgery. Diagnostic workup of anorectal disease is based on clinical examination with basic functional tests followed by more elaborate diagnostic tests. Since the incidence of anorectal disorders increases with age, more patients will present in outpatient clinics, thus underlining the relevance of this topic. Methods: A PubMed literature search was performed using the terms 'anal incontinence', 'anal and rectal surgery', 'functional diagnostics', and combinations of these terms...
April 2018: Visceral Medicine
Ines Gockel, Sebastian Murad Rabe, Stefan Niebisch
Background: Indications for benign esophageal surgery and postoperative follow-up need to be highly elaborated with differentiated and structured algorithms, based on objective functional workup in the esophageal laboratory. Functional outcome is of utmost interest and has to be driven by the need for comprehensive but purposeful diagnostic methods. Methods: Preoperative diagnostic workup procedures by the functional laboratory include 24-h pH-monitoring, impedance testing, and high-resolution manometry (HRM) - in addition to upper gastrointestinal endoscopy and barium swallow/timed barium esophagogram...
April 2018: Visceral Medicine
Jutta Keller
International guidelines agree that high-resolution esophageal manometry (HRM) is an integral part of the diagnostic evaluation of patients with refractory reflux symptoms and should be performed before antireflux surgery. Its most important goal is to explore differential diagnoses, in particular major esophageal motility disturbances, that may be responsible for symptoms. HRM additionally provides insights into all relevant pathomechanisms of gastroesophageal reflux disease (GERD): It can reveal important information on the morphology and function of the esophagogastric junction (EGJ), the presence of a hiatus hernia, transient lower esophageal sphincter relaxations, and dysmotility of the esophageal body...
April 2018: Visceral Medicine
H F Wang, F Liu, M Wang, S Y Du, Y L Zhang
Objective: To compare the clinical data, esophageal motility and reflux characteristic in patients with non-erosive reflux disease (NERD) and reflux esophagitis (RE). Methods: A total of 167 patients of NERD were enrolled in the study[60 males, 107 females, mean age(44.1±13.4) years old], and 151 patients of RE were enrolled [74 males, 77 females, mean age(46.5±9.9) years old]. All patients were surveyed by questionnaires to investigate the clinical data. All patients accepted the esophageal highresolution manometry and 24 hours pH+ impedance monitoring to investigate the esophageal motility and reflux characteristic...
May 29, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Ji-Hong Chen, Jan D Huizinga
No abstract text is available yet for this article.
June 7, 2018: Digestive Diseases and Sciences
Sergey Morozov, Vasily Isakov, Mariya Konovalova
AIM: To investigate the effect of dietary fiber on symptoms and esophageal function testing parameters in non-erosive gastroesophageal reflux disease (GERD) (NERD) patients. METHODS: Thirty-six NERD patients with low (< 20 g/d) dietary fiber intake were enrolled in the study. They were examined with the use of symptom questionnaire (GERD-Q), high-resolution esophageal manometry, 24-h esophageal pH-impedance examinations, and food frequency questionnaire before and after 10 d of usual diet supplemented by psyllium 5...
June 7, 2018: World Journal of Gastroenterology: WJG
Cosimo Alex Leo, Emanuel Cavazzoni, Gregory P Thomas, Jonathan Hodgkison, Jamie Murphy, Carolynne J Vaizey
Background/Aims: The Anopress device is a new portable manometry system. The aim of this study is to formulate normative data using this new device by recording the anorectal function of asymptomatic subjects. Patient comfort was also assessed. Methods: Anorectal function was assessed in asymptomatic volunteers using the Anopress. All volunteers were examined in a standardized way in accordance with the study protocol. Normative values for the Anopress were obtained from the recorded data and patient comfort was assessed using a visual analogue scale...
June 7, 2018: Journal of Neurogastroenterology and Motility
Yeong Yeh Lee, Askin Erdogan, Siegfried Yu, Annie Dewitt, Satish S C Rao
Background/Aims: Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known. Methods: Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down "on-bed" without inflated rectal balloon and "on-commode (toilet)" with 60-mL inflated rectal balloon...
June 7, 2018: Journal of Neurogastroenterology and Motility
Mark R Fox, Peter J Kahrilas, Sabine Roman, C Prakash Gyawali, S Mark Scott, Satish S Rao, Jutta Keller, Michael Camilleri
Symptoms related to abnormal gastrointestinal motility and function are common. Oropharyngeal and oesophageal dysphagia, heartburn, bloating, abdominal pain and alterations in bowel habits are among the most frequent reasons for seeking medical attention from internists or general practitioners and are also common reasons for referral to gastroenterologists and colorectal surgeons. However, the nonspecific nature of gastrointestinal symptoms, the absence of a definitive diagnosis on routine investigations (such as endoscopy, radiology or blood tests) and the lack of specific treatments make disease management challenging...
June 5, 2018: Nature Reviews. Gastroenterology & Hepatology
Dakshitha Praneeth Wickramasinghe, Umesh Jayarajah, Dharmabandhu Nandadeva Samarasekera
OBJECTIVES: Anorectal manometry (ARM) is an integral part of evaluating the anal sphincter function. The current recommendation of waiting for 5 min (lead-in-time) prior to beginning the recording has no evidence. A prolonged procedure may reduce patient compliance. RESULTS: We analyzed data from 100 consecutive patients who underwent 3-dimensional ARM at a single center. Their pressure studies were analyzed in consecutive 10-s segments, beginning from the time of insertion of the probe into the anal canal...
June 5, 2018: BMC Research Notes
Yasutaka Kuribayashi, Toshiro Iizuka, Kosuke Nomura, Tsukasa Furuhata, Satoshi Yamashita, Akira Matsui, Daisuke Kikuchi, Toshifumi Mitani, Mitsuru Kaise, Shu Hoteya
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) for superficial esophageal cancer is sometimes extensive, and in our experience, patients not infrequently present with dysphagia after ESD even in the absence of esophageal stricture. The aim of this study was to evaluate esophageal motility using high-resolution manometry (HRM) in patients with and without dysphagia after extensive circumferential ESD. METHODS: HRM was performed in a total of 52 patients who had undergone ESD for superficial esophageal cancer and a mucosal defect after ESD exceeded more than two-thirds of the esophageal circumference...
June 5, 2018: Digestion
Jacqueline K Benfield, Lisa F Everton, Philip M Bath, Timothy J England
OBJECTIVE: To describe and systematically review the current evidence on the effects of swallow therapy augmented by biofeedback in adults with dysphagia (PROSPERO 2016:CRD42016052942). DATA SOURCES: Two independent reviewers conducted searches which included MEDLINE, EMBASE, trial registries and grey literature up to December 2016. STUDY SELECTION: Randomised controlled trials (RCTs) and non-RCTs were assessed, including for risk of bias and quality...
May 30, 2018: Archives of Physical Medicine and Rehabilitation
James L West, Garret P Greenway, Rebecca M Garner, Carol A Aschenbrenner, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
INTRODUCTION: The relationship between degree of angiographic venous sinus stenosis and the trans-stenosis pressure gradient magnitude in idiopathic intracranial hypertension (IIH) is poorly understood. The present study aimed to assess the utility of angiography, venography, and non-invasive imaging (MRV or CTV) for the diagnosis and characterization of clinically significant VSS. METHODS: Retrospective analysis of a prospectively collected database was performed to identify patients with medically refractory IIH who were evaluated by angiography and venous manometry for the presence of VSS with associated clinically significant pressure gradient...
June 1, 2018: Journal of Neurointerventional Surgery
Juan Gomez Cifuentes, Rocio Lopez, Prashanthi N Thota
BACKGROUND: Patients with non-cardiac chest pain (NCCP) are referred for esophageal motility testing and pH monitoring since gastroesophageal reflux disease (GERD) and esophageal motility disorders are frequently encountered in these patients. Our aim was to determine the prevalence and distribution of these disorders and to identify predictors of abnormal esophageal function testing. METHODS: We performed a retrospective study of NCCP patients who presented after a negative cardiac evaluation and underwent esophageal manometry, esophageal pH monitoring and upper endoscopy from January 2010 to January 2017...
May 30, 2018: Scandinavian Journal of Gastroenterology
J D G Cifuentes, P N Thota, R Lopez
Opiates can cause heartburn and spastic esophageal dysmotility but their role in noncardiac chest pain (NCCP) is not known. Our aim was to characterize opiate effects on esophageal function using esophageal pH monitoring and high-resolution manometry (HREM) in these patients.We performed a cross sectional study of opiate users with NCCP who underwent HREM and esophageal pH study from 2010 to 2017 using opiate nonusers as a comparison group. Demographic data, symptoms, opiate use, endoscopic findings, esophageal pH study parameters, and HREM data were abstracted...
May 26, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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