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https://www.readbyqxmd.com/read/29351396/mechanisms-of-repetitive-retrograde-contractions-in-response-to-sustained-esophageal-distension-a-study-evaluating-patients-with-post-fundoplication-dysphagia
#1
Dustin A Carlson, Peter J Kahrilas, Katherine Ritter, Zhiyue Lin, John E Pandolfino
BACKGROUND: Repetitive, retrograde contractions (RRCs) in response to sustained esophageal distension are a distinct contractility pattern observed with functional luminal imaging probe (FLIP) panometry that are common in type III (spastic) achalasia. RRCs are hypothesized to be indicative of either impaired inhibitory innervation or esophageal outflow obstruction. We aimed to apply FLIP panometry to patients with post-fundoplication dysphagia (a model of esophageal obstruction) to explore mechanisms behind RRCs...
December 21, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29343623/identifying-dna-methylation-biomarkers-for-non-endoscopic-detection-of-barrett-s-esophagus
#2
Helen R Moinova, Thomas LaFramboise, James D Lutterbaugh, Apoorva Krishna Chandar, John Dumot, Ashley Faulx, Wendy Brock, Omar De la Cruz Cabrera, Kishore Guda, Jill S Barnholtz-Sloan, Prasad G Iyer, Marcia I Canto, Jean S Wang, Nicholas J Shaheen, Prashanti N Thota, Joseph E Willis, Amitabh Chak, Sanford D Markowitz
We report a biomarker-based non-endoscopic method for detecting Barrett's esophagus (BE) based on detecting methylated DNAs retrieved via a swallowable balloon-based esophageal sampling device. BE is the precursor of, and a major recognized risk factor for, developing esophageal adenocarcinoma. Endoscopy, the current standard for BE detection, is not cost-effective for population screening. We performed genome-wide screening to ascertain regions targeted for recurrent aberrant cytosine methylation in BE, identifying high-frequency methylation within the CCNA1 locus...
January 17, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29333061/critical-appraisal-of-rome-iv-criteria-hypersensitive-esophagus-does-belong-to-gastroesophageal-reflux-disease-spectrum
#3
REVIEW
Leonardo Frazzoni, Marzio Frazzoni, Nicola de Bortoli, Salvatore Tolone, Irene Martinucci, Lorenzo Fuccio, Vincenzo Savarino, Edoardo Savarino
The Rome IV Committee introduced a major change in the classification of functional gastrointestinal disorders, proposing a more restrictive definition of gastroesophageal reflux disease (GERD). It was suggested that hypersensitive esophagus (HE) may sit more firmly within the functional realm. It was suggested that GERD diagnosis should be based upon abnormal acid exposure time (AET) only, implying no advantage of impedance-pH over pH monitoring. Symptom association probability (SAP), symptom index (SI) and heartburn relief with proton pump inhibitor (PPI) therapy were regarded as unreliable, whereas a lack of response to PPI was considered as evidence of functional heartburn...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29305305/the-safety-and-efficacy-of-the-procedureless-intragastric-balloon
#4
Salman Alsabah, Eliana Al Haddad, Shehab Ekrouf, Ahmad Almulla, Saud Al-Subaie, Mubarak Al Kendari
BACKGROUND: Obesity is on a continuous rise worldwide, and with it, novel bariatric procedures have emerged. The introduction of gastric balloons has opened up a nonsurgical option for patients opting for it. However, they still require some form of sedation and endoscopy for insertion and/or removal. OBJECTIVES: The Elipse balloon is a novel creation that has managed to bypass both these procedures; therefore, the investigation into its effectiveness is of importance...
December 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29216832/a-long-surviving-patient-with-advanced-esophageal-basaloid-squamous-cell-carcinoma-treated-only-with-radiotherapy-case-report-and-literature-review
#5
Toshiya Maebayashi, Naoya Ishibashi, Takuya Aizawa, Masakuni Sakaguchi, Homma Taku, Moritaka Ohhara, Toshirou Takimoto, Yoshiaki Tanaka
BACKGROUND: Esophageal basaloid squamous cell carcinoma (EBSCC) is a rare malignant disease. Advanced EBSCC (AEBSCC) has a poorer prognosis than the more common esophageal squamous cell carcinoma, but no treatment policy has yet been established. This is the first reported case with AEBSCC treated only with radiotherapy. Thus, our long-surviving patient merits consideration. We therefore reviewed cases with the same stage of AEBSCC for further investigation. CASE PRESENTATION: An 85-year-old man with a chief complaint of difficulty swallowing foods was diagnosed with AEBSCC, cT3N1M0, stage III, by thorough examination...
December 8, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29208549/the-natural-history-of-achalasia-evidence-of-a-continuum-the-evolutive-pattern-theory
#6
Renato Salvador, Guerrino Voltarel, Edoardo Savarino, Giovanni Capovilla, Elisa Pesenti, Anna Perazzolo, Loredana Nicoletti, Andrea Costantini, Stefano Merigliano, Mario Costantini
BACKGROUND: It is currently unclear if the three manometric patterns of esophageal achalasia represent distinct entities or part of a disease continuum. The study's aims were: a) to test the hypothesis that the three patterns represent different stages in the evolution of achalasia; b) to investigate whether manometric patterns change after Laparoscopic-Heller-Dor (LHD). METHODS: We assessed the patients diagnosed with achalasia who underwent LHD as their first treatment from 1992 to 2016...
November 26, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29168642/a-new-swallowable-intragastric-balloon-elipse%C3%A2-coffee-for-everybody-the-position-of-gettemo
#7
Eduardo Espinet Coll, Javier Nebreda Durán, Gontrand López-Nava Breviere
Recently, the Elipse® swallow balloon with spontaneous evacuation has been incorporated. GETTEMO wants to position defending innovations in endoscopic treatment of bariatric patients, including this new gastric balloon. Any bariatric endoscopic procedure must always be done within a suitable protocol and in a Multidisciplinary Unit. In order to ensure maximum safety and to be able to effectively solve potential complications, in most of the cases a prior endoscopy should be required to rule out complications, the balloon must be implanted (or supervised) by a bariatric endoscopist and it is necessary to have an Endoscopic Emergency Department...
November 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29152989/real-time-visualization-may-be-advisable-to-exclude-aspiration-in-patients-undergoing-capsule-endoscopy-examination
#8
Davide Giuseppe Ribaldone, Mauro Bruno, Paolo Solidoro, Claudio De Angelis
Capsule endoscopy (CE) is currently considered as a first line diagnostic tool for small bowel examination. Some patients find swallowing the capsule difficult. However, capsule aspiration is relatively uncommon and is only reported in isolated cases. The majority of these cases are male (39/41; 95.1%) with an age ranging from 56-93 years and only 4 (9.8%) patients had a recorded history of dysphagia. Twenty-four out of 41 (58.5%) patients experienced symptoms of capsule aspiration. The aspiration self-resolved in 11/41 patients and the CE was retrieved during bronchoscopy in the other cases...
November 20, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29141375/-relationship-between-the-severity-of-reflux-esophagitis-and-the-esophageal-motility-features-on-high-resolution-manometry
#9
Z W Hu, Z G Wang, J M Wu, S R Tian, Y Zhang, X L Zhan, X Du, F Wang, R H Xin, H Xu
Objective: To analyze esophageal motility dysfunction in gastroesophageal reflux disease (GERD) with different severity of esophagitis, and the relationship between the esophageal motility dysfunction and the severity of esophagitis. Methods: GERD patients simultaneously undergone endoscopy and high-resolution manometry were divided into four groups: Non-esophagitis (Non-erosive gastroesophageal reflux disease, NERD) group, mild esophagitis group, moderate esophagitis group and severe esophagitis group. The gender and age were matched for each group, and every group consisted of 80 cases...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29138887/-developments-in-dysphagia-diagnostics-presentation-of-an-interdisciplinary-concept
#10
REVIEW
C Pflug, T Flügel, J C Nienstedt
Demographic developments and medical progress will cause the already high prevalence of swallowing disorders to increase further in the future. With the same number of specialists and economic resources, it is necessary to improve the efficiency of dysphagia diagnostics and continue to offer patients a treatment concept tailored to their needs. Manifold and often co-existing causes of dysphagia require interdisciplinary cooperation in this area. Endoscopic swallowing diagnostics play a prominent role in dysphagia diagnostics and should always contain thorough endoscopy of the upper aerodigestive tract-the domain of the ENT specialist and phoniatrician...
November 14, 2017: HNO
https://www.readbyqxmd.com/read/29133255/high-prevalence-of-barrett-s-esophagus-and-esophageal-squamous-cell-carcinoma-after-repair-of-esophageal-atresia
#11
Floor W T Vergouwe, Hanneke IJsselstijn, Katharina Biermann, Nicole S Erler, René M H Wijnen, Marco J Bruno, Manon C W Spaander
BACKGROUND & AIMS: Esophageal atresia is rare, but improved surgical and intensive care techniques have increased rates of survival in children, so there are now many adults with this disorder. Many patients with esophageal atresia develop gastroesophageal reflux (GER), raising concerns about increased risk of Barrett's esophagus (BE; prevalence of 1.3%-1.6% in general population) and esophageal carcinoma. We assessed the prevalence of BE and esophageal carcinoma in this population. METHODS: We performed a prospective study of 289 patients with esophageal atresia at the Department of Gastroenterology and Hepatology at Erasmus MC University Medical Center in The Netherlands, from May 2012 through March 2017...
November 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29118840/too-many-pills-to-swallow-a-case-of-a-mixed-overdose
#12
Louise Emily Hopkins, Jonathan Sunkersing, Andrew Jacques
Propranolol is a highly lipid-soluble beta-receptor antagonist. We describe a case of mixed overdose, including propranolol, amlodipine and olanzapine, resulting in severe resistant hypotension which was successfully treated. A 21-year-old student ingested 6.4 g of propranolol, 280 mg of amlodipine and 560 mg of olanzapine. The patient was brought to the emergency department and exhibited signs of severe systemic toxicity - profound hypotension and circulatory collapse, respiratory depression and coma...
August 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29110963/gastric-preparation-for-magnetically-controlled-capsule-endoscopy-a-prospective-randomized-single-blinded-controlled-trial
#13
Shu-Guang Zhu, Yang-Yang Qian, Xin-Ying Tang, Qian-Qian Zhu, Wei Zhou, Han Du, Wei An, Xiao-Ju Su, An-Jing Zhao, Hey-Long Ching, Mark Edward McAlindon, Zhao-Shen Li, Zhuan Liao
BACKGROUND AND AIMS: Magnetically controlled capsule endoscopy (MCE) is a novel technique for which there is no agreed gastric preparation. We aimed to determine an optimal standardized gastric preparation regimen. METHODS: 120 patients referred for MCE were randomly assigned to gastric preparation with either water alone (A), water with simethicone (B) or water, simethicone and pronase (C). Image quality was assessed using cleanliness and visualization scores, higher scores equating to better image quality...
October 6, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29104588/preoperative-diagnosis-of-hiatal-hernia-barium-swallow-x-ray-high-resolution-manometry-or-endoscopy
#14
Michael Weitzendorfer, Gernot Köhler, Stavros A Antoniou, Leo Pallwein-Prettner, Lisa Manzenreiter, Philipp Schredl, Klaus Emmanuel, Oliver Owen Koch
Background: The assessment of hiatal hernias (HH) is typically done with barium swallow X‑ray, upper endoscopy, and by high-resolution esophageal manometry (HRM). The aim of this study was to assess the clinical utility of these methods in terms of HH detection and their correlation to gastroesophageal reflux disease (GERD). Methods: A retrospective comparative analysis of patients with symptoms of GERD was carried out. The performance of endoscopy and HRM in diagnosing HH was assessed, taking barium swallow X‑ray as a reference...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
https://www.readbyqxmd.com/read/29097867/dysphagia-thinking-outside-the-box
#15
REVIEW
Hamish Philpott, Mayur Garg, Dunya Tomic, Smrithya Balasubramanian, Rami Sweis
Dysphagia is a common symptom that is important to recognise and appropriately manage, given that causes include life threatening oesophageal neoplasia, oropharyngeal dysfunction, the risk of aspiration, as well as chronic disabling gastroesophageal reflux (GORD). The predominant causes of dysphagia varies between cohorts depending on the interplay between genetic predisposition and environmental risk factors, and is changing with time. Currently in white Caucasian societies adopting a western lifestyle, obesity is common and thus associated gastroesophageal reflux disease is increasingly diagnosed...
October 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29089698/laparoscopic-heller-s-myotomy-for-achalasia-cardia-one-time-treatment-in-developing-countries
#16
Vishal Gupta, Hunaid Hatimi, Saket Kumar, Abhijit Chandra
Laparoscopic Heller's myotomy (LHM) and endoscopic balloon dilation are two main treatment modalities for achalasia cardia. The best treatment modality in Indian setting, however, is still unknown. Here, we present the early results of LHM in achalasia. Hospital data from January 2009 to October 2013 was analyzed. Preoperative assessment included Eckardt's scoring, esophagogastroduodenoscopy, barium swallow examination, and esophageal manometry. Thirty-five patients (19 males and 16 females, median age 31 years, range 12-65) underwent LHM with partial fundoplication (with intraoperative endoscopy)...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29071416/feasibility-and-safety-of-a-novel-magnetic-assisted-capsule-endoscope-system-in-a-preliminary-examination-for-upper-gastrointestinal-tract
#17
Gi-Shih Lien, Ming-Shun Wu, Chun-Nan Chen, Chih-Wen Liu, Fat-Moon Suk
BACKGROUND AND STUDY AIM: Current capsule endoscopy procedures are ineffective for upper gastrointestinal (GI) tract examination because they do not allow for operator-controlled navigation of the capsule. External controllability of a capsule endoscope with an applied magnetic field is a possible solution to this problem. We developed a novel magnetic-assisted capsule endoscope (MACE) system to visualize the entire upper GI tract. The present study evaluated the safety and feasibility of the MACE system for the examination of the upper GI tract, including the esophagus, stomach, and duodenum...
October 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29069877/is-robot-assisted-surgery-really-scarless-surgery-immediate-reconstruction-with-a-jejunal-free-flap-for-esophageal-rupture-after-robot-assisted-thyroidectomy
#18
Seong Hoon Park, Joo Hyun Kim, Jun Won Lee, Hii Sun Jeong, Dong Jin Lee, Byung Chun Kim, In Suck Suh
Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury...
November 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29067156/the-national-oesophagogastric-cancer-awareness-campaign-a-locality-outcome-analysis-from-county-durham
#19
Sara Koo, Bidour Awadelkarim, Anjan Dhar
INTRODUCTION: Oesophageal and gastric cancer is common. Despite advances in investigation and treatment, the outcomes from these cancers remain poor. As part of the Be Clear On Cancer Campaign, the Department of Health runs the National Oesophagogastric Cancer Campaign each year, with key messages of (1) 'Having heartburn most days, for 3 weeks or more could be a sign of cancer' and (2) 'if food is sticking when you swallow, tell your doctor'. METHODS: We evaluated the effect of the National Oesophagogastric Cancer Campaign in our locality...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29063954/a-gastroenterologist-s-perspective-on-the-role-of-barium-esophagography-in-gastroesophageal-reflux-disease
#20
David A Katzka
Although endoscopy is a sophisticated technique for evaluating patients with gastroesophageal reflux disease (GERD), the single diagnostic test that enables the most comprehensive assessment for GERD is a well-performed video esophagram. Not only does the barium study permit assessment of morphologic abnormalities in the pharynx and esophagus, but also oropharyngeal swallowing function, esophageal motility, and gastroesophageal reflux. These factors are especially important for detection of anatomic findings such as strictures and hernias, for assessment of esophageal motility before and after fundoplication, and for excluding conditions that mimic GERD...
October 24, 2017: Abdominal Radiology
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