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Endoscopy swallowing

Jan Friso Nast, Christoph Berliner, Thomas Rösch, Daniel von Renteln, Tania Noder, Guido Schachschal, Stefan Groth, Harald Ittrich, Jan F Kersten, Gerhard Adam, Yuki B Werner
BACKGROUND: The newly developed technique of peroral endoscopic myotomy (POEM) has been shown to be effective in several short- and mid-term studies. Limited information is available about the adequacy of immediate post-POEM monitoring tests. METHODS: POEM was performed under general anesthesia in 228 patients (59.6% male, mean age 45.6 ± 15.5 years). Post-procedural checks comprised clinical and laboratory examination, and, during post-procedure days 1-5, endoscopy and-in the first 114 cases-radiologic examination using water-soluble contrast (1st group); the remaining patients underwent post-procedure controls without radiology (2nd group)...
March 15, 2018: Surgical Endoscopy
S Sanagapalli, A Emmanuel, R Leong, S Kerr, L Lovat, R Haidry, M Banks, D Graham, A Raeburn, N Zarate-Lopez, R Sweis
BACKGROUND: Esophageal dysmotility may predispose to Barrett's esophagus (BE). We hypothesized that high-resolution manometry (HRM) performed with additional physiologic challenge would better delineate dysmotility in BE. METHODS: Included patients had typical reflux symptoms and underwent endoscopy, HRM with single water swallows and adjunctive testing with solids and rapid drink challenge (RDC) before ambulatory pH-impedance monitoring. BE and endoscopy-negative reflux disease (ENRD) subjects were compared against functional heartburn patient-controls (FHC)...
March 15, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Artur Nemeth, Daniel Agardh, Gabriele Wurm Johansson, Henrik Thorlacius, Ervin Toth
Background: Video capsule endoscopy (VCE) is a noninvasive method enabling excellent visualization of the small bowel (SB) mucosa. The aim of this study was to examine the impact and safety of VCE performed in children and adolescents with suspected or established Crohn's disease (CD). Methods: A total of 180 VCE examinations in 169 consecutive patients conducted in 2003-14 in a single center were retrospectively analyzed. The median age was 13 years (range 3-17 years) and indications for VCE were suspected (125 cases, 69%) and established (55 cases, 31%) CD...
2018: Therapeutic Advances in Gastroenterology
Cristina Gîndea, Adrian Constantin, Petre Hoară, Andrei Cărăgui, Abdullah AlKadour, Silviu Constantinoiu
Introduction: Thoracic esophageal diverticulum is a rare pathology frequently associated with esophageal motility disorders. Surgery is the only option in patients with severe symptoms. METHOD: This is a retrospective case series study of 10 patients who underwent diverticulectomy for thoracic (epiphrenic or mid-esophageal) diverticula. It was recorded: main preoperative symptoms, usual blood tests, barium swallow, upper endoscopy and esophageal manometry. We analyzed the postoperative complications, length of stay in hospital and intensive care unit...
January 2018: Chirurgia
Dragoş Predescu, Silviu Constantinoiu
Background: A few decades ago, esophageal substitution was mainly dedicated particularly in postcaustic esophageal stenosis; currently, the reconstruction has expanded its palette of indications to other areas of benign esophageal pathology (severe motor disorders, esophageal achalasia with multiple relapses, peptic stenosis, etc.) but has also become a quasi-obligatory final time in the esophagectomy for cancer whenever it is possible. The techniques of esophageal reconstruction using the stomach, regardless of the indication and the chosen technical option, remain a valuable and effective method...
January 2018: Chirurgia
Michel R Fernandes, Marina De Oliveira, Sidia M Callegari-Jacques, Gissele V R Gonçalves, Fernando Fornari
Background/Aims: Evaluation of esophageal clearance by orange juice swallowing could be useful to identify different categories of gastroesophageal reflux disease. We determined whether a juice test at the beginning of esophageal pH monitoring can identify nonerosive reflux disease (NERD) among heartburn patients. Methods: Multiple swallows of orange juice (pH 3) were performed at the beginning of esophageal pH monitoring in 71 heartburn patients off acid-suppressive therapy...
February 27, 2018: Journal of Neurogastroenterology and Motility
G Böhm
BACKGROUND: The radiological evaluation of the upper gastrointestinal tract (GI tract) is a diagnostic challenge. Although endoscopy has pushed radiographic methods into the background, these methods continue to play a key role in the diagnosis of dysphagia. In addition, cross-sectional imaging (computed tomography, magnetic resonance imaging) is increasingly used in complex clinical cases to evaluate surrounding tissue changes. METHODS: By combining conventional double-contrast techniques with a video recording, the entire upper GI tract can be assessed both anatomically and functionally in one examination procedure...
February 23, 2018: Der Radiologe
C Prakash Gyawali, Peter J Kahrilas, Edoardo Savarino, Frank Zerbib, Francois Mion, André J P M Smout, Michael Vaezi, Daniel Sifrim, Mark R Fox, Marcelo F Vela, Radu Tutuian, Jan Tack, Albert J Bredenoord, John Pandolfino, Sabine Roman
Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET <4% and <40 reflux episodes on pH-impedance monitoring off proton pump inhibitors...
February 3, 2018: Gut
V V Ilyashenko, Viktor V Grubnyk, V V Grubnik
BACKGROUND: Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh can lead to a reduce of recurrence rate. Despite this reduction, the type of mesh used and the placement technique are controversial. In our study, we used a new type of non-absorbable, self-fixating mesh to reinforce the cruroplasty. The aim of the present study was to compare the long-term results of laparoscopic treatment of large hiatal hernia with mesh reinforcement versus simple crura repair...
February 8, 2018: Surgical Endoscopy
C Chen, L T Tan, Z M Xu
Objectives: To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC). Methods: A retrospective case study was conducted at an academic children's hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow...
January 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
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
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
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
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
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
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
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
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...
December 2017: Revista Española de Enfermedades Digestivas
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]
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
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