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Esophagogastric reflux

I Absah, A Rishi, N J Talley, D Katzka, M Halland
BACKGROUND: Rumination syndrome is a functional gastrointestinal disorder characterized by effortless and repetitive regurgitation of recently ingested food from the stomach to the oral cavity followed by either re-swallowing or spitting. Rumination is thought to occur due to a reversal of the esophagogastric pressure gradient. This is achieved by a coordinated abdominothoracic maneuver consisting of a thoracic suction, crural diaphragm relaxation and an increase in intragastric pressure...
October 20, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Rita Barros, Daniela Pereira, Catarina Callé, Vânia Camilo, Ana Isabel Cunha, Leonor David, Raquel Almeida, António Dias-Pereira, Paula Chaves
Barrett's esophagus (BE) is the replacement of the normal esophageal squamous epithelium by a columnar lining epithelium. It is a premalignant condition for the development of adenocarcinoma of the esophagus and esophagogastric junction. BE is associated with gastroesophageal reflux which might change the expression profile of key transcription factors involved in the establishment of tissue differentiation, namely, SOX2 (associated with esophageal and gastric differentiation) and CDX2 (associated with intestinal differentiation)...
2016: Disease Markers
Shunsuke Akimoto, Saurabh Singhal, Takahiro Masuda, Se Ryung Yamamoto, Wendy Jo Svetanoff, Sumeet K Mittal
BACKGROUND: The Chicago classification has recently added a morphological subclassification for the esophagogastric junction (EGJ). Our aim was to assess the distal esophageal acid exposure in patients with this new Chicago EGJ-type IIIa and IIIb classification. STUDY DESIGN: From a prospectively collected high-resolution manometry (HRM) database, we identified patients who underwent 24-h pH study between October 2011 and June 2015 and were diagnosed with EGJ-type III based on HRM...
October 11, 2016: Digestive Diseases and Sciences
Francesco Torresan, Daniele Mandolesi, Alexandros Ioannou, Simone Nicoletti, Leonardo Henry Eusebi, Franco Bazzoli
Gastroesophageal reflux disease (GERD) is recognized to be a multifactorial disease and several mechanisms leading to reflux have been described, nevertheless its pathophysiology has not been fully clarified. Hiatus hernia is a known risk factor for GERD since it impairs the esophagogastric junction, leading to: reduction in lower esophageal sphincter pressure; increase in the frequency of the transient lower esophageal sphincter relaxation; and impairment of esophageal clearance. Last generation diagnostic techniques have improved the understanding of these mechanisms...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Juha Kauppi, Jari Räsänen, Eero Sihvo, Urpo Nieminen, Perttu Arkkila, Markku Ahotupa, Jarmo Salo
OBJECTIVES: Oxidative stress (OS) is an essential element in the pathogenesis of Barrett's esophagus (BE) and its transformation to adenocarcinoma (EAC). The state of OS in the proximal stomach of patients with BE and EAC is unknown. Isoprostanes are a specific marker of OS not previously used to determine OS from BE/EAC tissue samples. PATIENTS AND METHODS: OS was measured in 42 patients with BE (n = 9), EAC (n = 9), or both (n = 24) and 15 control patients. A STAT-8-Isoprostane EIA Kit served to identify 8-Isoprostanes (8-IP), and a Glutathione Assay Kit was used to measure glutathione reduced form (GSH) and glutathione oxidized form...
August 2016: Translational Oncology
Yoshitake Ueda, Norio Shiraishi, Manabu Toujigamori, Hidefumi Shiroshita, Tsuyoshi Etoh, Masafumi Inomata
BACKGROUND AND OBJECTIVES: There is no standardized method of reconstruction in laparoscopic proximal gastrectomy (LPG). We present a novel technique of reconstruction with a long, narrow gastric tube in LPG for early gastric cancer (EGC). METHODS: During the laparoscopic procedure, the upper part of the stomach is fully mobilized with perigastric and suprapancreatic lymphadenectomy, and then the abdominal esophagus is transected. After a minilaparotomy is created, the entire stomach is pulled outside...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Katarzyna Rerych, Józef Kurek, Ewa Klimacka-Nawrot, Barbara Błońska-Fajfrowska, Antoni Stadnicki
Background/Aims: The study was aimed to evaluate pre and postfundoplication profile of esophagogastric junction (EGJ) and esophageal peristalsis by high-resolution manometry (HRM) in patients with gastroesophageal reflux disease (GERD). Methods: HRM was performed in 25 patients with GERD before (pre-ops) and after (post-ops) laparoscopic Nissen fundoplication. The study involved capturing HRM data for 10 consecutive swallows of 10 mL water boluses in upright position...
August 17, 2016: Journal of Neurogastroenterology and Motility
G L Zheng, Z C Zheng, Y Zhao, T Zhang, J J Zhang
OBJECTIVE: To conduct a retrospective analysis of clinicopathological data of patients with Siewert type Ⅱand Ⅲ adenocarcinoma of the esophagogastric junction (AEG), who underwent total gastrectomy (TG) or proximal gastrectomy (PG), to discuss the differences between the two groups in 3-year and 5-year survival rates, postoperative complications and so forth, and to provide theoretical and clinical basis for choosing an ideal surgical approach for patients with Siewert typeⅡ and ⅢAEG...
July 2016: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Chenxi Xie, Jinhui Wang, Yuwen Li, Niandi Tan, Yi Cui, Minhu Chen, Yinglian Xiao
Background/Aims: Anti-reflux barrier dysfunction is one of the primary mechanisms in gastroesophageal reflux disease (GERD) pathogenesis. The esophagogastric junction contractile integral (EGJ-CI) is a new metric adopted to evaluate the EGJ contractility, which implied the anti-reflux barrier function. The aim of the current study was to validate this new metric in GERD patients and its correlation with the esophageal acid exposure, as well as the efficacy of proton pump inhibitor treatment...
July 16, 2016: Journal of Neurogastroenterology and Motility
D Ang, M Hollenstein, B Misselwitz, K Knowles, J Wright, E Tucker, R Sweis, M Fox
BACKGROUND/AIMS: The Chicago Classification for diagnosis of esophageal motility disorders by high-resolution manometry (HRM) is based on single water swallows (SWS). Emerging data suggest that a "Rapid Drink Challenge" (RDC) increases sensitivity for motility disorders. This study establishes normal values and diagnostic thresholds for RDC in clinical practice. METHODS: Two cohort studies were performed in patients with dysphagia or reflux symptoms (development and validation sets)...
July 15, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
M Â N E Souza, R A Nobre, P C Bezerra, A A Dos Santos, D Sifrim
BACKGROUND: Inspiratory esophagogastric junction (EGJ) pressure is lower in gastroesophageal reflux disease (GERD) and patients fail to increase EGJ pressure during the inspiratory effort. The aim of this study was to assess the EGJ activity during inspiratory maneuvers (high-resolution manometry, HRM) and the crural diaphragm (CD) thickness (endoscopic ultrasound, EUS) in GERD. METHODS: Twenty esophagitis patients (average age 45 years, 7 grade A, 13 grade B) had HRM and EUS...
July 14, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
George Triadafilopoulos, Dan Azagury
Patients experiencing heartburn and acid regurgitation despite proton pump inhibition therapy who are averse to antireflux surgery fall into what is called the gastroesophageal reflux disease (GERD) treatment gap. This gap may be potentially addressed by several endoscopic and laparoscopic techniques, including gastric bypass surgery for those patients who are obese. These novel techniques do not significantly alter the anatomy of the esophagogastric junction, minimizing short- and long-term adverse effects...
July 6, 2016: Annals of the New York Academy of Sciences
Leonardo M Del Grande, Fernando A M Herbella, Amilcar M Bigatao, Jose R Jardim, Marco G Patti
BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients have a high incidence of gastroesophageal reflux disease (GERD) whose pathophysiology seems to be linked to an increased trans-diaphragmatic pressure gradient and not to a defective esophagogastric barrier. Inhaled beta agonist bronchodilators are a common therapy used by patients with COPD. This drug knowingly not only leads to a decrease in the lower esophageal sphincter (LES) resting pressure, favoring GERD, but also may improve ventilatory parameters, therefore preventing GERD...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
KwanHyeong Jo, Soyoung Kim, Jongtae Cha, Sang Hyun Hwang, Narae Lee, Mijin Yun, Won Jun Kang
PURPOSE: The aim of this study was to compare the esophageal findings of 2-deoxy-2-[(18)F]fluoro-d-glucose positron emission tomography-computed tomography ((18)F-FDG PET/CT) and esophagogastroduodenoscopy (EGD). METHODS: We retrospectively reviewed (18)F-FDG PET/CT and EGD findings of 369 subjects who underwent medical examination between January 2014 and December 2014. The range and intensity of esophageal (18)F-FDG uptake were visually analyzed. The maximum standardized uptake value (SUVmax) of the esophagus and around the esophagogastric (EG) junction was measured...
June 2016: Nuclear Medicine and Molecular Imaging
Z J Liu, K Wang, L P Duan, Z W Xia, Z J Xu, Y Ge, W H Bao
OBJECTIVES: To compare the clinical features and high-resolution esophageal motility-impedance characteristics among esophagogastric junction outflow obstruction (Eoo) patients, type Ⅱ achalasia (Ach) patients and healthy controls (Con), in order to explore the values of esophageal high-resolution manometry (HRM) in diagnosis and treatment of Eoo patients. METHODS: Patients with dysphagia were enrolled from December 2011 to December 2014 at the outpatient department of Peking University Third Hospital, so were age-matched healthy volunteers...
May 17, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Akiko Tonouchi, Takahiro Kinoshita, Hideki Sunagawa, Takuya Hamakawa, Akio Kaito, Hidehito Shibasaki, Takeshi Kuwata, Yosuke Seki, Toshirou Nishida
BACKGROUND: We herein report a case of a bronchogenic cyst arising from the esophagogastric junction treated by laparoscopic full-thickness extirpation. The full-thickness defect was closed by hand sewing a T-shaped line over the gastroendoscope as a bougie to prevent postoperative deformity or stenosis. Partial fundoplication (Toupet fundoplication) was added to prevent reflux. CASE PRESENTATION: A 32-year-old woman with a body mass index of 43 kg/m(2) was admitted for treatment of a cyst-forming submucosal tumor (60 mm in diameter) on the anterior wall of the esophagogastric junction, which was detected during screening endoscopy before bariatric surgery...
December 2016: Surgical Case Reports
Atsushi Muraoka, Masahiko Kobayashi, Yasutaka Kokudo
BACKGROUND: No standard proximal gastrectomy method for gastric cancer of the upper third of the stomach (UGC) has been established because few of the current methods prevent gastro-esophageal reflux and allow easy postoperative endoscopic surveillance. In the present study, we describe laparoscopic proximal gastrectomy with the hinged double flap method (Kamikawa's method) in detail and examine the short- to medium-term outcomes of this approach, which resulted in excellent postoperative function...
October 2016: World Journal of Surgery
Thomas V K Herregods, Froukje B van Hoeij, Jacobus M Oors, Albert J Bredenoord, André J P M Smout
OBJECTIVES: Reflux symptoms are common among athletes and can have a negative impact on athletic performance. At present, the mechanisms underlying excess reflux during exercise are still poorly understood. The aim of this study was to investigate the effect of exercise on reflux severity and examine the underlying reflux mechanisms. METHODS: Healthy sporty volunteers were studied using both high-resolution manometry and pH-impedance monitoring. After a meal and a rest period, subjects ran on a treadmill for 30 min at 60% of maximum heart rate, followed by a short rest period and another 20-min period of running at 85% of maximum heart rate...
July 2016: American Journal of Gastroenterology
K Wang, L P Duan, Y Ge, Z W Xia, Z J Xu
OBJECTIVE: To study the role of esophagogastric junction contractile index (EGJ-CI) in evaluating the function of anti-reflux barrier, and in differentiating patients with gastroesophageal reflux disease (GERD) from those with functional heartburn (FH). METHODS: A total of 115 patients presenting heartburn were enrolled in the study from January 2012 to June 2015.All subjects had completed Gerd-Q questionnaire and undergone gastroscopy, 24-hour pH-impedance monitoring and esophageal high-resolution manometry...
April 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Tammy L Kindel, Dmitry Oleynikov
Obesity and gastroesophageal reflux disease (GERD) are prevalent in Western populations. In obese patients, high-resolution manometry often shows altered gastroesophageal pressure gradients, promoting retrograde gastric content flow into the esophagus and esophagogastric junction disruption, leading to a hiatal hernia. Hernia recurrence is higher in the obese, and recurrence is seen regardless of the operative approach used. Bariatric surgery is the gold-standard treatment for GERD in obese patients, and symptom improvement varies depending on the specific bariatric procedure performed, Roux-en-Y (RYGB), laparoscopic adjustable gastric banding (LAGB), or sleeve gastrectomy (SG)...
April 2016: Obesity Surgery
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