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Esophagogastric reflux

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https://www.readbyqxmd.com/read/28911949/postprandial-high-resolution-impedance-manometry-identifies-mechanisms-of-non-response-to-proton-pump-inhibitors
#1
Rena Yadlapati, Michael Tye, Sabine Roman, Peter J Kahrilas, Katherine Ritter, John E Pandolfino
BACKGROUND & AIMS: Recognition of rumination and supragastric belching is often delayed as symptoms may be mistakenly attributed to gastroesophageal reflux disease (GERD). However, distinct from GERD, rumination and supragastric belching are more responsive to behavioral interventions than to acid-suppressive and anti-reflux therapies. Postprandial high-resolution impedance manometry (PP-HRIM) is an efficient method to identify rumination and belches. We investigated the distribution of postprandial profiles determined by PP-HRIM, and identified patient features associated with postprandial profiles among patients with non-response to proton pump inhibitors (PPIs)...
September 11, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28881879/spectrum-of-esophageal-dysmotility-in-systemic-sclerosis-on-high-resolution-esophageal-manometry-as-defined-by-chicago-classification
#2
N Aggarwal, R Lopez, S Gabbard, N Wadhwa, P Devaki, P N Thota
The classic manometric findings in systemic sclerosis are aperistalsis of the esophageal body with hypotensive lower esophageal sphincter. These changes contribute to gastroesophageal reflux disease in these patients. With widespread use of high-resolution esophageal manometry, diverse abnormalities are seen. The aim of this study is to characterize esophageal dysmotility in patients with systemic sclerosis undergoing high-resolution esophageal manometry and compare demographic features and diagnostic test results among patients with varying degrees of esophageal dysmotility...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28856802/esophagogastric-junction-cancer-successfully-treated-by-laparoscopic-proximal-gastrectomy-and-lower-esophagectomy-with-intrathoracic-double-flap-technique-a-case-report
#3
Kei Hosoda, Keishi Yamashita, Hiromitsu Moriya, Marie Washio, Hiroaki Mieno, Akira Ema, Masahiko Watanabe
A 66-year-old man was referred to our hospital for treatment of esophagogastric junction cancer. He was diagnosed as cT2N0M0, and the esophageal invasion was found to be 1 cm from the esophagogastric junction. He underwent laparoscopy-assisted proximal gastrectomy and lower esophagectomy with esophagogastrostomy using the intrathoracic double-flap technique through the transhiatal approach. The operative time was 662 min (suturing time was 198 min), and blood loss was 200 mL. The operative time was much longer for this procedure than for esophagogastrostomy with the conventional (intra-abdominal) double-flap technique...
August 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28827081/management-of-gastroesophageal-reflux-disease
#4
C Prakash Gyawali, Ronnie Fass
Management of GERD commonly starts with an empiric trial of proton pump inhibitor (PPI) therapy and complementary lifestyle measures, for patients without alarm symptoms. Optimization of therapy (improving compliance and timing of PPI doses), or increasing PPI dosage to twice daily in select circumstances, can reduce persistent symptoms. Patients with continued symptoms can be evaluated with endoscopy and tests of esophageal physiology, to better determine their disease phenotype and optimize treatment. Laparoscopic fundoplication, magnetic sphincter augmentation, and endoscopic therapies can benefit patients with well-characterized GERD...
August 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28737572/european-society-for-paediatric-gastroenterology-hepatology-and-nutrition-guidelines-for-the-evaluation-and-treatment-of-gastrointestinal-and-nutritional-complications-in-children-with-neurological-impairment
#5
Claudio Romano, Myriam van Wynckel, Jessie Hulst, Ilse Broekaert, Jiri Bronsky, Luigi Dall'Oglio, Nataša F Mis, Iva Hojsak, Rok Orel, Alexandra Papadopoulou, Michela Schaeppi, Nikhil Thapar, Michael Wilschanski, Peter Sullivan, Frédéric Gottrand
OBJECTIVES: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment...
August 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28724307/per-oral-endoscopic-myotomy-poem-a-new-endoscopic-treatment-for-achalasia
#6
Pablo Miranda García, Fernando Casals Seoane, Jean-Michel Gonzalez, Marc Barthet, Cecilio Santander Vaquero
BACKGROUND/AIMS: Per-oral endoscopic myotomy (POEM) is a new minimally invasive technique to treat achalasia. METHODS: We performed a review of the literature of POEM with a special focus on technical details and the results obtained with this technique in patients with achalasia and other esophageal motility disorders. RESULTS: Thousands of POEM procedures have been performed worldwide since its introduction in 2008. The procedure is based on the creation of a mucosal entry point in the proximal esophagus to reach the cardia through a submucosal tunnel and then perform a myotomy of the muscular layers of the cardia, esophagogastric junction and distal esophagus, as performed in a Heller myotomy...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28662022/impaired-esophageal-motility-and-clearance-post-lung-transplant-risk-for-chronic-allograft-failure
#7
Anupong Tangaroonsanti, Augustine S Lee, Michael D Crowell, Marcelo F Vela, Daryl R Jones, David Erasmus, Cesar Keller, Jorge Mallea, Francisco Alvarez, Cristina Almansa, Kenneth R DeVault, Lesley A Houghton
OBJECTIVES: Gastroesophageal reflux is common in patients post-lung transplantation (LTx) and thus considered a risk factor for aspiration and consequently allograft rejection and the development of chronic allograft failure. However, evidence supporting this remains unclear and often contradictory. Our aim was to examine the role played by esophageal motility on gastroesophageal reflux exposure, along with its clearance and that of boluses swallowed, and the relationship to development of obstructive chronic lung allograft dysfunction (o-CLAD)...
June 29, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28544357/classification-of-esophageal-motor-findings-in-gastro-esophageal-reflux-disease-conclusions-from-an-international-consensus-group
#8
REVIEW
C P Gyawali, S Roman, A J Bredenoord, M Fox, J Keller, J E Pandolfino, D Sifrim, R Tatum, R Yadlapati, E Savarino
BACKGROUND: High-resolution manometry (HRM) has resulted in new revelations regarding the pathophysiology of gastro-esophageal reflux disease (GERD). The impact of new HRM motor paradigms on reflux burden needs further definition, leading to a modern approach to motor testing in GERD. METHODS: Focused literature searches were conducted, evaluating pathophysiology of GERD with emphasis on HRM. The results were discussed with an international group of experts to develop a consensus on the role of HRM in GERD...
May 24, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28475744/clinical-characteristics-and-associated-factors-of-japanese-patients-with-adenocarcinoma-of-the-esophagogastric-junction-a-multicenter-clinicoepidemiological-study
#9
K Matsueda, N Manabe, N Toshikuni, Y Sato, T Watanabe, H Yamamoto, K Haruma
Gastroesophageal reflux disease-related diseases, such as Barrett's esophagus and adenocarcinoma of the esophagogastric junction (AEGJ), are believed to occur less frequently in Asia than in Western countries. However, the number of reported cases is increasing, yet little is known regarding the epidemiology of AEGJ in Japan. The primary study aim is to investigate the clinicoepidemiological characteristics of AEGJ. The secondary aim is to identify factors associated with it. In the 6.5 years between January 2008 and June 2014, we reviewed 88,199 esophagogastroduodenoscopy (EGD) reports and associated medical records (Study 1)...
June 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28466556/esophagogastric-junction-in-systemic-sclerosis-a-study-with-the-functional-lumen-imaging-probe
#10
L Fynne, D Liao, K Aksglaede, C Lottrup, H Gregersen, N C Bjerregaard, A M Drewes, K Krogh
BACKGROUND: Fibrosis and atrophy of esophageal smooth muscle cells cause gastro-esophageal reflux and dysphagia in most patients with systemic sclerosis (SSc). Recent studies indicate that distensibility of the esophagogastric junction (EGJ), assessed with the Functional Lumen Imaging Probe (FLIP) may be a more sensitive and accurate measure of sphincter function than manometry. We aim to describe and compare distension parameters of the EGJ in a well-characterized group of patients with SSc...
May 3, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28451814/the-relationship-between-manometric-subtype-and-outcomes-of-surgical-treatment-for-patients-with-achalasia-achalasia-manometric-subtypes
#11
Oscar Maximiliano Crespin, Roger Perry Tatum, Keliang Xiao, Ana Valeria Martin, Saurabh Khandelwal, Carlos Alberto Pellegrini, Brant Kurt Oelschlager
BACKGROUND: The Chicago Classification describes three distinct subtypes of achalasia and it appears to be a promising tool in predicting results of treatment with standard Heller Myotomy. The aim of this study is to analyze the outcomes of surgical treatment for achalasia using an extended Heller myotomy for each subtype and to identify additional parameters that may predict the success of therapy. METHODS: 72 consecutive patients with achalasia were evaluated at the University of Washington between 2008 and 2013...
April 27, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28441166/minimally-invasive-organ-preserving-surgery-for-large-submucosal-tumors-in-the-abdominal-esophagus
#12
Eiji Kanehira, Takashi Tanida, Aya Kamei, Kodai Takahashi
BACKGROUND: Surgical resection of submucosal tumors (SMTs) in the abdominal esophagus is not standardized. Enucleation may be a minimally invasive option, whereas its oncological validity is not very clear. Moreover, how to treat the esophageal wall defect after enucleation and necessity of additional antireflux procedure are also undetermined. METHODS: In 13 patients with a SMT originating the abdominal esophagus laparoscopic enucleation was performed with preserving the integrity of submucosa...
June 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28425657/different-time-trend-and-management-of-esophagogastric-junction-adenocarcinoma-in-three-asian-countries
#13
Waku Hatta, Daniel Tong, Yeong Yeh Lee, Shin Ichihara, Noriya Uedo, Takuji Gotoda
Esophagogastric junction (EGJ) adenocarcinoma has been on the increase in Western countries. However, in Asian countries, data on the incidence of EGJ adenocarcinoma are evidently lacking. In the present review, we focus on the current clinical situation of EGJ adenocarcinoma in three Asian countries: Japan, Hong Kong, and Malaysia. The incidence of EGJ adenocarcinoma has been reported to be gradually increasing in Malaysia and Japan, whereas it has stabilized in Hong Kong. However, the number of cases in these countries is comparatively low compared with Western countries...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28425653/endoscopic-gastric-mucosal-atrophy-distinguishes-the-characteristics-of-superficial-esophagogastric-junction-adenocarcinoma
#14
Noriya Uedo, Toshiyuki Yoshio, Shigetaka Yoshinaga, Manabu Takeuchi, Waku Hatta, Tomonori Yano, Tokuma Tanuma, Osamu Goto, Akiko Takahashi, Daniel Tong, Yeong Yeh Lee, Yoshiko Nakayama, Shin Ichihara, Takuji Gotoda
BACKGROUND AND AIM: Western studies have suggested two distinct etiologies of esophagogastric junction (EGJ) cancer: Helicobacter pylori-associated atrophic gastritis and non-atrophic gastric mucosa resembling esophageal adenocarcinoma. The present study investigated whether endoscopic gastric mucosal atrophy can distinguish between these two types of EGJ adenocarcinoma. METHODS: Data were collected from patients with Siewert type II, T1 EGJ adenocarcinoma who underwent endoscopic or surgical resection at eight Japanese institutions in 2010-2015...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28425652/endoscopic-findings-of-esophagogastric-junction-in-children
#15
Yoshiko Nakayama, Shinobu Ida
Esophagogastric landmarks are recognizable in the same way both in children and in adults, and palisade-shaped vessels can be observed at the distal position of esophageal mucosa, even in infants. Few studies have been done in respect to Barrett's esophagus (BE) in children. Incidence of endoscopically suspected BE among all children undergoing esophagogastroduodenoscopy (EGD) is approximately 0.25-1.4%, but can be up to 9.7% in patients with gastroesophageal reflux disease (GERD). Some data suggest that BE is an acquired disorder and point to the possibility of a congenital component in combination with severe mucosal injury...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28378424/novel-3d-high-resolution-manometry-metrics-for-quantifying-esophagogastric-junction-contractility
#16
Zhiyue Lin, Yinglian Xiao, Yuwen Li, John E Pandolfino, Minhu Chen, Peter J Kahrilas
BACKGROUND: The esophagogastric junction (EGJ) is a complex sphincter composed of both the crural diaphragm (CD) and lower esophageal sphincter (LES). Three dimensional high-resolution manometry (3D-HRM) provides a dynamic 360° representation of EGJ pressure in which the CD has a distinct pressure signature. We aimed to develop 3D-HRM metrics to: (i) quantify the vigor of CD contractility, (ii) best eliminate the CD contribution and thereby isolate the LES component of EGJ contractility, and (iii) compare these metrics with conventional HRM metric of EGJ contractility...
April 5, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28337865/helicobacter-pylori-and-barrett%C3%A2-s-esophagus-a-protective-factor-or-a-real-cause
#17
REVIEW
G Tomasello, F Giordano, M Mazzola, R Jurjus, A Jurjus, P Damiani, S Nobile, F Carini, A Leone
Notwithstanding the definite aetiopathogenetic path of certain diseases, the relationship between Helicobacter pylori (H. pylori) and Barrett’s esophagus (BE), a condition that increases the risk for dysplasia and consequently adenocarcinoma of the distal esophagus and esophagogastric junction, remains uncertain. This paper reviews the current scientific literature with emphasis on the protective correlation between H. pylori infection and BE and demonstrates that a causal relationship has not been disproved with certainty...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28275309/esophagogastric-junction-distensibility-assessed-using-the-functional-lumen-imaging-probe
#18
REVIEW
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/28260353/is-there-a-role-for-high-resolution-manometry-in-gerd-diagnosis
#19
Salvatore Tolone, Edoardo Savarino, Ludovico Docimo
Gastroesophageal reflux disease (GERD) is a condition, which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. In patients with alarm symptoms or signs or in those refractory to antiacid therapy, it is indicated to perform instrumental tests to correctly diagnose GERD presence. Esophageal manometry is currently considered the gold standard test for the diagnosis of esophageal dysmotility. However, it has shown limited capability in diagnosing GERD. With the advent of high resolution manometry (HRM), more accurate evaluations of esophageal motility are now possible...
September 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28258452/pathophysiology-of-gastroesophageal-reflux-disease
#20
Mariano A Menezes, Fernando A M Herbella
Gastroesophageal reflux disease pathophysiology is multifactorial and linked to a misbalance between the aggressiveness of the refluxate into the esophagus or adjacent organs and the failure of protective mechanisms associate or not to a defective valvular mechanism at the level of the esophagogastric junction incapable of dealing with a transdiaphragmatic pressure gradient. Antireflux mechanisms include the lower esophageal sphincter and abdominal esophagus, the diaphragm, the angle of His, the Gubaroff valve, and the phrenoesophageal membrane...
July 2017: World Journal of Surgery
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