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Esophagus motility disorders

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https://www.readbyqxmd.com/read/28375487/the-role-of-heller-myotomy-and-poem-for-nonachalasia-motility-disorders
#1
F Schlottmann, N J Shaheen, R D Madanick, M G Patti
The best-defined primary esophageal motor disorder is achalasia. However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders such as Diffuse Esophageal Spasm (DES), Nutcracker Esophagus (NE) and the Hypertensive Lower Esophageal Sphincter (HTN-LES). Most patients with DES and HTN-LES who complain of dysphagia improve after a myotomy. Patients with NE whose main complaint is chest pain, often do not have relief of the pain and can even develop dysphagia as a consequence of the myotomy...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28246468/lymphocytic-esophagitis-still-an-enigma-a-decade-later
#2
REVIEW
Carol Rouphael, Ilyssa O Gordon, Prashanthi N Thota
Lymphocytic esophagitis (LE) is a clinicopathologic entity first described by Rubio et al in 2006. It is defined as peripapillary intraepithelial lymphocytosis with spongiosis and few or no granulocytes on esophageal biopsy. This definition is not widely accepted and the number of lymphocytes needed to make the diagnosis varied in different studies. Multiple studies have described potential clinical associations and risk factors for LE, such as old age, female gender and smoking history. This entity was reported in inflammatory bowel disease in the pediatric population but not in adults...
February 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28243108/successful-peroral-endoscopic-myotomy-performed-in-endoscopy-department-as-a-radical-long-term-treatment-for-esophageal-achalasia-the-greek-experience
#3
Nikolas Eleftheriadis, Eleni Damianos Eleftheriadou
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been considered as a minimal-invasive, innovative technique for long-term treatment of all types of esophageal achalasia and other esophageal motility disorders. PATIENTS AND METHODS: We report on 20 consecutive Greek patients with manometrically proved esophageal achalasia (14 patients with type I, 4 with type II, 2 with type III, and 4 with sigmoid esophagus), with an age range of 32-92 years, mean age 59 years, 12 males, successfully treated by POEM from 2013 to 2015...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28214088/a-case-of-seropositive-autoimmune-autonomic-ganglionopathy-with-diffuse-esophageal-spasm
#4
Nobutoshi Morimoto, Sakuma Takahashi, Tomoki Inaba, Motonori Takamiya, Yasuhiko Kageyama, Mizuki Morimoto, Yoshiaki Takahashi, Hirotake Nishimura, Shunya Nakane, Koji Abe
Autoimmune autonomic ganglionopathy (AAG) is an immune-mediated disorder that leads to various autonomic failures associated with anti-ganglionic acetylcholine receptor antibodies (anti-gAChR-Abs). Diffuse esophageal spasm (DES) is an uncommon esophageal motility disorder. We herein report the case of a 68-year-old woman with DES as a partial symptom of AAG. She presented with chronic esophageal transit failure, constipation, and numbness of the hands and feet, Adie's pupil, thermal hypoalgesia, and decreased deep tendon reflexes...
February 14, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28188367/current-status-of-achalasia-management-a-review-on-diagnosis-and-treatment
#5
REVIEW
Joshua Tuason, Haruhiro Inoue
BACKGROUND: Achalasia is a rare esophageal motility disorder that is characterized by loss of peristalsis and failure of relaxation of the lower esophageal sphincter (LES), particularly during swallowing. This review focuses on the diagnosis of esophageal motility disorders as defined by the Chicago Classification ver 3.0, and presents management options with regard to per-oral endoscopic myotomy (POEM) as the treatment of choice. METHODS: A concise review of literature was performed for articles related to the management of achalasia, and this was contrasted with our institution's current practice...
April 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28141904/catheter-based-high-frequency-intraluminal-ultrasound-imaging-is-a-powerful-tool-to-study-esophageal-dysmotility-patients
#6
Cecilio Santander, Elena Perea, María Caldas, Pere Clave
High-resolution manometry (HRM) is currently the most important diagnostic test for esophageal motility disorders, providing information on the contraction pattern of the circular muscle layer, which helps classify these esophageal motor diseases. However, with the increasing development of ultrasound, other techniques, such as high-frequency intraluminal ultrasound (HFIUS), have gained importance. This technique uses a flexible shaft with a central wire integrated into a standard endoscope, which facilitates real-time sonography...
January 31, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28133854/waist-to-hip-ratio-is-a-better-predictor-of-esophageal-acid-exposure-than-body-mass-index
#7
C Ringhofer, J Lenglinger, M Riegler, I Kristo, A Kainz, S Schoppmann
BACKGROUND: Obesity and gastroesophageal reflux disease (GERD) are major health problems showing an inconstant relationship in the literature. Therefore, anthropometric parameters which are predictive and can simply be assessed at first patient presentation may lead to a better patient selection for ambulatory reflux monitoring. We aimed to examine the association of body mass index (BMI) and waist to hip ratio (WHR) with gastroesophageal reflux activity during 24 hour-pH-impedance monitoring...
January 29, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28109370/midesophageal-pulsion-diverticulum-resulting-from%C3%A2-hypercontractile-jackhammer-esophagus
#8
Onkar V Khullar, Sagar R Shroff, Sonali S Sakaria, Seth D Force
We report a patient with significant dysphagia from hypercontractile "jackhammer" esophagus and a midesophageal pulsion diverticulum. This was treated with a thoracoscopic diverticulectomy and a long esophageal myotomy sparing the lower esophageal sphincter (LES). We describe the clinical diagnosis and surgical treatment of this uncommon esophageal motility disorder. To our knowledge, this is the first report in the literature of a midesophageal diverticulum caused by jackhammer esophagus. We propose that in the setting of normal LES function, successful treatment should include diverticulectomy with an LES-sparing myotomy...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28101664/history-and-evolution-of-the-barium-swallow-for-evaluation-of-the-pharynx-and-esophagus
#9
REVIEW
Marc S Levine, Stephen E Rubesin
This article reviews the history of the barium swallow from its early role in radiology to its current status as an important diagnostic test in modern radiology practice. Though a variety of diagnostic procedures can be performed to evaluate patients with dysphagia or other pharyngeal or esophageal symptoms, the barium study has evolved into a readily available, non-invasive, and cost-effective technique that can facilitate the selection of additional diagnostic tests and guide decisions about medical, endoscopic, or surgical management...
February 2017: Dysphagia
https://www.readbyqxmd.com/read/28098054/long-term-esophageal-motility-changes-after-thyroidectomy-associations-with-aerodigestive-disorders
#10
G Scerrino, A Inviati, S Di Giovanni, N C Paladino, S Di Giovanni, N C Paladino, V Di Paola, C Raspanti, G I Melfa, F Cupido, S Mazzola, C Porrello, S Bonventre, G Gullotta
BACKGROUND: Patients undergoing thyroidectomy often complain aerodigestive disorders. In a previous study we showed the associations between voice impairment and proximal acid reflux, swallowing impairment and Upper Esophageal Sphyncter (UES) incoordination and the decrease in UES pressure in thirty-six patients observed before and soon afterwards uncomplicated thyroidectomy. This study investigated the state of post-thyroidectomy esophageal motility changes and its associations with these disorders after 18-24 months...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28068730/impaired-bolus-clearance-in-combined-high-resolution-esophageal-manometry-and-impedance-measurement-helps-to-differentiate-between-esophagogastric-junction-outflow-obstruction-and-achalasia
#11
Eugen Zizer, Thomas Seufferlein, Mark Martin Hänle
Introduction and aims High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for esophagogastric junction outflow obstruction (EGJOO) in comparison to achalasia patients. The collected data were assessed in a retrospective analysis. Patients and methods After gastroscopy excluded a mechanical esophageal or gastric obstruction, 142 consecutive patients underwent combined HRM-impedance examination...
February 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28028956/assessment-of-clinical-symptoms-and-multichannel-intraluminal-impedance-and-ph-monitoring-in-children-after-thoracoscopic-repair-of-esophageal-atresia-and-distal-tracheoesophageal-fistula
#12
Barbara M Iwańczak, Agnieszka Kosmowska-Miśków, Anna Kofla-Dłubacz, Mateusz Palczewski, Michał Grabiński, Katarzyna Pawłowska, Krzysztof Matusiewicz, Dariusz Patkowski
BACKGROUND: Motility disturbances of the esophagus and gastroesophageal reflux disease (GERD) are observed frequently in children after repair of congenital esophageal atresia with distal tracheoesophageal fistula (EA/TEF). Recently, in many pediatric surgical centers, thoracoscopic repair was introduced, which theoretically would change the postoperative course. OBJECTIVES: The goal of the study was to assess physical development, disease symptoms, and GERD symptom frequency in children who underwent thoracoscopic surgery of congenital EA/TEF...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/27921112/-gastroenterological-diseases-as-triggers-of-chest-pain
#13
J Labenz, C Labenz
BACKGROUND: Non-cardiac chest pain is very common and gastroenterological diseases are one of the most important causes. The frequency distribution of the underlying causes depends on the sector of the healthcare system in which it is ascertained. In individual cases it must always be taken into consideration that detection of coronary heart disease, for example, does not exclude another origin of chest pain. OBJECTIVE: This article provides a systematic review of gastroenterological diseases that can cause chest pain...
January 2017: Der Internist
https://www.readbyqxmd.com/read/27921050/esophagus-related-symptoms-in-first-degree-relatives-of-patients-with-achalasia-is-screening-necessary
#14
Henning R Gockel, Moritz Lesse, Johannes Schumacher, Michaela Müller, Ines Gockel
BACKGROUND: Despite an increasing understanding of the pathophysiology of achalasia, the etiology of this esophageal motility disorder remains largely unknown. However, the occurrence of familial achalasia, its association with well-defined genetic syndromes, the candidate gene approach, and recent presentation of the first systematic genome-wide association study on achalasia suggest the involvement of genetic factors. METHODS: In this study we analyzed the frequency with which symptoms associated with esophageal function (swallowing difficulties, regurgitations, retrosternal cramps/pain, heartburn) occur in first-degree relatives of patients with achalasia to determine if screening is useful and justified against the background of early diagnosis in a genetically predisposed population...
October 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27833517/clinical-utility-of-esophageal-manometry-in-the-patients-with-dysphagia-experience-from-sudan
#15
Amin M Abbas, Sami Medani, Tajeldin M Abdallah, Gasim I Gasim
OBJECTIVES: The aim of this study was to assess the clinical utility of esophageal manometry among Sudanese patients presenting to the National Centre for Gastrointestinal and Liver Diseases, Ibn Sina Hospital, Khartoum, Sudan. METHODOLOGY: Consecutive patients referred for esophageal manometry at the aforementioned center from July 2008 through January 2011 were included in the study. Manometric studies were done after stopping medicines with a known effect on esophageal motility and an overnight fast...
October 2016: International Journal of Health Sciences
https://www.readbyqxmd.com/read/27818585/update-on-the-endoscopic-treatments-for-achalasia
#16
REVIEW
Dushant S Uppal, Andrew Y Wang
Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. It is characterized by impaired deglutitive relaxation of the lower esophageal sphincter. High-resolution manometry allows for definitive diagnosis and classification of achalasia, with type II being the most responsive to therapy. Since no cure for achalasia exists, early diagnosis and treatment of the disease is critical to prevent end-stage disease. The central tenant of diagnosis is to first rule out mechanical obstruction due to stricture or malignancy, which is often accomplished by endoscopic and fluoroscopic examination...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27725650/evaluation-of-esophageal-motility-utilizing-the-functional-lumen-imaging-probe
#17
Dustin A Carlson, Peter J Kahrilas, Zhiyue Lin, Ikuo Hirano, Nirmala Gonsalves, Zoe Listernick, Katherine Ritter, Michael Tye, Fraukje A Ponds, Ian Wong, John E Pandolfino
OBJECTIVES: Esophagogastric junction (EGJ) distensibility and distension-mediated peristalsis can be assessed with the functional lumen imaging probe (FLIP) during a sedated upper endoscopy. We aimed to describe esophageal motility assessment using FLIP topography in patients presenting with dysphagia. METHODS: In all, 145 patients (aged 18-85 years, 54% female) with dysphagia that completed upper endoscopy with a 16-cm FLIP assembly and high-resolution manometry (HRM) were included...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27699951/muscle-layer-histopathology-and-manometry-pattern-of-primary-esophageal-motility-disorders-including-achalasia
#18
N Nakajima, H Sato, K Takahashi, G Hasegawa, K Mizuno, S Hashimoto, Y Sato, S Terai
BACKGROUND: Histopathology of muscularis externa in primary esophageal motility disorders has been characterized previously. We aimed to correlate the results of high-resolution manometry with those of histopathology. METHODS: During peroral endoscopic myotomy, peroral esophageal muscle biopsy was performed in patients with primary esophageal motility disorders. Immunohistochemical staining for c-kit was performed to assess the interstitial cells of Cajal (ICCs)...
March 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27692369/-tension-pneumothorax-during-peroral-endoscopic-myotomy-for-treatment-of-esophageal-achalasia-under-general-anesthesia
#19
Tsung-Shih Li, Tsung-Yang Lee, Kate Hsiurong Liao
More and more endoscopically gastrointestinal procedures require anesthesiologists to perform general anesthesia, such as "peroral endoscopic myotomy". Peroral endoscopic myotomy is a novel invasive treatment for the primary motility disorder of esophagus, called esophageal achalasia. Despite of its minimally invasive feature, there are still complications during the procedure which develop to critical conditions and threat patients' lives. Herein we describe a case about tension pneumothorax subsequent to esophageal rupture during peroral endoscopic myotomy...
September 27, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27681220/novel-insights-into-esophageal-diagnostic-procedures
#20
Edoardo Savarino, Andrea Ottonello, Salvatore Tolone, Ottavia Bartolo, Myong Ki Baeg, Farhood Farjah, Shiko Kuribayashi, Katerina P Shetler, Christian Lottrup, Ellen Stein
The 21st century offers new advances in diagnostic procedures and protocols in the management of esophageal diseases. This review highlights the most recent advances in esophageal diagnostic technologies, including clinical applications of novel endoscopic devices, such as ultrathin endoscopy and confocal laser endomicroscopy for diagnosis and management of Barrett's esophagus; novel parameters and protocols in high-resolution esophageal manometry for the identification and better classification of motility abnormalities; innovative connections between esophageal motility disorder diagnosis and detection of gastroesophageal reflux disease (GERD); impedance-pH testing for detecting the various GERD phenotypes; performance of distensibility testing for better pathophysiological knowledge of the esophagus and other gastrointestinal abnormalities; and a modern view of positron emission tomography scanning in metastatic disease detection in the era of accountability as a model for examining other new technologies...
September 2016: Annals of the New York Academy of Sciences
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