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https://www.readbyqxmd.com/read/29774515/eating-disorder-or-oesophageal-achalasia-during-adolescence-diagnostic-difficulties
#1
REVIEW
Aurélie Letranchant, Bénédicte Pigneur, Martine Flament, Nathalie Godart
Marine was a fourteen and a half-year-old adolescent female hospitalized for an eating disorder (ED) of the anorexic type with purging behaviors. She has had a complicated life course, made up of disruptions and discontinuities, both family and school. Since the age of five, Marine had been intermittently treated in psychiatry for a diagnosis of oppositional defiant disorder. The current illness started with spontaneous and induced vomiting associated with major weight loss (body mass index, 15.27 kg m-2 )...
May 17, 2018: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/29766515/results-of-pneumatic-dilation-in-treating-achalasia-predictive-factors
#2
REVIEW
Valter Nilton Felix
Forced pneumatic dilatation (PD) of the cardia is one of the most consecrated therapeutic measures for esophageal achalasia. The procedure only achieved better standardization with the appearance of the Rigiflex balloon. Results and predictive factors of success and failure of PD are reviewed, right after the description of the main technical aspects of the procedure. The success rates, providing control of dysphagia for about 1 year from the procedure using the Rigiflex balloon, are quite satisfactory, with success in more than 75% of patients...
May 16, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29766276/anti-ganglionic-achr-antibodies-in-japanese-patients-with-motility-disorders
#3
Akihiro Mukaino, Hitomi Minami, Hajime Isomoto, Hitomi Hamamoto, Eikichi Ihara, Yasuhiro Maeda, Osamu Higuchi, Tohru Okanishi, Yohei Kokudo, Kazushi Deguchi, Fumisato Sasaki, Toshihito Ueki, Ken-Ya Murata, Takeshi Yoshida, Mistuyo Kinjo, Yoshihiro Ogawa, Akio Ido, Hidenori Matsuo, Kazuhiko Nakao, Shunya Nakane
BACKGROUND: The existence of several autoantibodies suggests an autoimmune basis for gastrointestinal (GI) dysmotility. Whether GI motility disorders are features of autoimmune autonomic ganglionopathy (AAG) or are related to circulating anti-ganglionic acetylcholine receptor (gAChR) antibodies (Abs) is not known. The aim of this study was to determine the associations between autonomic dysfunction, anti-gAChR Abs, and clinical features in patients with GI motility disorders including achalasia and chronic intestinal pseudo-obstruction (CIPO)...
May 15, 2018: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29760072/estrogen-receptor-%C3%AE-controls-proliferation-of-enteric-glia-and-differentiation-of-neurons-in-the-myenteric-plexus-after-damage
#4
F D'Errico, G Goverse, Y Dai, W Wu, M Stakenborg, E Labeeuw, V De Simone, B Verstockt, P J Gomez-Pinilla, M Warner, A Di Leo, G Matteoli, J A Gustafsson
Injury to the enteric nervous system (ENS) can cause several gastrointestinal (GI) disorders including achalasia, irritable bowel syndrome, and gastroparesis. Recently, a subpopulation of enteric glial cells with neuronal stem/progenitor properties (ENSCs) has been identified in the adult ENS. ENSCs have the ability of reconstituting the enteric neuronal pool after damage of the myenteric plexus. Since the estrogen receptor β (ERβ) is expressed in enteric glial cells and neurons, we investigated whether a selective ERβ agonist, LY3201, can influence neuronal and glial cell differentiation...
May 14, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29756656/pathophysiology-and-treatment-of-achalasia-in-a-muscle-mechanical-perspective
#5
REVIEW
Hans Gregersen, Kar Man Lo
This review provides a biomechanical perspective on the pathophysiology and treatment of achalasia. The esophagus is efficient in transporting ingested material to the stomach in healthy subjects. A fine balance exists between the peristaltic forces generated in the esophageal body (which herein is defined as the preload) and the resistance in the outlet, the esophago-gastric junction (which is defined as the afterload). Achalasia is a rare esophageal disease that progressively over many years challenges esophageal efficacy...
May 14, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29756011/transoral-incisional-fundoplication-for-reflux-after-peroral-endoscopic-myotomy-a-crucial-addition-to-our-arsenal
#6
Amy Tyberg, Anthony Choi, Monica Gaidhane, Michel Kahaleh
Introduction:  Increased esophageal acid exposure is seen in a large percentage of patients with achalasia who undergo peroral endoscopic myotomy (POEM). Endoscopic transoral fundoplication (TIF) is a novel endoscopic technique for the management of patients with chronic gastroesophageal reflux (GERD). We present the first case series evaluating the role of TIF post-POEM. Methods:  Consecutive patients 18 years or older from our academic institution who underwent a POEM procedure and subsequently underwent TIF for symptomatic reflux or regurgitation between December 2014 and June 2017 were included...
May 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29748564/screening-for-dysplasia-with-lugol-chromoendoscopy-in-longstanding-idiopathic-achalasia
#7
Fraukje A Ponds, An Moonen, André J P M Smout, Wout O A Rohof, Jan Tack, Stijn van Gool, Raf Bisschops, Albert J Bredenoord, Guy E Boeckxstaens
BACKGROUND: Achalasia patients with longstanding disease are considered to be at risk for developing esophageal cancer. Endoscopic screening is not standardized and detection of dysplastic lesions is difficult, for which Lugol chromoendoscopy could be helpful. Aim was to evaluate the efficacy of screening for esophageal dysplasia and carcinoma in patients with longstanding achalasia using Lugol chromoendoscopy. METHODS: In this cohort study achalasia patients underwent three-annual screening by Lugol chromoendoscopy between January 2000 and March 2016...
May 11, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29744068/steerable-esophageal-thermometer-for-atrial-fibrillation-ablation-in-a-patient-with-esophageal-achalasia-a-case-report
#8
Hidehira Fukaya, Shinichi Niwano, Sho Ogiso, Yuki Arakawa, Ai Horiguchi, Ryo Nishinarita, Hironori Nakamura, Jun Oikawa, Akira Satoh, Jun Kishihara, Junya Ako
Esophageal injury is a major concern during catheter ablation of atrial fibrillation. Operators avoid radiofrequency applications on the esophagus by changing ablation line; however, it is unavoidable in patients with a dilated esophagus, such as esophageal achalasia. Steerable esophageal thermometer is useful for evaluating precise temperatures to prevent esophageal injury.
May 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29742777/peroral-endoscopic-dual-myotomy-dual-poem-for-achalasia-with-severe-esophageal-dilatation
#9
Xiang-Lei Yuan, Wei Liu, Lian-Song Ye, Ping Yan, Yu Wang, Naveed Khan, Bing Hu
No abstract text is available yet for this article.
May 9, 2018: Endoscopy
https://www.readbyqxmd.com/read/29733830/genesis-of-esophageal-pressurization-and-bolus-flow-patterns-in-patients-with-achalasia-esophagus
#10
Subum Park, Ali Zifan, Dushyant Kumar, Ravinder K Mittal
BACKGROUND & AIMS: In patients with achalasia esophagus, swallows induce simultaneous pressure waves known as esophageal pressurization. We studied the mechanism of esophageal pressurization and bolus flow patterns in patients with type 2 or type 3 achalasia. METHODS: We recorded high-resolution manometry with impedance and intraluminal ultrasound images concurrently in patients with type 2 achalasia (n=6) or type 3 achalasia (n=8) and in 10 healthy subjects (controls) during swallows of 5 ml, 0...
May 4, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29733014/peroral-endoscopic-myotomy-versus-heller-myotomy-for-achalasia-pros-and-cons
#11
Cristian Tefas, Rami Ababneh, Marcel Tanţău
Achalasia is an esophageal motor disorder that has multiple endoscopic and surgical methods of treatment. However, there is no consensus on optimal therapy in patients suffering from this disorder. This review discusses two therapies with similar but technically different concepts, peroral endoscopic myotomy and Heller surgical myotomy. After a brief introduction to the basic problems of achalasia, technical considerations, intra and postprocedural complications are presented and the advantages and disadvantages of the two procedures are discussed, based on the relevant articles in the literature...
March 2018: Chirurgia
https://www.readbyqxmd.com/read/29716731/symptoms-versus-testing-how-should-we-follow-up-achalasia-after-myotomy
#12
EDITORIAL
Victor van Berkel
No abstract text is available yet for this article.
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29713739/barium-upper-gi-series-in-adults-a-surgeon-s-perspective
#13
Daniel T Dempsey
Barium upper GI series performed by an interested and competent radiologist is still a very useful study to evaluate a variety of esophagogastric disorders. It usually provides information complementary to upper endoscopy and other foregut studies. Barium upper GI series is an important part of the diagnostic workup for gastroesophageal reflux disease, hiatal hernia, and esophageal motility disorders including achalasia. It is also an important part of the follow-up after operation for these common problems and after other operations such as resection or bariatric surgery...
April 30, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29712597/esophageal-resection-for-end-stage-achalasia
#14
REVIEW
Alberto Aiolfi, Emanuele Asti, Gianluca Bonitta, Stefano Siboni, Luigi Bonavina
Achalasia is a rare disease characterized by impaired lower esophageal sphincter relaxation loss and of peristalsis in the esophageal body. Endoscopic balloon dilation and laparoscopic surgical myotomy have been established as initial treatment modalities. Indications and outcomes of esophagectomy in the management of end-stage achalasia are less defined. A literature search was conducted to identify all reports on esophagectomy for end-stage achalasia between 1987 and 2017. MEDLINE, Embase, and Cochrane databases were consulted matching the terms "achalasia," "end-stage achalasia," "esophagectomy," and "esophageal resection...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712596/the-treatment-of-achalasia-in-obese-patients
#15
REVIEW
Julie A Wesp, Timothy M Farrell
Epidemiological studies have demonstrated that obesity is frequently associated with esophageal motility disorders. Morbid obesity and achalasia may coexist in the same patient. The management of the morbidly obese patient with achalasia is complex and the most effective treatment remains controversial. The aim of this study is to review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of achalasia in morbidly obese patients. EVIDENCE REVIEW: PubMed search from January 1990 to July 2017, including the following terms: achalasia, morbid obesity, bariatric, and treatment...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712595/laparoscopic-heller-myotomy-versus-per-oral-endoscopic-myotomy-evidence-based-approach-to-the-treatment-of-esophageal-achalasia
#16
Francisco Schlottmann, Marco G Patti
Esophageal achalasia is a rare disorder characterized by a failure of the lower esophageal sphincter to relax during swallowing, combined with aperistalsis of the esophageal body. Treatment is not curative, but aims to eliminate the outflow resistance caused by the nonrelaxing lower esophageal sphincter. Current evidence suggests that both laparoscopic Heller myotomy and per oral endoscopic myotomy (POEM) are very effective in the relief of symptoms in patients with achalasia. Specifically, for type III achalasia, POEM may achieve higher success rates...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712594/poem-for-achalasia
#17
Daniel A Kroch, Ian S Grimm
In 2008, a new treatment modality for esophageal achalasia was introduced-peroral endoscopic myotomy (POEM). POEM is a procedure performed endoscopically, which allows transection of the muscular fibers of the distal esophagus and of the lower esophageal sphincter. The procedure is therefore similar to a laparoscopic Heller myotomy without a fundoplication. Short-term studies have shown that POEM is very effective in relieving dysphagia and regurgitation, but concerns have been raised about the incidence of post-POEM gastroesophageal reflux...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712593/laparoscopic-heller-myotomy-and-fundoplication-what-is-the-evidence
#18
REVIEW
Fabrizio Rebecchi, Marco E Allaix, Francisco Schlottmann, Marco G Patti, Mario Morino
There is no agreement about the best type of fundoplication to add in patients undergoing laparoscopic Heller myotomy (LHM) for achalasia to reduce the risk of postoperative gastroesophageal reflux. This article reviews the current evidence about the outcomes in achalasia patients undergoing LHM with a partial anterior, a partial posterior, or a total fundoplication. We performed a review of the literature in PubMed/Medline electronic databases, which was evaluated according to the GRADE system. The results of the published randomized controlled trials show with a high level of evidence that the addition of a fundoplication reduces the risk of postoperative abnormal reflux, without impairing the food emptying of the esophagus...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712592/laparoscopic-heller-myotomy-for-achalasia-technical-aspects
#19
Francisco Schlottmann, Marco E Allaix, Marco G Patti
Esophageal achalasia is a primary esophageal motility disorder defined by the lack of esophageal peristalsis, and by a lower esophageal sphincter that fails to relax in response to swallowing. Patients' symptoms include dysphagia, regurgitation, aspiration, heartburn, and chest pain. Achalasia is a chronic condition without cure, and treatment options are aimed at providing symptomatic relief, improving esophageal emptying, and preventing the development of megaesophagus. Presently, a laparoscopic Heller myotomy with a partial fundoplication is considered the best treatment modality...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29712591/endoscopic-pneumatic-dilation-for-esophageal-achalasia
#20
Sheraz Markar, Giovanni Zaninotto
Pneumatic dilation is a well-established treatment modality that has withstood the test of time. Prospective and randomized trials have shown that in expert hands, it provides results similar to a laparoscopic Heller myotomy with fundoplication. In addition, it should be considered the primary form of treatment in patients who experience recurrence of symptoms after a surgical myotomy.
April 1, 2018: American Surgeon
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