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https://www.readbyqxmd.com/read/28219434/when-is-proton-pump-inhibitor-use-appropriate
#1
EDITORIAL
Rena Yadlapati, Peter J Kahrilas
Proton pump inhibitor (PPI) therapy is commonly used outside of Food and Drug Administration indication for a broad range of conditions such as extra-esophageal reflux and PPI-responsive esophageal eosinophilia. While this may be appropriate in some scenarios, it has also resulted in widespread inappropriate PPI use. At the same time, data suggesting adverse effects of long-term PPI therapy are multiplying, albeit mainly from low quality studies. The systematic review by Scarpignato et al. (BMC Med 14:179, 2016) addresses this dilemma with a comprehensive analysis of the risks and benefits of PPI use...
February 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28195178/recurrence-of-barrett-s-esophagus-is-rare-following-endoscopic-eradication-therapy-coupled-with-effective-reflux-control
#2
Srinadh Komanduri, Peter J Kahrilas, Kumar Krishnan, Tim McGorisk, Kiran Bidari, David Grande, Laurie Keefer, John Pandolfino
OBJECTIVES: Recent data suggest that effective control of gastroesophageal reflux improves outcomes associated with endoscopic eradication therapy (EET) for Barrett's esophagus (BE). However, the impact of reflux control on preventing recurrent intestinal metaplasia and/or dysplasia is unclear. The aims of the study were: (a) to determine the effectiveness and durability of EET under a structured reflux management protocol and (b) to determine the impact of optimizing anti-reflux therapy on achieving complete eradication of intestinal metaplasia (CE-IM)...
February 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28119934/ineffective-esophageal-motility-progressing-into-distal-esophageal-spasm-and-then-type-iii-achalasia
#3
Salih Samo, Dustin A Carlson, Peter J Kahrilas, John E Pandolfino
The clinical significance of minor esophageal motility disorders is unclear, though they typically carry a benign course. Distal esophageal spasm progressing to achalasia has been reported, although it appears to be rare. We report a case of a patient with dysphagia and chest pain who was found to have ineffective esophageal motility on high-resolution manometry, which developed into distal esophageal spasm and then progressed to type III achalasia.
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28054418/could-the-peristaltic-transition-zone-be-caused-by-non-uniform-esophageal-muscle-fiber-architecture-a-simulation-study
#4
W Kou, J E Pandolfino, P J Kahrilas, N A Patankar
BACKGROUND: Based on a fully coupled computational model of esophageal transport, we analyzed how varied esophageal muscle fiber architecture and/or dual contraction waves (CWs) affect bolus transport. Specifically, we studied the luminal pressure profile in those cases to better understand possible origins of the peristaltic transition zone. METHODS: Two groups of studies were conducted using a computational model. The first studied esophageal transport with circumferential-longitudinal fiber architecture, helical fiber architecture and various combinations of the two...
January 5, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28050744/simulation-studies-of-the-role-of-esophageal-mucosa-in-bolus-transport
#5
Wenjun Kou, John E Pandolfino, Peter J Kahrilas, Neelesh A Patankar
Based on a fully coupled computational model for esophageal transport, we analyzed the role of the mucosa (including the submucosa) in esophageal bolus transport and how bolus transport is affected by mucosal stiffness. Two groups of studies were conducted using a computational model. In the first group, a base case that represents normal esophageal transport and two hypothetical cases were simulated: (1) esophageal mucosa replaced by muscle and (2) esophagus without mucosa. For the base case, the geometric configuration of the esophageal wall was examined and the mechanical role of mucosa was analyzed...
January 3, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/27739183/benchmarks-for-the-interpretation-of-esophageal-high-resolution-manometry
#6
R Yadlapati, R N Keswani, K B Dunbar, A J Gawron, C P Gyawali, P J Kahrilas, P O Katz, D Katzka, S J Spechler, R Tatum, J E Pandolfino
BACKGROUND: Competent interpretation of esophageal high-resolution manometry (HRM) is integral to a quality study. Currently, methods to assess physician competency for the interpretation of esophageal HRM do not exist. The aim of this study was to use formal techniques to (i) develop an HRM interpretation exam, and (ii) establish minimum competence benchmarks for HRM interpretation skills at the trainee, physician interpreter, and master level. METHODS: A total of 29 physicians from 8 academic centers participated in the study: 9 content experts separated into 2 study groups-expert test-takers (n=7) and judges (n=2), and 20 HRM inexperienced trainees ("trainee test-taker"; n=20)...
October 13, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27725650/evaluation-of-esophageal-motility-utilizing-the-functional-lumen-imaging-probe
#7
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/27698386/high-resolution-impedance-manometry-metrics-of-the-esophagogastric-junction-for-the-assessment-of-treatment-response-in-achalasia
#8
Dustin A Carlson, Zhiyue Lin, Peter J Kahrilas, Joel Sternbach, Eric S Hungness, Nathaniel J Soper, Michelle Balla, Zoe Listernick, Michael Tye, Katherine Ritter, Jenna Craft, Jody D Ciolino, John E Pandolfino
OBJECTIVES: We aimed to evaluate the value of novel high-resolution impedance manometry (HRIM) metrics, bolus flow time (BFT), and esophagogastric junction (EGJ) contractile integral (CI), as well as EGJ pressure (EGJP) and the integrated relaxation pressure (IRP), as indicators of treatment response in achalasia. METHODS: We prospectively evaluated 75 patients (ages 19-81, 32 female) with achalasia during follow-up after pneumatic dilation or myotomy with Eckardt score (ES), timed-barium esophagram (TBE), and HRIM...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27693348/how-to-effectively-use-high-resolution-esophageal-manometry
#9
Dustin A Carlson, Peter J Kahrilas
No abstract text is available yet for this article.
November 2016: Gastroenterology
https://www.readbyqxmd.com/read/27647522/high-resolution-impedance-manometry-parameters-enhance-the-esophageal-motility-evaluation-in-non-obstructive-dysphagia-patients-without-a-major-chicago-classification-motility-disorder
#10
D A Carlson, T Omari, Z Lin, N Rommel, K Starkey, P J Kahrilas, J Tack, J E Pandolfino
BACKGROUND: High-resolution impedance manometry (HRIM) allows evaluation of esophageal bolus retention, flow, and pressurization. We aimed to perform a collaborative analysis of HRIM metrics to evaluate patients with non-obstructive dysphagia. METHODS: Fourteen asymptomatic controls (58% female; ages 20-50) and 41 patients (63% female; ages 24-82), 18 evaluated for dysphagia and 23 for reflux (non-dysphagia patients), with esophageal motility diagnoses of normal motility or ineffective esophageal motility, were evaluated with HRIM and a global dysphagia symptom score (Brief Esophageal Dysphagia Questionnaire)...
March 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27618926/downhole-transformation-of-the-hydraulic-fracturing-fluid-biocide-glutaraldehyde-implications-for-flowback-and-produced-water-quality
#11
Genevieve A Kahrilas, Jens Blotevogel, Edward R Corrin, Thomas Borch
Hydraulic fracturing fluid (HFF) additives are used to enhance oil and gas extraction from unconventional shale formations. Several kilometers downhole, these organic chemicals are exposed to temperatures up to 200 °C, pressures above 10 MPa, high salinities, and a pH range from 5-8. Despite this, very little is known about the fate of HFF additives under these extreme conditions. Here, stainless steel reactors are used to simulate the downhole chemistry of the commonly used HFF biocide glutaraldehyde (GA)...
October 18, 2016: Environmental Science & Technology
https://www.readbyqxmd.com/read/27614002/chronic-cough-due-to-gastroesophageal-reflux-in-adults-chest-guideline-and-expert-panel-report
#12
Peter J Kahrilas, Kenneth W Altman, Anne B Chang, Stephen K Field, Susan M Harding, Andrew P Lane, Kaiser Lim, Lorcan McGarvey, Jaclyn Smith, Richard S Irwin
BACKGROUND: We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome. METHODS: Two population, intervention, comparison, outcome (PICO) questions were addressed by systematic review: (1) Can therapy for gastroesophageal reflux improve or eliminate cough in adults with chronic and persistently troublesome cough? and (2) Are there minimal clinical criteria to guide practice in determining that chronic cough is likely to respond to therapy for gastroesophageal reflux? RESULTS: We found no high-quality studies pertinent to either question...
December 2016: Chest
https://www.readbyqxmd.com/read/27581064/incidence-and-prevalence-of-achalasia-in-central-chicago-2004-2014-since-the-widespread-use-of-high-resolution-manometry
#13
Salih Samo, Dustin A Carlson, Dyanna L Gregory, Susan H Gawel, John E Pandolfino, Peter J Kahrilas
BACKGROUND & AIMS: Reported global incidence and prevalence values for achalasia vary widely, from 0.03 to 1.63 per 100,000 persons per year and from 1.8 to 12.6 per 100,000 persons per year, respectively. This study aimed to reconcile these low values with findings from a major referral center, in central Chicago (which began using high-resolution manometry in 2004 and used it in all clinical studies since 2005), and has determined the incidence and prevalence of achalasia to be much greater...
August 28, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27513156/per-oral-endoscopic-myotomy-poem-after-the-learning-curve-durable-long-term-results-with-a-low-complication-rate
#14
Eric S Hungness, Joel M Sternbach, Ezra N Teitelbaum, Peter J Kahrilas, John E Pandolfino, Nathaniel J Soper
OBJECTIVE: We aimed to report long-term outcomes for patients undergoing per-oral endoscopic myotomy (POEM) after our initial 15-case learning curve. BACKGROUND: POEM has become an established, natural-orifice surgical approach for treating esophageal motility disorders. To date, published outcomes and comparative-effectiveness studies have included patients from the early POEM experience. METHODS: Consecutive patients undergoing POEM after our initial 15 cases, with a minimum of 1-year postoperative follow-up, were included...
September 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27493601/transoral-incisionless-fundoplication-for-the-treatment-of-gastroesophageal-reflux-disease
#15
Peter J Kahrilas
No abstract text is available yet for this article.
June 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27477826/validation-of-criteria-for-the-definition-of-transient-lower-esophageal-sphincter-relaxations-using-high-resolution-manometry
#16
S Roman, R Holloway, J Keller, F Herbella, F Zerbib, Y Xiao, L Bernard, A J Bredenoord, S Bruley des Varannes, M Chen, M Fox, P J Kahrilas, R K Mittal, R Penagini, E Savarino, D Sifrim, J Wu, E Decullier, J E Pandolfino, F Mion
BACKGROUND: Criteria for transient lower esophageal sphincter relaxations (TLESRs) are well-defined for Dentsleeve manometry. As high-resolution manometry (HRM) is now the gold standard to assess esophageal motility, our aim was to propose a consensus definition of TLESRs using HRM. METHODS: Postprandial esophageal HRM combined with impedance was performed in 10 patients with gastroesophageal reflux disease. Transient lower esophageal sphincter relaxations identification was performed by 17 experts using a Delphi process...
February 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27380834/development-and-validation-of-the-brief-esophageal-dysphagia-questionnaire
#17
T H Taft, M Riehl, J B Sodikoff, P J Kahrilas, L Keefer, B Doerfler, J E Pandolfino
BACKGROUND: Esophageal dysphagia is common in gastroenterology practice and has multiple etiologies. A complication for some patients with dysphagia is food impaction. A valid and reliable questionnaire to rapidly evaluate esophageal dysphagia and impaction symptoms can aid the gastroenterologist in gathering information to inform treatment approach and further evaluation, including endoscopy. METHODS: 1638 patients participated over two study phases. 744 participants completed the Brief Esophageal Dysphagia Questionnaire (BEDQ) for phase 1; 869 completed the BEDQ, Visceral Sensitivity Index, Gastroesophageal Reflux Disease Questionnaire, and Hospital Anxiety and Depression Scale for phase 2...
December 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27200524/severity-of-endoscopically-identified-esophageal-rings-correlates-with-reduced-esophageal-distensibility-in-eosinophilic-esophagitis
#18
Joan W Chen, John E Pandolfino, Zhiyue Lin, Jody D Ciolino, Nirmala Gonsalves, Peter J Kahrilas, Ikuo Hirano
BACKGROUND/AIMS: A grading system for the endoscopic features of eosinophilic esophagitis (EoE) has recently been validated. The EoE Endoscopic Reference Score (EREFS) incorporates both inflammatory and remodeling features of EoE. High resolution impedance planimetry using the functional luminal imaging probe (FLIP) is a technique for quantification of esophageal remodeling. The aim of this study was to evaluate the association between endoscopic severity with EREFS and esophageal distensibility as measured with the FLIP...
September 2016: Endoscopy
https://www.readbyqxmd.com/read/27187299/turning-the-pathogenesis-of-acute-peptic-esophagitis-inside-out
#19
EDITORIAL
Peter J Kahrilas
No abstract text is available yet for this article.
May 17, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27006255/therapy-risks-associated-with-chronic-ppi-use-signal-or-noise
#20
Leila Kia, Peter J Kahrilas
No abstract text is available yet for this article.
May 2016: Nature Reviews. Gastroenterology & Hepatology
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