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https://www.readbyqxmd.com/read/29454796/endoscopic-myotomy-for-foregut-motility-disorders
#1
Mouen A Khashab, Petros C Benias, Lee L Swanstrom
Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure classically performed for the treatment of achalasia. The procedure is based on principles of submucosal endoscopy and is comprised of a mucosal incision, submucosal tunneling, myotomy and mucosal closure. Multiple published studies that collectively include more than 6000 patients reported clinical success in more than 80-90% of patients. Recent literature also suggested durability of response over a medium-term follow-up. POEM is associated with a low rate of adverse events when performed by experienced operators...
February 15, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29444254/high-resolution-esophageal-manometry-in-a-mexican-population-diagnostic-outcome
#2
G Vazquez-Elizondo, L E Hernández-González, S R Achem
High-resolution esophageal manometry (HREM) has become the method of choice for evaluation of esophageal motility disorders. There is a paucity of data with this technique from Hispanic countries. This study aims to characterize the diagnostic outcome of HREM in a large cohort of consecutive patients in Mexico.This study was conducted in Monterrey, Mexico from March 1, 2013 to March 31, 2015. Our diverse study population included patients from a major academic institution and the community. HREM was done applying the Chicago Classification 3...
February 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29441683/cardiovascular-safety-of-prokinetic-agents-a-focus-on-drug-induced-arrhythmias
#3
REVIEW
J R Giudicessi, M J Ackerman, M Camilleri
BACKGROUND: Gastrointestinal sensorimotor dysfunction underlies a wide range of esophageal, gastric, and intestinal motility and functional disorders that collectively constitute nearly half of all referrals to gastroenterologists. As a result, substantial effort has been dedicated toward the development of prokinetic agents intended to augment or restore normal gastrointestinal motility. However, the use of several clinically efficacious gastroprokinetic agents, such as cisapride, domperidone, erythromycin, and tegaserod, is associated with unfavorable cardiovascular safety profiles, leading to restrictions in their use...
February 14, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29440962/focal-achalasia-case-report-and-review-of-the-literature
#4
Marcus Joachim Herzig, Radu Tutuian
Esophageal achalasia is a primary smooth muscle motility disorder specified by aperistalsis of the tubular esophagus in combination with a poorly relaxing and occasionally hypertensive lower esophageal sphincter (LES). These changes occur secondary to the destruction of the neural network coordinating esophageal peristalsis and LES relaxation (plexus myentericus). There are limited data on segmental involvement of the esophagus in adults. We report on the case of a 54-year-old man who presented initially with complete aperistalsis limited to the distal esophagus...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29439587/clinical-management-of-pediatric-achalasia
#5
Marinde van Lennep, Michiel P van Wijk, Taher I Omari, Marc A Benninga, Maartje M J Singendonk
Achalasia is a rare esophageal motility disorder. Much of the literature is based on the adult population. In adults, guidance of therapeutic approach by manometric findings has led to improvement in patient outcome. Promising results have been achieved with novel therapies such as PerOral Endoscopic Myotomy (POEM). Areas covered: In this review, we provide an overview of the novel diagnostic and therapeutic tools for achalasia management and in what way they will relate to the future management of pediatric achalasia...
February 13, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29435819/expanding-role-of-third-space-endoscopy-in-the-management-of-esophageal-diseases
#6
REVIEW
Dennis Yang, Peter V Draganov
OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders...
February 12, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29430111/scintigraphic-evaluation-of-esophageal-motility-and-gastroesophageal-reflux-in-patients-presenting-with-upper-respiratory-tract-symptoms
#7
Jaykanth Amalachandran, Shelley Simon, Indirani Elangoven, Avani Jain, Thangalakshmi Sivathapandi
Purpose of Study: The purpose is to evaluate the findings and utility of esophageal transit scintigraphy (ETS) and gastroesophageal reflux scintigraphy (GES) in patients presenting with upper respiratory tract (URT) symptoms suspected to be due to gastroesophageal reflux (GER) disease. Materials and Methods: Thirty patients aged between 19 and 60 years underwent nasopharyngolaryngoscopy (NPL), ETS, and GES. Correlation between GER, esophageal motility, and NPL was evaluated...
January 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29421915/esophageal-motor-disorders-are-frequent-during-pre-and-post-lung-transplantation-can-they-influence-lung-rejection
#8
Constanza Ciriza de Los Ríos, Fernando Canga Rodríguez-Valcárcel, Alicia de Pablo Gafas, Isabel Castel de Lucas, David Lora Pablos, Gregorio Castellano Tortajada
BACKGROUND: lung transplantation (LTx) is a viable option for most patients with end-stage lung diseases. Esophageal motor disorders (EMD) are frequent in candidates for LTx, but there is very little data about changes in esophageal motility post-LTx. AIM: the aim of our study was to assess esophageal motor disorders by high resolution manometry (HRM) both pre-LTx and six months post-LTx in patients with and without organ rejection. STUDY: HRM (Manoscan®) was performed in 57 patients both pre-LTx and six months post-LTx...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29406039/the-effect-of-race-in-patients-with-achalasia-diagnosed-with-high-resolution-esophageal-manometry
#9
Victor Chedid, Elizabeth Rosenblatt, Kunjal Komal Gandhi, Sameer Dhalla, Monica C Nandwani, Ellen M Stein, John O Clarke
BACKGROUND: The advent of the Chicago Classification for esophageal motility disorders allowed for clinically reproducible subgrouping of patients with achalasia based on manometric phenotype. However, there are limited data with regards to racial variation using high-resolution esophageal manometry (HREM). The aim of our study was to evaluate the racial differences in patients with achalasia diagnosed with HREM using the Chicago Classification. We evaluated the clinical presentation, treatment decisions and outcomes between blacks and non-blacks with achalasia to identify potential racial disparities...
February 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29405099/trypanosoma-cruzi-detection-in-colombian-patients-with-a-diagnosis-of-esophageal-achalasia
#10
Santiago Panesso-Gómez, Paula Pavia, Iván Enrique Rodríguez-Mantilla, Paola Lasso, Luis A Orozco, Adriana Cuellar, Concepción J Puerta, Belén Mendoza de Molano, John M González
Achalasia is a motility disorder of the esophagus that might be secondary to a chronic Trypanosoma cruzi infection. Several studies have investigated esophageal achalasia in patients with Chagas disease (CD) in Latin America, but no related studies have been performed in Colombia. The goals of the present study were to determine the presence of anti-T. cruzi antibodies in patients with esophageal achalasia who visited a referral hospital in Bogotá, Colombia, and to detect the presence of the parasite and its discrete typing units (DTUs)...
February 5, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29379856/endogenous-hydrogen-sulfide-contributes-to-tone-generation-in-porcine-lower-esophageal-sphincter-via-na-ca2-exchanger
#11
Xiaopeng Bai, Eikichi Ihara, Katsuya Hirano, Yoshimasa Tanaka, Kayoko Nakano, Satomi Kita, Takahiro Iwamoto, Haruei Ogino, Mayumi Hirano, Yoshinao Oda, Kazuhiko Nakamura, Yoshihiro Ogawa
Background and Aims: Hydrogen sulfide (H2S) is a major physiologic gastrotransmitter. Its role in the regulation of the lower esophageal sphincter (LES) function remains unknown. The present study addresses this question. Methods: Isometric contraction was monitored in circular smooth muscle strips of porcine LES. Changes in cytosolic Ca2+ concentration ([Ca2+]i) and force were simultaneously monitored in fura-2-loaded strips with front-surface fluorometry. The contribution of endogenous H2S to LES contractility was investigated by examining the effects of inhibitors of H2S-generating enzymes, including cystathionine-β-synthase, cystathionine-γ-lyase, and 3-mercaptopyruvate sulfurtransferase, on the LES function...
March 2018: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29377271/-management-of-achalasia-cardia-expert-consensus-statements
#12
REVIEW
Mohan Ramchandani, D Nageshwar Reddy, Zaheer Nabi, Radhika Chouhan, Amol Bapaye, Shobhna Bhatia, Nilay Mehta, Pankaj Dhawan, Adarsh Chaudhary, Uday Ghoshal, Mathew Philip, Horst Neuhaus, Jacques Deviere, Haruhiro Inoue
Achalasia cardia (AC) is a frequently encountered motility disorder of the esophagus resulting from an irreversible degeneration of neurons. Treatment modalities are palliative in nature and there is no curative treatment available for AC as of now. Significant advancements have been made in the management of AC over last decade. The introduction of high resolution manometry (HRM) and per-oral endoscopic myotomy (POEM) have strengthened the diagnostic and therapeutic armamentarium of AC. HRM allows for the characterization of the type of achalasia which in turn has important therapeutic implications...
January 29, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29356781/clinical-characteristics-and-associated-systemic-diseases-in-patients-with-esophageal-absent-contractility-a-clinical-algorithm
#13
Sobia Laique, Tavankit Singh, David Dornblaser, Abhishek Gadre, Vikram Rangan, Ronnie Fass, Donald Kirby, Soumya Chatterjee, Scott Gabbard
GOALS: This study was carried out to assess the clinical characteristics and associated systemic diseases seen in patients diagnosed with absent contractility as per the Chicago Classification version 3.0, allowing us to propose a diagnostic algorithm for their etiologic testing. BACKGROUND: The Chicago Classification version 3.0 has redefined major and minor esophageal motility disorders using high-resolution esophageal manometry. There is a dearth of publications based on research on absent contractility, which historically has been associated with myopathic processes such as systemic sclerosis (SSc)...
January 19, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29351396/mechanisms-of-repetitive-retrograde-contractions-in-response-to-sustained-esophageal-distension-a-study-evaluating-patients-with-post-fundoplication-dysphagia
#14
Dustin A Carlson, Peter J Kahrilas, Katherine Ritter, Zhiyue Lin, John E Pandolfino
BACKGROUND: Repetitive, retrograde contractions (RRCs) in response to sustained esophageal distension are a distinct contractility pattern observed with functional luminal imaging probe (FLIP) panometry that are common in type III (spastic) achalasia. RRCs are hypothesized to be indicative of either impaired inhibitory innervation or esophageal outflow obstruction. We aimed to apply FLIP panometry to patients with post-fundoplication dysphagia (a model of esophageal obstruction) to explore mechanisms behind RRCs...
December 21, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29349482/-esophageal-diverticula-excluding-cricopharyngeal-diverticula
#15
C A Gutschow, H Schmidt
Diverticula of the middle and lower third of the esophagus are commonly associated with esophageal motility disorders. The increase of intraluminal pressure leads to an outpouching of the mucosal and submucosal layers through the esophageal muscle coat. These pouches are also called false diverticula, because they only consist of the mucosal and submucosal esophageal layers. In contrast, the more rarely encountered true diverticula that retain the complete esophageal wall are generally associated with periesophageal granulomatous lymph node disease...
January 18, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29343964/achalasia-following-reflux-disease-coincidence-consequence-or-accommodation-an-experience-based-literature-review
#16
András Vereczkei, Laura Bognár, András Papp, Örs Péter Horváth
Achalasia is a motility disorder of the esophagus characterized by the defective peristaltic activity of the esophageal body and impaired relaxation of the lower esophageal sphincter due to the degeneration of the inhibitory neurons in the myenteric plexus of the esophageal wall. The histopathological and pathophysiological changes in achalasia have been well described. However, the exact etiological factors leading to the disease still remain unclear. Currently, achalasia is believed to be a multifactorial disease, involving both extrinsic and intrinsic factors...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29342262/preliminary-study-of-1940-nm-thulium-laser-usage-in-peroral-endoscopic-myotomy-for-achalasia
#17
J Liu, Y Jiao, Y Niu, L Yu, M Ji, S Zhang
Esophageal achalasia is a type of motility disorder characterized by incomplete relaxation of lower esophageal sphincter (LES) and absence of esophageal peristalsis. Peroral endoscopic myotomy (POEM) is a new treatment option for achalasia that is less invasive, more effective, and safe as compared to surgery. High-frequency electrotome is commonly used in POEM, but takes longer time to make the tunnel in the esophagus and causes many complications. The thulium laser decreases the risk of bleeding and perforation in endoscopy but has not been reported in digestive diseases, especially in POEM...
January 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29340927/achalasia-cardia-in-a-young-infant
#18
V Poornachand, K Kumarasamy, S P Karamath, V Seenivasan, Sumathi Bavanandam, Nirmala Dheivamani
Achalasia cardia is an esophageal motility disorder rarely reported in children and more so in young infants. Common clinical presentations include vomiting, dysphagia, regurgitation, recurrent pulmonary aspiration and failure to thrive. Diagnosis is made by barium swallow study and esophageal manometry, which is the gold standard test. Pharmocological management and endotherapy often fails and results in recurrence of symptoms. Laparoscopic Hellers myotomy, with or without anti-reflux procedure is the standard treatment of choice for children...
January 17, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29338493/challenges-of-peroral-endoscopic-myotomy-in-the-treatment-of-distal-esophageal-spasm
#19
Fraukje Anna-Marie Ponds, André J P M Smout, Paul Fockens, Albert J Bredenoord
OBJECTIVE: Distal esophageal spasm (DES) is a rare motility disorder characterized by premature and rapidly propagated contractions of the distal esophagus. Treatment options are limited and often poorly effective. Peroral endoscopic myotomy (POEM) seems an effective and attractive new treatment option for DES. In this case report we describe some of the difficulties that could arise. MATERIALS AND METHODS: A 84-year old man with therapy-refractory DES and complaints of severe dysphagia and chest pain underwent a POEM procedure under general anesthesia...
January 17, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29286206/high-resolution-vs-conventional-esophageal-manometry-in-the-assessment-of-esophageal-motor-disorders-in-patients-with-non-cardiac-chest-pain
#20
O Akinsiku, T Yamasaki, S Brunner, S Ganocy, R Fass
BACKGROUND: High-resolution esophageal manometry (HREM) has become a leading tool in the assessment of esophageal motor disorders, replacing conventional manometry. However, there is limited data about the contribution of HREM as compared with conventional manometry to the assessment of esophageal motor disorders in patients with non-cardiac chest pain (NCCP). The aim of the study was to compare the distribution of esophageal motor disorders in patients with NCCP using HREM as compared with conventional manometry and to determine if HREM improved diagnosis of these disorders...
December 29, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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