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esophageal motility disorders

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https://www.readbyqxmd.com/read/28214088/a-case-of-seropositive-autoimmune-autonomic-ganglionopathy-with-diffuse-esophageal-spasm
#1
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/28207499/laparoscopic-heller-myotomy-is-not-superior-to-pneumatic-dilation-in-the-management-of-primary-achalasia-conclusions-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Ji-Wei Cheng, Yin Li, Wen-Qun Xing, Hong-Wei Lv, Hao-Ran Wang
BACKGROUND: Achalasia is an esophageal motility disorder, of unknown cause, which results in increased lower esophageal sphincter tone and symptoms of difficulty swallowing. Current major therapeutic options include laparoscopic Heller myotomy (LHM) and pneumatic dilation (PD). We undertake a systematic review comparing the efficacy and safety of these 2 treatments in the treatment of esophageal achalasia. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trial investigating LHM versus PD in the treatment of primary achalasia...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28191707/mechanisms-underlying-reflux-symptoms-and-dysphagia-in-patients-with-joint-hypermobility-syndrome-with-and-without-postural-tachycardia-syndrome
#3
A Fikree, Q Aziz, D Sifrim
BACKGROUND: The joint hypermobility syndrome (JHS) is a common non-inflammatory connective tissue disorder which frequently co-exists with postural tachycardia syndrome (PoTS), a form of orthostatic intolerance. Gastrointestinal symptoms and dysmotility have been reported in PoTS. Dysphagia and reflux are common symptoms in JHS, yet no studies have examined the physiological mechanism for these, subdivided by PoTS status. METHODS: Thirty patients (28 female, ages: 18-62) with JHS and symptoms of reflux (n=28) ± dysphagia (n=25), underwent high-resolution manometry and 24 hour pH-impedance monitoring after questionnaire-based symptom assessment...
February 12, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28188367/current-status-of-achalasia-management-a-review-on-diagnosis-and-treatment
#4
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...
February 10, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28161707/pathogenesis-of-double-dose-proton-pump-inhibitor-resistant-non-erosive-reflux-disease-and-mechanism-of-reflux-symptoms-and-gastric-acid-secretion-suppressive-effect-in-the-presence-or-absence-of-helicobacter-pylori-infection
#5
Noriyuki Kawami, Nana Takenouchi, Mariko Umezawa, Shintaro Hoshino, Yuriko Hanada, Yoshimasa Hoshikawa, Hirohito Sano, Yoshio Hoshihara, Tsutomu Nomura, Eiji Uchida, Katsuhiko Iwakiri
BACKGROUND: Various mechanisms have been suggested to be responsible for contributing to the occurrence of proton pump inhibitor (PPI)-resistant non-erosive reflux disease (NERD). The aims of this study were to clarify the pathogenesis of PPI-resistant NERD. METHODS: Fifty-three patients with NERD, who had persistent reflux symptoms despite taking double-dose PPI, were included in this study. After excluding eosinophilic esophagitis (EoE) and primary esophageal motility disorder, esophageal impedance-pH monitoring was carried out...
February 4, 2017: Digestion
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/28139656/the-chicago-classification-3-0-results-in-more-normal-findings-and-fewer-hypotensive-findings-with-no-difference-in-other-diagnoses
#7
H Monrroy, D Cisternas, C Bilder, A Ditaranto, J Remes-Troche, A Meixueiro, M A Zavala, J Serra, I Marín, A Ruiz de León, J Pérez de la Serna, A Hani, A Leguizamo, L Abrahao, R Coello, M A Valdovinos
OBJECTIVES: High-resolution manometry (HRM) is the preferred method for the evaluation of motility disorders. Recently, an update of the diagnostic criteria (Chicago 3.0) has been published. The aim of this study was to compare the performance criteria of Chicago version 2.0 (CC2.0) vs. 3.0 (CC3.0) in a cohort of healthy volunteers and symptomatic patients. METHODS: HRM studies of asymptomatic and symptomatic individuals from several centers of Spain and Latin America were analyzed using both CC2...
January 31, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28133854/waist-to-hip-ratio-is-a-better-predictor-of-esophageal-acid-exposure-than-body-mass-index
#8
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/28120278/long-term-management-challenges-in-esophageal-atresia
#9
REVIEW
Abby White, Raphael Bueno
Esophageal atresia is a rare congenital anomaly, but improved surgical and critical care has resulted in survival rates exceeding 90%. Long-term survival is associated with numerous management challenges including chronic motility disorders, dysphagia, strictures, reflux, esophagitis and attendant complications, tracheomalacia and chronic restrictive lung disease, and recurrent pulmonary infections. No guidelines for adolescents and younger or older adults exist for the treatment and monitoring of this specialized patient population...
January 24, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28120018/-surgical-treatment-of-achalasia-endoscopic-or-laparoscopic-proposal-for-a%C3%A2-tailored-approach
#10
B H A von Rahden, J Filser, M Al-Nasser, C-T Germer
Primary idiopathic achalasia is the most common form of the rare esophageal motility disorders. A curative therapy which restores the normal motility does not exist; however, the therapeutic principle of cardiomyotomy according to Ernst Heller leads to excellent symptom control in the majority of cases. The established standard approach is Heller myotomy through the laparoscopic route (LHM), combined with Dor anterior fundoplication for reflux prophylaxis/therapy. At least four meta-analyses of randomized controlled trials (RCTs) have demonstrated superiority of LHM over pneumatic dilation (PD); therefore, LHM should be used as first line therapy (without prior PD) in all operable patients...
January 24, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28119934/ineffective-esophageal-motility-progressing-into-distal-esophageal-spasm-and-then-type-iii-achalasia
#11
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/28109370/midesophageal-pulsion-diverticulum-resulting-from%C3%A2-hypercontractile-jackhammer-esophagus
#12
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
#13
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
#14
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
#15
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
#16
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/28018097/contraindications-for-video-capsule-endoscopy
#17
REVIEW
Dirk Bandorski, Niehls Kurniawan, Peter Baltes, Reinhard Hoeltgen, Matthias Hecker, Dominik Stunder, Martin Keuchel
Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn's disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28005634/the-role-of-esophageal-hypersensitivity-in-functional-esophageal-disorders
#18
Adam D Farmer, James K Ruffle, Qasim Aziz
The Rome IV diagnostic criteria delineates 5 functional esophageal disorders which include functional chest pain, functional heartburn, reflux hypersensitivity, globus, and functional dysphagia. These are a heterogenous group of disorders which, despite having characteristic symptom profiles attributable to esophageal pathology, fail to demonstrate any structural, motility or inflammatory abnormalities on standard clinical testing. These disorders are associated with a marked reduction in patient quality of life, not least considerable healthcare resources...
February 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27921112/-gastroenterological-diseases-as-triggers-of-chest-pain
#19
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
#20
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
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