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https://www.readbyqxmd.com/read/28319561/pediatric-enteric-neuropathies-diagnosis-and-current-management
#1
Maggie L Westfal, Allan M Goldstein
PURPOSE OF REVIEW: Neurointestinal diseases are increasingly recognized as causes of significant gastrointestinal morbidity in children. This review highlights the most common pediatric enteric neuropathies and their diagnosis and management, emphasizing insights and discoveries from the most recent literature available. RECENT FINDINGS: The embryologic and histopathologic causes of enteric neuropathies are varied. They range from congenital aganglionosis in Hirschsprung disease, to autoimmune-mediated loss of neuronal subtypes in esophageal achalasia and Chagas disease, to degenerative neuropathies in some cases of chronic intestinal pseudo-obstruction and gastroparesis...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28317607/nutritional-aspects-of-dysphagia-management
#2
C Gallegos, E Brito-de la Fuente, P Clavé, A Costa, G Assegehegn
This chapter describes the nutritional aspects of dysphagia management by starting with the definition of these two conditions (dysphagia and malnutrition) that share three main clinical characteristics: (a) their prevalence is very high, (b) they can lead to severe complications, and (c) they are frequently underrecognized and neglected conditions. From an anatomical standpoint, dysphagia can result from oropharyngeal and/or esophageal causes; from a pathophysiological perspective, dysphagia can be caused by organic or structural diseases (either benign or malignant) or diseases causing impaired physiology (mainly motility and/or perception disorders)...
2017: Advances in Food and Nutrition Research
https://www.readbyqxmd.com/read/28277856/electrical-therapies-for-gastrointestinal-motility-disorders
#3
Jiande D Z Chen, Jieyun Yin, Wei Wei
Gastrointestinal (GI) motility disorders are common in clinical settings, including esophageal motility disorders, gastroesophageal reflux disease, functional dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction, post-operative ileus, irritable bowel syndrome, diarrhea and constipation. While a number of drugs have been developed for treating GI motility disorders, few are currently available. Emerging electrical stimulation methods may provide new treatment options for these GI motility disorders...
March 6, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28246468/lymphocytic-esophagitis-still-an-enigma-a-decade-later
#4
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
#5
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
#6
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
#7
REVIEW
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
#8
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
#9
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/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
#10
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...
2017: Digestion
https://www.readbyqxmd.com/read/28141904/catheter-based-high-frequency-intraluminal-ultrasound-imaging-is-a-powerful-tool-to-study-esophageal-dysmotility-patients
#11
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
#12
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
#13
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
#14
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...
March 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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