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https://www.readbyqxmd.com/read/29656451/patient-with-mediastinitis-caused-by-delayed-mucosal-damage-after-peroral-endoscopic-myotomy
#1
Hiroki Okada, Hironari Shiwaku, Kanefumi Yamashita, Toshihiro Ohmiya, Haruhiro Inoue, Suguru Hasegawa
Peroral endoscopic myotomy (POEM) is a groundbreaking procedure for treating esophageal achalasia, and many reports from various facilities have described its safety and efficacy. However, there have been few reports on adverse events. Here, we report a case of a patient with mediastinitis caused by delayed mucosal damage after POEM. This case was the most severe among all POEM cases at our hospital. A 58-year-old man had experienced dysphagia and chest tightness since he was around 50 years old. At a previous hospital, he had been diagnosed with nonerosive reflux disease and had undergone fundoplication...
April 15, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29642692/noncardiac-chest-pain-a-2018-update
#2
Marilena Durazzo, Giuseppe Gargiulo, Rinaldo Pellicano
Noncardiac chest pain (NCCP) is defined as recurring, angina-like, chest pain of noncardiac origin. Studies have estimated that gastroesophageal reflux disease (GERD) is the most common contributing factor for NCCP. In patients with non-GERD related NCCP, esophageal motility disorders, and functional chest pain (FCP) of presumed esophageal origin are the main underlying mechanisms for symptoms. Epidemiologic studies show a high prevalence of panic disorder, anxiety and major depression in NCCP patients. The diagnostic esophageal workup starts only after that cardiac and pulmonary diseases have been ruled out...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29616831/identifying-clinically-relevant-sliding-hiatal-hernias-a-population-based-endoscopy-study
#3
Bengt Wallner, Ove Björ, Anna Andreasson, Per M Hellström, Anna M Forsberg, Nicholas J Talley, Lars Agreus
OBJECTIVES: The clinical relevance of small to moderate sliding hiatal hernias is controversial. The aims of the present study were to (1) investigate which symptoms are associated with sliding hiatal hernias and (2) define the length of a sliding hiatal hernia at which gastrointestinal symptoms occur. METHODS: A study population representative of the general Swedish population answered a questionnaire regarding gastrointestinal symptoms and was investigated with an upper endoscopy...
April 4, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29606884/proton-pump-inhibitor-refractory-gastroesophageal-reflux-disease-challenges-and-solutions
#4
REVIEW
Joseph Mermelstein, Alanna Chait Mermelstein, Maxwell M Chait
A significant percentage of patients with gastroesophageal reflux disease (GERD) will not respond to proton pump inhibitor (PPI) therapy. The causes of PPI-refractory GERD are numerous and diverse, and include adherence, persistent acid, functional disorders, nonacid reflux, and PPI bioavailability. The evaluation should start with a symptom assessment and may progress to imaging, endoscopy, and monitoring of esophageal pH, impedance, and bilirubin. There are a variety of pharmacologic and procedural interventions that should be selected based on the underlying mechanism of PPI failure...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29605977/esophageal-motor-disorders-are-a-strong-and-independant-associated-factor-of-barrett-s-esophagus
#5
Camille Bazin, Alban Benezech, Marine Alessandrini, Jean-Charles Grimaud, Veronique Vitton
Background/Aims: Esophageal motor disorder (EMD) has been shown to be associated with gastroesophageal reflux disease (GERD). However, the association of EMD with a Barrett's esophagus (BE) is controversial. Our objective was to evaluate whether the presence of EMD was an independent factor associated with BE. Methods: A retrospective case-control study was conducted in GERD patients who all had oeso-gastroduodenal endoscopy and high-resolution esophageal manometry...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29603881/decreased-risk-for-microscopic-colitis-and-inflammatory-bowel-disease-among-patients-with-reflux-disease
#6
Amnon Sonnenberg, Kevin O Turner, Robert M Genta
BACKGROUND: Previous studies found an increased risk for microscopic colitis (MC) associated with proton pump inhibitors. In patients with ulcerative colitis (UC) or Crohn's disease (CD), proton pump inhibitors have been associated with an increased risk for IBD flares and impaired outcomes. AIMS: To test the epidemiologic associations between gastrooesophageal reflux disease (GERD) and MC, UC or CD in a large database. METHOD: The Miraca Life Sciences Database is a national electronic repository of histopathological records of patients distributed throughout the entire US...
March 31, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29575167/empirical-treatment-of-outpatients-with-gastroesophageal-reflux-disease-with-proton-pump-inhibitors-a-survey-of-chinese-patients-the-enlight-study
#7
Bin Lu, Ling Zhang, Jiangbin Wang, Bangmao Wang, Xiaoping Zou, Guijun Fei, Dongfeng Chen, Xuehong Wang, Bin Wu, Duowu Zou
BACKGROUND: Empirical proton pump inhibitor (PPI) treatment is recommended as a diagnostic indicator for GERD and as a therapy for symptomatic control, with responses generally seen within 4 weeks. However, there are no real-world data assessing the effectiveness of short-term empirical treatment with PPIs in patients with GERD in China. METHODS: The ENLIGHT study was a multicenter, prospective, observational study conducted in China. The primary outcome was the overall response rate after 4 weeks' empirical treatment with PPIs...
March 25, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29560665/esophagitis-dissecans-superficialis-a-case-series-of-7-patients-and-review-of-the-literature
#8
Elias Fiani, François Guisset, Quitterie Fontanges, Jacques Devière, Arnaud Lemmers
INTRODUCTION : Esophagitis dissecans superficialis (EDS) is a rare desquamative disorder of the eso-phagus, characterized by sloughing of the superficial mucosa. It is a benign entity of uncertain etiology. Most cases of EDS are idiopathic but can be caused by medications, hot beverages, chemical irritants, celiac disease and many skin conditions. AIM: Knowing that few case series have described this entity, we decided to review all the cases diagnosed in our center to characterize them...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29560641/the-association-between-gastroesophageal-flap-valve-function-and-gastroesophageal-reflux-symptoms
#9
O Keskin, Ç Kalkan, A Yaman, A Tüzün, I Soykan
BACKGROUND AND STUDY AIMS: Upper gastrointestinal endoscopic examination is usually the first step in the evaluation of patients with suspected gastroesopageal reflux disease. The primary aim of this study was to investigate the association between gastroesophageal flap valve function (GEFV) and gastroesophapgeal reflux symptoms in patients undergoing routine upper endoscopy. Patients and methods: 1507 patients were included into the study and the GEFV graded I to IV as follows: Hill I-II: normal GEFV, and Hill III-IV: abnormal GEFV...
October 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29559053/videoesophagography-versus-endoscopy-for-prediction-of-intraoperative-hiatal-hernia-size
#10
James M Tatum, Kamran Samakar, Michael E Bowdish, Wendy J Mack, Nikolai Bildzukewicz, John C Lipham
Magnetic sphincter augmentation is a novel surgical procedure for gastroesophageal reflux disease. Limited dissection at the hiatus is one of the benefits of the procedure, but makes precise and accurate preoperative assessment of even small hiatal hernia critical. Retrospective cohort study of 136 patients having undergone both endoscopy (EGD) and videoesophagography followed by operative assessment for hiatal hernia during magnetic sphincter augmentation. The objective of the study is to determine which preoperative modality more accurately predicts operative hiatal hernia size...
March 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29558791/comparison-of-tight-junction-protein-related-gene-mrna-expression-levels-between-male-and-female-gastroesophageal-reflux-disease-patients
#11
Jin Joo Kim, Nayoung Kim, Ji Hyun Park, Young Sun Kim, Sun Min Lee, Dong Ho Lee, Hyun Chae Jung
Background/Aims: Male predominance has been observed in the erosive reflux disease (ERD), but reverse finding in nonerosive reflux disease (NERD). This suggests sex-specific medicine approach is needed but its mechanism is remained to be elucidated. We aimed to compare clinical characteristics and mRNA expression levels of tight junction-related proteins between male and female gastroesophageal reflux disease (GERD) patients. Methods: Sixteen healthy controls, 45 ERD, and 14 NERD patients received upper endoscopies and completed questionnaires...
March 21, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29549453/a-modified-nissen-fundoplication-subjective-and-objective-midterm-results
#12
Sabrina Rampado, Edoardo Savarino, Angelica Ganss, Giulia Pozza, Romeo Bardini
PURPOSE: The failure rate of laparoscopic anti-reflux surgery is approximately 10-20%. The aim of our prospective study was to investigate whether a modified Nissen fundoplication (MNF) can improve reflux symptoms and prevent surgical treatment failure in the midterm. METHODS: The MNF consisted of (1) suturing the esophagus to the diaphragmatic crura on each side using four non-absorbable stitches, (2) reinforcing clearly weak crura with a tailored Ultrapro mesh, and (3) fixing the upper stitch of the valve to the diaphragm...
March 17, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29543695/mucosal-impedance-measurements-differentiate-pediatric-patients-with-active-vs-inactive-eosinophilic-esophagitis
#13
Mary Allyson Lowry, Michael F Vaezi, Hernan Correa, Tina Higginbotham, James C Slaughter, Sari Acra
BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is a chronic disorder in children that requires continued assessment of disease activity, involving repeated sedation, endoscopy, and biopsy analysis. We investigated whether mucosal impedance measurements can be used to monitor disease activity in pediatric patients with EoE. METHODS: We measured mucosal impedance at 3 locations in the esophagus in pediatric patients (1-18 years old; 32 with active EoE, 10 with inactive EoE, 32 with non-erosive reflux disease [NERD]) and 53 children with symptoms but normal findings from histologic analyses (controls) undergoing routine esophagogastroduodenoscopy at the Vanderbilt Pediatric Gastroenterology Clinic...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29542847/impaired-motility-in-barrett-s-esophagus-a-study-using-high-resolution-manometry-with-physiologic-challenge
#14
S Sanagapalli, A Emmanuel, R Leong, S Kerr, L Lovat, R Haidry, M Banks, D Graham, A Raeburn, N Zarate-Lopez, R Sweis
BACKGROUND: Esophageal dysmotility may predispose to Barrett's esophagus (BE). We hypothesized that high-resolution manometry (HRM) performed with additional physiologic challenge would better delineate dysmotility in BE. METHODS: Included patients had typical reflux symptoms and underwent endoscopy, HRM with single water swallows and adjunctive testing with solids and rapid drink challenge (RDC) before ambulatory pH-impedance monitoring. BE and endoscopy-negative reflux disease (ENRD) subjects were compared against functional heartburn patient-controls (FHC)...
March 15, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29534167/simultaneous-laryngopharyngeal-ph-monitoring-restech-and-conventional-esophageal-ph-monitoring-correlation-using-a-large-patient-cohort-of-more-than-100-patients-with-suspected-gastroesophageal-reflux-disease
#15
H F Fuchs, D T Müller, F Berlth, M K Maus, C Fuchs, M Dübbers, W Schröder, C J Bruns, J M Leers
24-hour esophageal pH-metry is not designed to detect laryngopharyngeal reflux (LPR). The new laryngopharyngeal pH-monitoring system (Restech) may detect LPR better. There is no established correlation between these two techniques as only small case series exist. The aim of this study is to examine the correlation between the two techniques with a large patient cohort. All patients received a complete diagnostic workup for gastroesophageal reflux including symptom evaluation, endoscopy, 24-hour pH-metry, high resolution manometry, and Restech...
March 8, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29531469/four-cancer-cases-after-esophageal-atresia-repair-time-to-start-screening-the-upper-gastrointestinal-tract
#16
Floor Wt Vergouwe, Madeleine Gottrand, Bas Pl Wijnhoven, Hanneke IJsselstijn, Guillaume Piessen, Marco J Bruno, René Mh Wijnen, Manon Cw Spaander
Esophageal atresia (EA) is one of the most common congenital digestive malformations and requires surgical correction early in life. Dedicated centers have reported survival rates up to 95%. The most frequent comorbidities after EA repair are dysphagia (72%) and gastroesophageal reflux (GER) (67%). Chronic GER after EA repair might lead to mucosal damage, esophageal stricturing, Barrett's esophagus and eventually esophageal adenocarcinoma. Several long-term follow-up studies found an increased risk of Barrett's esophagus and esophageal carcinoma in EA patients, both at a relatively young age...
March 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29526236/efficacy-and-safety-of-amla-phyllanthus-emblica-l-in-non-erosive-reflux-disease-a-double-blind-randomized-placebo-controlled-clinical-trial
#17
Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat
BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal complaints. GERD, caused by the reflux of stomach contents into the esophagus, leads to troublesome symptoms such as heartburn and regurgitation. It is classified into two types: erosive esophagitis, characterized by visible esophageal mucosa erosion in endoscopy, and non-erosive reflux disease (NERD). GERD is a chronic and recurrent disease that impairs the quality of life and imposes socioeconomic and therapeutic burdens to both patients and society...
March 2018: Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29519608/the-impact-of-preoperative-investigations-on-the-management-of-bariatric-patients-results-of-a-cohort-of-more-than-1200-cases
#18
Romano Schneider, Ioannis Lazaridis, Marko Kraljević, Christoph Beglinger, Bettina Wölnerhanssen, Ralph Peterli
BACKGROUND: Despite the increasing use of bariatric surgery as the most effective treatment of morbid obesity, there is still no consensus on its preoperative diagnostic workup. The aim of this study was to identify the pathologies of the endoscopic and radiologic investigations before performing bariatric surgery and to evaluate their impact on the patient management. METHODS: Retrospective analysis of prospectively collected data of 1225 consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass (n = 834) or sleeve gastrectomy (n = 391) at our institution...
January 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29513170/esophagitis-dissecans-superficialis-a-case-series-of-7-patients-and-review-of-the-literature
#19
E Fiani, F Guisset, Q Fontanges, J Deviere, A Lemmers
INTRODUCTION : Esophagitis dissecans superficialis (EDS) is a rare desquamative disorder of the eso-phagus, characterized by sloughing of the superficial mucosa. It is a benign entity of uncertain etiology. Most cases of EDS are idiopathic but can be caused by medications, hot beverages, chemical irritants, celiac disease and many skin conditions. AIM AND METHODS: Knowing that few case series have described this entity, we decided to review all the cases diagnosed in our center to characterize them...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29509536/gastroesophageal-reflux-before-metabolic-surgery
#20
Ionuţ Hutopilă, A Constantin, Cătălin Copăescu
Background: Obesity has significantly increased in the last decades and metabolic (bariatric) surgery has been extended accordingly. Clinical manifestations of Gastroesophageal reflux disease (GERD) are frequent in the obese population but the presence of GERD premises (i.e. Hiatala hernia) or complications in asymptomatic patients undergoing metabolic surgery is unclear. AIM: (1) to identify gastroesophageal reflux condition or complications in patients undergoing metabolic surgery. (2) Study the correlations of the clinical symptoms of GERD with the preoperative radiological and endoscopic findings...
January 2018: Chirurgia
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