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John pandolfino

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https://www.readbyqxmd.com/read/29702296/advances-in-management-of-esophageal-motility-disorders
#1
REVIEW
Peter J Kahrilas, Albert J Bredenoord, Dustin A Carlson, John E Pandolfino
The widespread adoption of high-resolution manometry (HRM) has led to a restructuring in the classification of esophageal motility disorder classification summarized in the Chicago Classification, currently in version 3.0. It has become apparent that the cardinal feature of achalasia, impaired lower esophageal sphincter relaxation, can occur in several disease phenotypes: without peristalsis, with premature (spastic) distal esophageal contractions, with panesophageal pressurization, or even with preserved peristalsis...
April 24, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29686276/management-options-for-patients-with-gerd-and-persistent-symptoms-on-proton-pump-inhibitors-recommendations-from-an-expert-panel
#2
Rena Yadlapati, Michael F Vaezi, Marcelo F Vela, Stuart J Spechler, Nicholas J Shaheen, Joel Richter, Brian E Lacy, David Katzka, Philip O Katz, Peter J Kahrilas, C Prakash Gyawali, Lauren Gerson, Ronnie Fass, Donald O Castell, Jenna Craft, Luke Hillman, John E Pandolfino
BACKGROUND: The aim of this study was to assess expert gastroenterologists' opinion on treatment for distinct gastroesophageal reflux disease (GERD) profiles characterized by proton pump inhibitor (PPI) unresponsive symptoms. METHODS: Fourteen esophagologists applied the RAND/UCLA Appropriateness Method to hypothetical scenarios with previously demonstrated GERD (positive pH-metry or endoscopy) and persistent symptoms despite double-dose PPI therapy undergoing pH-impedance monitoring on therapy...
April 24, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29644483/studies-of-abnormalities-of-the-lower-esophageal-sphincter-during-esophageal-emptying-based-on-a-fully-coupled-bolus-esophageal-gastric-model
#3
Wenjun Kou, John E Pandolfino, Peter J Kahrilas, Neelesh A Patankar
The aim of this work was to develop a fully coupled bolus-esophageal-gastric model based on the immersed boundary-finite element method to study the process of esophageal emptying across the esophagogastric junction (EGJ). The model included an esophageal segment, an ellipsoid-shaped stomach, a bolus, and a simple model of the passive and active sphincteric functions of the lower esophageal sphincter (LES). We conducted three sets of case studies: (1) the effect of a non-relaxing LES; (2) the influence of the tissue anisotropy in the form of asymmetrical right- and left-sided compliance of the LES segment; and (3) the influence of LES and gastric wall stiffness on bulge formation of the distal esophageal wall...
April 11, 2018: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29622813/advances-in-the-physiological-assessment-and-diagnosis-of-gerd
#4
Edoardo Savarino, Albert J Bredenoord, Mark Fox, John E Pandolfino, Sabine Roman, C Prakash Gyawali
This corrects the article DOI: 10.1038/nrgastro.2017.130.
April 6, 2018: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29622812/advances-in-the-management-of-oesophageal-motility-disorders-in-the-era-of-high-resolution-manometry-a-focus-on-achalasia-syndromes
#5
Peter J Kahrilas, Albert J Bredenoord, Mark Fox, C Prakash Gyawali, Sabine Roman, André J P M Smout, John E Pandolfino
This corrects the article DOI: 10.1038/nrgastro.2017.132.
April 6, 2018: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29437910/modern-diagnosis-of-gerd-the-lyon-consensus
#6
REVIEW
C Prakash Gyawali, Peter J Kahrilas, Edoardo Savarino, Frank Zerbib, Francois Mion, André J P M Smout, Michael Vaezi, Daniel Sifrim, Mark R Fox, Marcelo F Vela, Radu Tutuian, Jan Tack, Albert J Bredenoord, John Pandolfino, Sabine Roman
Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET <4% and <40 reflux episodes on pH-impedance monitoring off proton pump inhibitors...
February 3, 2018: Gut
https://www.readbyqxmd.com/read/29410117/best-practice-update-incorporating-psychogastroenterology-into-management-of-digestive-disorders
#7
REVIEW
Laurie Keefer, Olafur S Palsson, John E Pandolfino
Chronic digestive diseases, including irritable bowel syndrome, gastroesophageal reflux disease, and inflammatory bowel diseases, cannot be disentangled from their psychological context-the substantial burden of these diseases is co-determined by symptom and disease severity and the ability of patients to cope with their symptoms without significant interruption to daily life. The growing field of psychogastroenterology focuses on the application of scientifically based psychological principles and techniques to the alleviation of digestive symptoms...
April 2018: Gastroenterology
https://www.readbyqxmd.com/read/29408585/the-upper-esophageal-sphincter-assist-device-is-associated-with-symptom-response-in-reflux-associated-laryngeal-symptoms
#8
Rena Yadlapati, Jenna Craft, Christopher J Adkins, John E Pandolfino
No abstract text is available yet for this article.
January 31, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29351396/mechanisms-of-repetitive-retrograde-contractions-in-response-to-sustained-esophageal-distension-a-study-evaluating-patients-with-postfundoplication-dysphagia
#9
Dustin A Carlson, Peter J Kahrilas, Katherine Ritter, Zhiyue Lin, John E Pandolfino
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 postfundoplication dysphagia (a model of esophageal obstruction) to explore mechanisms behind RRCs. Adult patients with dysphagia after Nissen fundoplication ( n = 32) or type III achalasia ( n = 25) were evaluated with high-resolution manometry (HRM) and upper endoscopy with FLIP...
March 1, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29155168/improved-assessment-of-bolus-clearance-in-patients-with-achalasia-using-high-resolution-impedance-manometry
#10
Dustin A Carlson, Claire A Beveridge, Zhiyue Lin, Michelle Balla, Dyanna Gregory, Michael Tye, Katherine Ritter, Peter J Kahrilas, John E Pandolfino
BACKGROUND & AIMS: Esophageal retention is typically evaluated by timed-barium esophagram in patients treated for achalasia. Esophageal bolus clearance can also be evaluated using high-resolution impedance manometry. We evaluated the associations of conventional and novel high-resolution impedance manometry metrics, esophagram, and patient-reported outcomes (PROs) in achalasia. METHODS: We performed a prospective study of 70 patients with achalasia (age, 20-81 y; 30 women) treated by pneumatic dilation or myotomy who underwent follow-up evaluations from April 2013 through December 2015 (median, 12 mo after treatment; range, 3-183 mo)...
May 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29081541/a-continuum-mechanics-based-musculo-mechanical-model-for-esophageal-transport
#11
Wenjun Kou, Boyce E Griffith, John E Pandolfino, Peter J Kahrilas, Neelesh A Patankar
In this work, we extend our previous esophageal transport model using an immersed boundary (IB) method with discrete fiber-based structural model, to one using a continuum mechanics-based model that is approximated based on finite elements (IB-FE). To deal with the leakage of flow when the Lagrangian mesh becomes coarser than the fluid mesh, we employ adaptive interaction quadrature points to deal with Lagrangian-Eulerian interaction equations based on a previous work (Griffith and Luo [1]). In particular, we introduce a new anisotropic adaptive interaction quadrature rule...
October 1, 2017: Journal of Computational Physics
https://www.readbyqxmd.com/read/29037470/pathophysiology-of-gastroesophageal-reflux-disease
#12
REVIEW
Jan Tack, John E Pandolfino
The pathogenesis of gastroesophageal reflux disease (GERD) is complex and involves changes in reflux exposure, epithelial resistance, and visceral sensitivity. The gastric refluxate is a noxious material that injures the esophagus and elicits symptoms. Esophageal exposure to gastric refluxate is the primary determinant of disease severity. This exposure arises via compromise of the anti-reflux barrier and reduced ability of the esophagus to clear and buffer the refluxate, leading to reflux disease. However, complications and symptoms also occur in the context of normal reflux burden, when there is either poor epithelial resistance or increased visceral sensitivity...
January 2018: Gastroenterology
https://www.readbyqxmd.com/read/29016559/the-reflux-improvement-and-monitoring-trim-program-is-associated-with-symptom-improvement-and-weight-reduction-for-patients-with-obesity-and-gastroesophageal-reflux-disease
#13
Rena Yadlapati, John E Pandolfino, Olga Alexeeva, Dyanna L Gregory, Meredith R Craven, David Liebovitz, Abbey Lichten, Erin Seger, Moira Workman, Nora St Peter, Jenna Craft, Bethany Doerfler, Rajesh N Keswani
OBJECTIVES: Current healthcare systems do not effectively promote weight reduction in patients with obesity and gastroesophageal reflux disease (GERD). The Reflux Improvement and Monitoring (TRIM) program provides personalized, multidisciplinary, health education and monitoring over 6 months. In this study we aimed to (i) measure the effectiveness of TRIM on GERD symptoms, quality of life, and weight, and (ii) examine patient health beliefs related to TRIM. METHODS: This prospective mixed methods feasibility study was performed at a single center between September 2015 and February 2017, and included adult patients with GERD and a body mass index ≥30 kg/m2 ...
January 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28981080/improvement-in-esophageal-distensibility-in-response-to-medical-and-diet-therapy-in-eosinophilic-esophagitis
#14
Dustin A Carlson, Ikuo Hirano, Angelika Zalewski, Nirmala Gonsalves, Zhiyue Lin, John E Pandolfino
OBJECTIVES: We aimed to evaluate the effect of medical and diet therapies on esophageal distensibility assessed using the functional lumen imaging probe (FLIP) and the association of changes in esophageal distensibility with clinical outcomes in eosinophilic esophagitis (EoE). METHODS: Patients with EoE were evaluated with FLIP during endoscopy at baseline and following therapy without interval dilatation. Evaluation also included a validated patient-reported outcome (PRO; a positive PRO was considered at a 30% score improvement), mucosal biopsies, and scoring of endoscopic features of EoE...
October 5, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28951582/expert-consensus-document-advances-in-the-physiological-assessment-and-diagnosis-of-gerd
#15
REVIEW
Edoardo Savarino, Albert J Bredenoord, Mark Fox, John E Pandolfino, Sabine Roman, C Prakash Gyawali
GERD is a common condition worldwide. Key mechanisms of disease include abnormal oesophagogastric junction structure and function, and impaired oesophageal clearance. A therapeutic trial of acid-suppressive PPI therapy is often the initial management, with endoscopy performed in the setting of alarm symptoms and to exclude other conditions. If symptoms persist and endoscopy does not reveal evidence of GERD, oesophageal function tests are performed, including oesophageal manometry and ambulatory reflux monitoring...
November 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28951579/expert-consensus-document-advances-in-the-management-of-oesophageal-motility-disorders-in-the-era-of-high-resolution-manometry-a-focus-on-achalasia-syndromes
#16
REVIEW
Peter J Kahrilas, Albert J Bredenoord, Mark Fox, C Prakash Gyawali, Sabine Roman, André J P M Smout, John E Pandolfino
High-resolution manometry (HRM) and new analysis algorithms, summarized in the Chicago Classification, have led to a restructured classification of oesophageal motility disorders. This advance has led to increased detection of clinically relevant disorders, in particular achalasia. It has become apparent that the cardinal feature of achalasia - impaired lower oesophageal sphincter (LES) relaxation - can occur in several disease phenotypes: without peristalsis (type I), with pan-oesophageal pressurization (type II), with premature (spastic) distal oesophageal contractions (type III), or with preserved peristalsis (outlet obstruction)...
November 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28911949/postprandial-high-resolution-impedance-manometry-identifies-mechanisms-of-nonresponse-to-proton-pump-inhibitors
#17
Rena Yadlapati, Michael Tye, Sabine Roman, Peter J Kahrilas, Katherine Ritter, John E Pandolfino
BACKGROUND & AIMS: Recognition of rumination and supragastric belching is often delayed as symptoms may be mistakenly attributed to gastroesophageal reflux disease. However, distinct from gastroesophageal reflux disease, rumination and supragastric belching are more responsive to behavioral interventions than to acid-suppressive and antireflux therapies. Postprandial high-resolution impedance manometry (PP-HRIM) is an efficient method to identify rumination and belches. We investigated the distribution of postprandial profiles determined by PP-HRIM, and identified patient features associated with postprandial profiles among patients with nonresponse to proton pump inhibitors (PPIs)...
February 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28895583/psychosocial-distress-and-quality-of-life-impairment-are-associated-with-symptom-severity-in-ppi-non-responders-with-normal-impedance-ph-profiles
#18
Rena Yadlapati, Michael Tye, Laurie Keefer, Peter J Kahrilas, John E Pandolfino
OBJECTIVES: Up to 50% of patients with reflux symptoms do not manifest a satisfactory symptom response to proton pump inhibitor (PPI) therapy. Our primary aim in this study was to identify factors associated with symptom perception among PPI non-responder phenotypes. METHODS: This prospective observational cohort study was performed from September 2014 to January 2017 at a single academic medical center and included PPI non-responders who underwent 24-h impedance-pH monitoring and completed a questionnaire set measuring patient-reported symptom severity, quality of life (QOL), and psychosocial distress...
January 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28469219/response-to-song-et-al
#19
Rena Yadlapati, John E Pandolfino, Bruce K Tan
No abstract text is available yet for this article.
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#20
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
July 2017: Current Opinion in Gastroenterology
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