Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal inflammatory disease that is becoming more widely recognized as a cause of feeding difficulties in infants and young children, as well as gastroesophageal reflux disease (GERD)-like symptoms, dysphagia, and food impaction in children and adolescents. The diagnosis of EoE is clinicopathologic, based on endoscopic, histologic, and clinical findings. Patients with suspected eosinophilic esophagitis require an endoscopy with biopsies. The diagnosis requires the presence of 15 or more intraepithelial eosinophils/HPF in at least one endoscopic esophageal mucosal biopsy. Histology will reveal mucosal eosinophilia isolated to the esophagus, which does not improve following Proton Pump Inhibitor (PPI) trial. Other disorders causing esophageal eosinophilia, such as GERD, celiac disease, Crohn's disease, infection, hypereosinophilic syndrome, achalasia, and drug hypersensitivity must be ruled out. The goals of treatment should include both histologic healing of the esophageal mucosa, as well as resolution of clinical symptoms. Treatment options include food elimination diets, topical steroids, and/or esophageal dilatation. While the understanding of EoE has evolved over the past twenty years, it continues to be a challenging diagnosis due to the clinical and histopathologic similarities to GERD. Much remains to be studied regarding the underlying pathology, as well as appropriate biomarkers to better evaluate response to therapy.
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PMID:Pediatric Eosinophilic Esophagitis. 3011 May 27

Down syndrome is the most common human chromosomal disorder. Among clinical findings, one constant concern is the high prevalence of gastrointestinal system alterations. The aim of this study was to determine the prevalence of gastrointestinal disorders at a Down syndrome outpatient clinic during a 10-year follow-up period. Data from medical files were retrospectively reviewed from 1,207 patients. Gastrointestinal changes occurred in 612 (50.7%). The most prevalent disorder was chronic intestinal constipation. Intestinal parasite occurred in 22% (mainly giardiasis), gastroesophageal reflux disease in 14%, digestive tract malformations occurred in 5%: 13 cases of duodenal atresia, 8 of imperforate anus, 4 annular pancreases, 2 congenital megacolon, 2 esophageal atresias, 2 esophageal compression by anomalous subclavian and 1 case of duodenal membrane. We had 38/1,207 (3.1%) patients with difficulty in sucking and only three with dysphagia that resolved before the second year of life. Peptic ulcer disease, celiac disease, and biliary lithiasis were less prevalent with 3% each. Awareness of the high prevalence of gastrointestinal disorders promotes outstanding clinical follow-up as well as adequate development and greater quality of life for patients with Down syndrome and their families.
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PMID:Gastrointestinal disorders in Down syndrome. 3118 86

Dysphagia is an uncommon symptom for celiac disease (CD). Typically, patients with CD present with abdominal pain, diarrhea, steatorrhea, weight loss, growth failure, anemia, or fatigue. We report a case of dysphagia in a pediatric patient with negative celiac serologies and positive histologic findings suspicious for CD. Our patient's dysphagia resolved after being placed on a gluten-free diet. Repeat interval endoscopy on a gluten-free diet to assess for resolution of histological changes confirmed the diagnosis of CD. In patients with dysphagia, CD should be considered in the differential diagnosis despite negative celiac serologies.
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PMID:Dysphagia as a Presentation of Celiac Disease. 3254 89

An esophageal web is a thin and smooth extension of normal esophageal tissue consisting of mucosa and submucosa that can occur anywhere along the length of the esophagus but is typically located in the cervical segment. The webs can be congenital or acquired, commonly associated with Plummer-Vinson syndrome and rarely with celiac disease, dermatological disorders or graft-versus-host disease. A 54-year-old man was referred to our hospital with a history of high non-progressive dysphagia to solid food, meat impaction and weight loss over last ten months. His medical history and family history were unremarkable nor was the physical examination. Complete blood count and basic biochemical tests were normal. Antigliadin and antiendomysial antibodies for celiac disease were negative. Barium swallow esophagography and upper endoscopy detected cervical esophageal webs. The treatment consisted of endoscopic balloon dilation. The patient's dysphagia resolved shortly after dilation, and the endoscope passed easily through the esophagus showing normal esophageal, gastric and duodenal mucosa. This report is consistent with a case of esophageal webs rarely documented in males and that is not related with common causes like Plummer-Vinson syndrome. Thus, the pathogenesis and treatment of esophageal webs are evolving.
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PMID:Idiopathic Cervical Esophageal Webs: A Case Report and Literature Review. 3323 85


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