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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 10 patients with peptic esophageal stricture the effect of esophageal dilatation on intraesophageal pH, stricture diameter, and dysphagia has been studied. Percentage of time during which intraesophageal pH was less than 4 and the number of reflux episodes per hour did not change significantly. Stricture diameter increased slightly, but consistently, from 7.0 +/- 0.5 mm to 9.1 +/- 0.5 mm (P less than 0.01) four days after dilatation, but was not significantly different from predilatation values after 12 weeks. Improvement in symptoms of dysphagia was striking (P less than 0.01) four days and six weeks after dilatation, but worsened again at 12 weeks (P = NS). It is unlikely that esophageal dilatation adversely affects the intraesophageal environment.
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PMID:Effect of dilatation of peptic esophageal strictures on gastroesophageal reflux, dysphagia, and stricture diameter. 334 83

One hundred seventy transnasal balloon catheter dilation procedures were performed in 35 patients with esophageal strictures to assess the efficacy and safety of the procedure. On the average, five dilations were required per patient. Depending on the cause of the esophageal stricture, success rates for the technique ranged from 67% to 87%, with success defined as the resolution of dysphagia to both fluids and solids. Three complications, all perforations, were seen; one perforation required surgical repair. No procedure-related deaths were identified in this series. Balloon catheter dilation can be safely applied to esophageal strictures from a variety of causes, with a high degree of clinical success.
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PMID:Esophageal strictures: balloon dilation. 336 26

We report a 7-year-old male with ampicillin-induced Stevens-Johnson syndrome with subsequent extensive skin, conjunctival, oropharyngeal, and laryngeal involvement. Over the next 5 months, he developed complete blindness and dysphagia. A barium swallow revealed absence of both right and left pyriform sinus, and a stricture involving the entire esophagus. Retrograde dilatations, complicated by malignant hyperthermia, have subsequently allowed for the difficult progression from an eight to a 40 French bougie. Eighteen months since the diagnosis of esophageal stricture, he has a normal appearing esophagus and is swallowing without difficulty.
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PMID:Esophageal stricture secondary to Stevens-Johnson syndrome. 343 Mar 22

Recent observation of one patient suffering from dysphagia lusoria has suggested critical review of treatment of the symptomatic aberrant right subclavian artery. Surgical correction of such an anomaly is difficult and may produce serious complications, and is not always successful. Endoscopic dilatation of the oesophageal stricture, even though it might only produce temporary relief of dysphagia, represents a valid therapeutical alternative because of its favourable cost/benefit ratio, low incidence of complications and patient acceptability.
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PMID:Dysphagia lusoria: proposal of a new treatment. 345 38

The authors evaluated the clinical course and management of 10 sclerotherapy patients with obliterated varices and symptomatic esophageal strictures. Strictures developed after 29 injections of 51 ml of sodium tetradecyl sulfate on an average of three sessions. Although the severity of dysphagia was variable, all patients were successfully managed with bougienage. To evaluate risk factors related to stricture formation a comparison was made with 14 nonstricture patients with obliterated varices. Multiple parameters of sclerotherapy were evaluated including total volume of sclerosant, number of injections, number of EVS sessions, volume of sclerosant, number of injections per session, number of esophageal ulcerations, and frequency of EVS treatments. No aspects of therapy clearly predicted the development of esophageal stricture.
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PMID:Esophageal strictures following endoscopic variceal sclerotherapy: clinical course and response to dilation therapy. 348 82

This paper reports a series of 52 patients with Barrett's (or columnar-lined) oesophagus from one medical unit diagnosed over a six-year period. The commonest associated symptoms were heartburn, regurgitation and dysphagia but 10 patients had no oesophageal symptoms and two had no symptoms at all. Gastrointestinal bleeding (overt or occult) was observed in almost one-third of patients. At diagnosis, 26 patients had oesophagitis, 23 had oesophageal ulceration and 10 had benign oesophageal strictures. An association between oesophageal ulceration and non-steroidal anti-inflammatory drug ingestion was suggested by the data and patients with oesophageal ulceration were significantly older than patients with uncomplicated Barrett's oesophagus. No patient had adenocarcinoma of the oesophagus at diagnosis and neither carcinoma nor dysplasia were seen during a mean period of 16.4 months. However, 17 per cent of patients in the series had malignancies in other sites. Most patients did well on medical treatment and only two were referred for anti-reflux surgery (both for non-healing oesophageal ulcers). Barrett's oesophagus was seen in 10 per cent of patients with gastro-oesophageal reflux at endoscopy. Oesophageal ulceration in patients with Barrett's oesophagus made up 21 per cent of oesophageal ulcers seen and benign oesophageal stricture in patients with Barrett's oesophagus constituted 13 per cent of all benign strictures seen. Barrett's oesophagus is common in our population and despite complications, it can be managed successfully, at least in the short term, by conservative means.
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PMID:Barrett's oesophagus: a clinical study of 52 patients. 349 62

To compare the efficacy and safety of one week versus three weeks interval treatment schedules of endoscopic sclerotherapy, injections were carried out in a prospective manner in 96 patients with variceal bleeding; 47 on a one week and 49 on a three weeks treatment schedule. Weekly endoscopic sclerotherapy eradicated oesophageal varices significantly (p less than 0.01) earlier (mean +/- SD 7.1 +/- 2.43 weeks) as compared with the three weeks regimen (mean +/- SD 14.86 +/- 4.86 weeks). The rebleeding rate was also significantly less (p less than 0.05) with weekly endoscopic sclerotherapy (8.5%) as compared with three weeks endoscopic sclerotherapy treatment (26.5%). The amount of alcohol and the number of endoscopic sclerotherapy courses required for complete variceal eradication did not differ significantly between the two groups. Patients undergoing weekly injections were seen to have significantly more oesophageal ulcers (p less than 0.01) as compared with the three weeks group, necessitating at times (23%) postponement of the procedure. There was, however, no difference between the two groups in the frequency of oesophageal stricture formation, dysphagia, retrosternal pain, and fever. Mortality was also similar in the two groups. It can be concluded that a weekly schedule of endoscopic sclerotherapy appears superior to a three weeks schedule.
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PMID:Comparison of the two time schedules for endoscopic sclerotherapy: a prospective randomised controlled study. 352 72

To assess the effects of endoscopic variceal sclerotherapy on esophageal symptoms and function, we prospectively studied 24 consecutive cirrhotic patients (group I), 60 days after variceal eradication had been achieved. Nine cirrhotics with varices (group II) and 16 normal volunteers (group III) were control groups. After sclerotherapy, 9 patients had persistent dysphagia and two others had heartburn. Nine patients developed an esophageal stricture, without dysphagia in 2 cases. Distal esophageal scars were observed in 8 out of 9 patients with stricture and 2 out of 15 patients without stricture. The percentage of patients with abnormal peristaltic waves (abnormal pattern, non propulsive contractions, respectively) was significantly (p less than 0.01) more important in group I (83 p. 100, 96 p. 100) than in group II (22 p. 100, 22 p. 100). A very particular manometric "en plateau" waveform pattern, never seen before, was observed in 75 p. 100 of patients in group I. Relaxation of lower esophageal sphincter (LES) was significantly (p less than 0.01) lower in patients with stricture (38 p. 100 median) than in the others (71 p. 100 median). Motility disturbances were observed in the 6 +/- 3 last centimeters of the esophagus, and were unchanged 9 months later in 5 patients who had further examination. The percentage of time below pH 4 and the Kaye's score did not differ between group I (n = 17) and group III on 3 hours postprandial esophageal pH monitoring. The percentage of time at pH less than 4 was more than 9 p. 100 in 31 p. 100 of group I patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Morphology and function of the esophagus after sclerotherapy of esophageal varices in cirrhotic patients]. 355 59

Eighty-nine patients who had resection of benign esophageal stricture with esophagogastrostomy were reviewed through medical records and by mailed questionnaire. The 30-day mortality rate was 8.9%. Seventy-six patients were available for follow-up for an average of 66.4 months (Group 1). Forty-three of these patients were followed up for longer than 5 years (Group 2). The incidence of postoperative heartburn in Groups 1 and 2 was 7.9% and 7.0%, respectively. The incidence of postoperative dysphagia in Groups 1 and 2 was 39.4% and 30.2%, respectively, with most episodes occurring within 2 years of operation. The vast majority of these patients required multiple esophageal dilatations over a long time. The high rate of restricture precludes support for the routine use of an esophagogastric anastomosis after resection of benign esophageal stricture.
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PMID:Esophagogastrectomy for benign esophageal stricture. Fate of the esophagogastric anastomosis. 356 74

51 patients with dysphagia caused by peptic oesophageal stricture due to primary or secondary reflux oesophagitis were treated by fibre-endoscope and Eder-Puestow dilatations under local anaesthesia and sedation, between 1976 and 1984. There was one death (2%) attributable to the procedure (perforation) and complications arose in three (6%) patients (perforation, pneumonia). The dilatation was successful in 96% but two patients (4%) had to be operated on because of undilatable stricture. Follow-up data was available for the other 44 patients for periods of one to eight (mean 2.8) years later. The stricture was cured by dilatation and antireflux treatment (conservative or operative) in all patients and 98% of them were able to eat solid food and improve their nutritional status. During follow-up 22 patients (50%) were asymptomatic and 22 (50%) had dysphagia or/and reflux symptoms. At endoscopy oesophagitis was healed with conservative or operative treatment in 25 patients (57%). It is concluded that fibre-endoscopic dilatation of peptic oesophageal strictures with the Eder-Puestow system combined with conservative or operative antireflux treatment, is a simple and safe procedure and gives good results in almost all patients. Surgical procedures aimed at total correction of the stricture are indicated only rarely in intractable cases.
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PMID:Fibre-endoscopic dilatation of peptic oesophageal strictures. 366 Oct 38


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