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)

Although recommended for patients requiring frequent dilations in whom surgery is not feasible, self-bougienage for benign esophageal stricture has not been examined critically. Thirteen patients performing self-dilations over a mean period of 4.8 years were evaluated. Dysphagia decreased in all patients and reflux symptoms were well-controlled in most patients with an antireflux regimen of elevation of the head of the bed, antacids, and cimetidine. Major complications of bleeding or perforation were not encountered, although three episodes of esophageal food impaction related to missed home dilation sessions did occur. Long-term self-bougienage is both safe and effective therapy for benign esophageal stricture for patients who require frequent dilations.
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PMID:Self-bougienage in the treatment of benign esophageal stricture. 671 48

This study attempted to define the esophageal motor disturbances and pathogenesis of symptoms in patients with lower esophageal diverticulum. Sixty-five patients were investigated by manometry in addition to roentgenography and endoscopy. Fifty had manometric evidence of abnormal motility, most often diffuse spasm or achalasia. Of the 15 patients with normal esophageal motility, 13 had hiatal hernia, and five of these had a high grade distal esophageal stricture. Pressures in the lower esophagus and lower esophageal sphincter in patients with lower esophageal diverticulum and motor disturbance were the same as for those in matched patients with motor disturbances but no diverticulum. Dysphagia, chest pain and regurgitation were common presenting symptoms. Of 46 patients with dysphagia, only ten had mechanical obstruction to explain this symptom. Of 32 patients with chest pain, only two had ulceration in the diverticulum as a possible cause of pain. We conclude that the development of lower esophageal diverticulum and its symptoms are associated with a motor disturbance of the esophagus in the majority of patients and with an organic obstruction in the minority of patients. The diverticulum itself is usually not the sole cause of the esophageal symptoms, although diverticula can produce symptoms in the absence of other definable conditions. When surgical treatment is indicated, the diverticulum should be excised and the underlying motor or mechanical obstruction should be corrected to prevent serious postoperative complications and recurrence of the diverticulum and its symptoms.
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PMID:Physiopathology of lower esophageal diverticulum and its implications for treatment. 677 41

Drug histories were obtained from 76 patients at the time of initial Eder-Puestow dilatation for benign oesophageal stricture. Six patients had consumed drugs known to cause oesophageal ulceration (emepronium bromide and potassium preparations). Of the remaining 70 patients, 22 had regularly taken a non-steroidal anti-inflammatory drug before the onset of dysphagia compared with 10 patients in a control group matched for age and sex; this difference was significant (p less than 0.02). Non-steroidal anti-inflammatory drugs may have a causative role in the formation of oesophageal stricture in patients with gastro-oesophageal reflux, in whom they should be prescribed with caution.
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PMID:Non-steroidal anti-inflammatory drugs and benign oesophageal stricture. 680 92

Eder-Puestow dilatation of esophageal strictures is a safe procedure. The treatment is followed by symptomatic improvement, but the effect of dilatation on the patients' nutritional state has so far not been reported. We have reviewed 33 patients with benign esophageal stricture with special regard to the effect of dilatation on body weight. A total of 152 dilatations was carried out. All patients had dysphagia, 32 patients had heartburn and 20 had regurgitation. Hiatus hernia was present in 29 patients. Thirteen patients had antireflux surgery; 10 operations were performed before, and four during the dilatation period. One patient required no further dilatations after operation. Dilators greater than 35 FG were passed in 85% of the dilatations. No serious complications occurred. Patients were followed for up to 5 yr (mean follow-up: 27 months). The mean interval between dilatations was 7 months. Body weight was recorded before and one month after dilatation on 78 occasions. There was a significant overall weight increase of 0.78 kg 1 month after dilatation. The mean weight increase was greater after the first dilatation (1.06 kg) than after subsequent ones (0.6 kg). We found that Eder-Puestow dilatation in patients with benign esophageal stricture led to symptomatic improvement and was followed by an increase in body weight.
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PMID:Results of Eder-Puestow dilatation in the management of esophageal peptic strictures. 684 18

Although bougienage is widely used to treat benign esophageal stricture, the rate of stricture recurrence and the long-term effectiveness of bougienage are unknown. We studied the natural history of esophageal stricture in 154 patients in whom bougienage was used as primary therapy. Dilatations were considered successful in terms of relief or major improvement of dysphagia in 84.5% of 103 patients followed 6 mo or longer (median, 26 mo). The risk of requiring esophageal dilatation after the initial episode was greatest in the first year of follow-up; thereafter, a smaller fraction of patients required dilatation each year. Forty-three percent of patients required no further dilatations, and a life-table analysis showed that 36% of patients would require no further dilatation during a projected 4-yr follow-up. The median frequency of subsequent dilatation was less than once a year. We were unable to identify any significant factors, such as initial severity of stricture, cause of stricture, presence of active esophagitis, or initial caliber of dilatation, that could predict the need for subsequent dilatation. Our results suggest that patients with benign strictures fall into two groups. In one group, the natural history was to improve or become asymptomatic after an initial series of dilatations, and only a small proportion eventually developed recurrent symptoms. The second group (46% of patients) required further dilatations to treat dysphagia during the first year of follow-up. Two-thirds of these patients needed regular dilatations in subsequent years. We conclude that bougienage is effective treatment for benign esophageal strictures, and should be utilized as primary therapy for most strictures.
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PMID:Natural history of benign esophageal stricture treated by dilatation. 686 59

Although esophageal strictures with attendant malignant degeneration are well known sequelae of caustic ingestion, fixed pharyngeal structural lesions and development of oral leukoplakia are not well appreciated consequences of such ingestion. We present a patient 12 yr after lye ingestion who displayed rapidly progressive dysphagia suggestive of esophageal carcinoma. Instead, adhesions bisecting the cricopharyngeal inlet and an upper esophageal stricture were found endoscopically. In addition, an area of hypopharyngeal leukoplakia with marked acanthosis, parakeratosis, and dysplasia was noted and resected. The management of this patient's dysphagia and subsequent follow-up for his potentially precancerous oral lesion form the basis of this report.
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PMID:Caustic cicatrization of the pharynx associated with dysphagia and premalignant mucosal changes. 706 65

A A retrospective study of 101 elderly patients who were referred for upper gastrointestinal barium studies showed that this led to a change of management in 36 patients. The commonest management change was endoscopic referral (10 patients). However, in only on patient did this sequence lead to surgery and this was merely palliative. Dysphagia, vomiting and weight loss were shown to be the presenting features most likely to result in an abnormal barium study. The most frequently detected abnormalities were hiatus hernia, reflux, oesophageal stricture, peptic ulcer and gastric carcinoma.
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PMID:Upper gastrointestinal barium studies in the elderly: follow-up in 101 patients. 711 71

To define the clinical course of patients with benign esophageal stricture treated with bougienage, we received the records of 76 patients undergoing dilatation. Patients with the diagnosis of scleroderma and those with previous hiatal hernia repair or gastric surgery were excluded. Initial evaluation included contrast study, esophagoscopy, and biopsy. Patients underwent a series of dilatations until a 44-Fr or larger bougie was passed. Patients were then instructed to return for recurrence of dysphagia. In this group, mean duration of follow-up from the first dilatation was 21.1 months. A total of 569 dilatations were performed with one major complication and no mortality. Benign esophageal stricture recurred in 65% of patients. After two or more recurrences, the likelihood of requiring an additional dilatation was 86--94% after each recurrence. The interval between required dilatations was variable; however, after 8 dilatations, it approximated once monthly. The shorter mean follow-up time of patients requiring a single dilatation (9.7 months) compared to those requiring multiple dilatations (28.8 months) suggests that the recurrence rates noted in this study are underestimations. In spite of high recurrence rates and short recurrence intervals, the low morbidity and absent mortality over long-term follow-up suggests that repeated bougienage is an effective modality for the management of benign esophageal stricture.
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PMID:Clinical course of esophageal stricture managed by bougienage. 711 73

Carcinoma of the lower oesophagus can be a complication of a peptic oesophageal stricture caused by reflux oesophagitis. In most cases there is also a hiatal hernia. The main symptoms are dysphagia and epigastric retrosternal pain. The most important examinations are x-ray contrast film of the oesophagus and oesophagogastroscopy combined with biopsy.
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PMID:[Peptic esophageal stenosis and its relation to reflux esophagitis and esophageal cancer]. 714 84

Over a four year period, 66 patients have undergone fibreoptic endoscopy and Eder Puestow dilatation for a presumed benign oesophageal stricture. Ten patients were subsequently shown to have carcinoma of the oesophagus. There were 121 dilatations with only one perforation, which healed with conservative treatment. Twenty eight of the 56 patients with a benign stricture have required only one dilatation with relief of dysphagia during follow-up periods ranging from 11 months to 61 months (mean 29 months). In those requiring repeat dilatations, relief has been obtained for periods ranging from two weeks to 35 months (mean 6 months). Mean time to restricture in the carcinoma group was two weeks. We conclude that the Eder Puestow method is safe, well tolerated, and less than 5% will require surgery. Strictures which recur rapidly should arouse suspicion of malignancy.
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PMID:Conservative management of benign oesophageal strictures. 722 27


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