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)

A patient is described who suffered from prolapse of the lower oesophageal mucosa in the presence of a Schatzki ring. There was variable dysphagia culminating in total aphagia. The clinical symptoms disappeared without any treatment once the patient had overcome several years of psychological stress. The radiological appearances gave rise to a discussion of the radiological anatomy of the terminal oesophagus with a Schatzki ring since numerous similar appearances illustrated in the literature have been interpreted as axial hiatus hernias. A comparison of manometric and radiological fingings has shown that a hernia did not exist. The advantages and errors inherent in diagnosing hernias with the help of the "three rings", as described by Hafter, are discussed. The mucosal prolapse during the stage of aphagia is demonstrated and compared with cases from the literature showing prolapse at the upper and lower vestibular margins. The mechanism leading to these appearances is discussed.
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PMID:[Invagination of the oesophageal mucosa in the presence of a Schatzki ring (author's transl)]. 15 Oct 7

Cancer excepted all other diseases of the esophagus are rare. Diverticula, benign tumors, perforations and the pathology of the cardia (hiatus hernia, achalasia and esophageal varices) are not studied here. We took into consideration the following diseases only: spasm of the cricopharyngeal muscle, Plummer-Vinson or Kelly-Paterson syndrome, cervical osteophytosis, dysphagia lusoria, benign and malignant mediastinal lymphatic nodes, Schatzki ring of the lower esophagus and esophageal duplications.
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PMID:[Some rare diseases of the esophagus (author's transl)]. 22 8

The lower esophageal ring, or Schatzki's ring, consists of a thin, submucosal, circumferential scar which forms a thin incomplete diaphragm in the lower esophageal lumen. The symptoms may be either episodic aphagia or progressive dysphagia, and the severity of symptoms is related to the diameter of the ring. Between 1970 and 1978, we saw 24 patients with lower esophageal rings and complaints of episodic aphagia or progressive dysphagia. Symptoms of esophagitis were present in 20 of the 24. Twenty were treated surgically by interrupting the rings and repairing the sliding hiatal hernias. Two were treated by dilatation and two received no treatment to the ring. Hiatal hernias have recurred in two patients. In one, there is a recurrent ring and in the other, an acid peptic stricture. The ring has responded to dilatation and the peptic stricture to dilatation and repair of the recurrent hernia. Two patients without symptoms of esophagitis, treated by dilatation, are doing well but the follow-up period is so far too short to draw any conclusion.
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PMID:Symptomatic lower esophageal ring: treatment of 24 patients. 47 13

Three hundred patients underwent 1,177 esophageal dilations over a nine-year period. There were 164 men and 136 women. Mean age was 63 years. Etiology of stricture was peptic (160), Schatzki's ring (124), cancer (8), post-surgical (3), post-radiation (2), caustic ingestion (1), and esophageal web (2). Dilators used were Maloney red-rubber mercury weighted (78.1%), Savary wire-guided (15.2%), Eder-Puestow (6.3%) and Balloon (0.4%). Fluoroscopy was used in 98% of cases. One hundred and two of the 111 patients with peptic strictures observed for longer than six months had successful dilation. Forty-five of these patients (40.5%) required 54 redilations to maintain relief of dysphagia. Nine patients were refractory to dilation, two needing serial dilation and seven surgery. All Schatzki's rings were treated successfully. Ten of 82 patients followed for greater than six months needed redilation (12%). Morbidity was 0.2% with two complications occurring, an esophageal perforation and one case of hematemesis. There was no mortality.
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PMID:Esophageal stricture: results of dilation of 300 patients. 140 61

Cellulose fiber diet pills have recently become a popular form of weight control. In the past 2 months, we have seen two patients in whom ingestion of these pills has resulted in complete distal esophageal obstruction. Further studies revealed that each patient had a previously undiagnosed anatomical abnormality of the distal esophagus; in one case a Schatzki's ring, and in the other a stricture probably secondary to chronic reflux. We conclude that patients with known esophageal narrowing, or with a history of reflux and/or dysphagia, should use cellulose fiber diet pills only with extreme caution.
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PMID:Cellulose fiber diet pills. A new cause of esophageal obstruction. 216 38

The purpose of this study is to report long-term results of 61 patients with Schatzki's ring who were dilated for relief of dysphagia. The severity of Schatzki's ring was mild in 28 patients (46%), moderate in 26 (43%), severe in 5 (8%), and indeterminate in 2 (3%). Follow-up information was available in 56 of 61 patients (mean, 75 months). During follow-up, 35 patients (63%) developed recurrent dysphagia and required repeated dilations: 19 patients (34%) had one to two dilations, 9 patients (16%) had three to seven dilations, 6 patients (11%) had more than seven dilations; 1 patient underwent surgery for resection of the Schatzki's ring (2%). The mean (range) dilation-free interval was 50.1 months (11.8 to 100 months) in mild cases, 44.5 months (8.9 to 82 months) in moderate cases, and 28.6 months (9 to 76 months) in severe cases. There was no significant correlation between the severity of Schatzki's ring on initial presentation and the subsequent dilation-free interval. Our data indicate that recurrent dysphagia is common among patients with Schatzki's ring after a successful dilation, and that the severity of Schatzki's ring is not a good prognostic indicator of the need for subsequent dilation.
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PMID:Schatzki's ring: long-term results following dilation. 207 Oct

Gastroesophageal reflux (GER) has been suggested as a cause of the lower esophageal (Schatzki) ring. We looked for the presence of GER and reflux injury in a series of 20 patients with lower esophageal ring and dysphagia, using a 24-hour esophageal pH monitoring and upper endoscopy with biopsy. Abnormal GER was documented in 13 of the patients (65%), 10 of whom had erosive reflux changes in the distal esophagus. Seven patients (35%) showed no evidence of pathologic GER or reflux esophagitis. All patients also underwent esophageal manometry. Nonspecific esophageal body motor dysfunction may have contributed to dysphagia in five patients, two of whom had no evidence of abnormal GER. We conclude that GER disease is a frequent cause of the gradually progressive ring stricturing and dysphagia seen in patients with lower esophageal ring. Antireflux therapy, as an adjunct to esophageal dilatation, may be appropriate for many symptomatic lower esophageal ring patients.
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PMID:Gastroesophageal reflux as a pathogenic factor in the development of symptomatic lower esophageal rings. 238 61

Schatzki's ring is a distinct anatomical entity associated with hiatal hernia; however, its significance is unclear. Thirty-two patients with a radiologically demonstrated Schatzki's ring were compared with 32 patients with hiatal hernia and no Schatzki's ring. Schatzki's ring was confirmed on endoscopy in 59 percent of patients. Seventy-five percent of patients with Schatzki's ring presented with dysphagia compared with 41 percent of control patients (p less than 0.01). Heartburn and regurgitation were less frequent than in control subjects (38 percent versus 91 percent, p less than 0.0001). Schatzki's ring patients were found to have a lower incidence of proven gastroesophageal reflux on 24-hour pH monitoring. Those with proven reflux were found to have a more efficient lower esophageal sphincter than control patients. Sixty-two percent of Schatzki's ring patients without proven reflux had a history of chronic ingestion of drugs known to be damaging to the esophageal mucosa, whereas only 26 percent of patients with reflux had this history. This was found in 16 percent of controls. Sixty-two percent of Schatzki's ring patients without reflux responded to a single dilatation compared with 37 percent of those with reflux. These findings suggest an etiologic relationship between pill lodgement and Schatzki's ring in patients without reflux and indicate that different therapy should be employed in these patients.
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PMID:Analysis of thirty-two patients with Schatzki's ring. 258 90

Oropharyngeal and esophageal dysphagia involve different phases of swallowing, have different causes, and can usually be distinguished by a thorough patient history. Initial evaluation of patients with suspected oropharyngeal dysphagia includes patient history, physical and neurologic examination, and careful videofluoroscopic study of pharyngeal dynamics. Initial evaluation of patients with suspected esophageal dysphagia includes patient history and barium swallow with esophagography. Lesions such as Schatzki's ring or peptic stricture may not be detected unless the esophagus is sufficiently distended and the patient is given a bolus challenge.
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PMID:Dysphagia. Diagnostic pitfalls and how to avoid them. 264 59

We review the incidence, etiopathogenesis, clinical manifestations and treatment of lower esophageal or Schatzki's rings. In patients with dysphagia caused by this ring, medical and dietetic treatment is the first step, and dilatation should be reserved for cases of failure of this treatment. Surgery is rarely needed, being indicated only in cases of recurrence or failure of dilatation treatment. In these cases, complete excision of the ring and end-to-end anastomosis of the gastric and esophageal mucosa through a gastrostomy is recommended before antireflux surgery is considered.
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PMID:[Schatzki's ring]. 268 40


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