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

Dysphagia is a frequent cause of referral for oesophageal manometry although the motor response to eating is not routinely studied. We examined symptoms and oesophageal motor patterns in response to eating bread in 30 patients with either gastro-oesophageal reflux (n = 20), or normal oesophageal function tests (n = 10). No patient experienced symptoms while swallowing water but one complained of heartburn and one developed symptomatic oesophageal 'spasm' during eating. In eight further patients, pain or dysphagia which occurred with swallowing bread was associated with aperistalsis. Comparing asymptomatic and symptomatic periods, there was a slight increase in mean swallow frequency from 7.5 (0.79) (SEM) to 9.0 (1.17) swallows per minute (NS; n = 10). The mean number of aperistalsis swallows increased from 4.5 (0.96) per minute to 6.2 (1.30) (p less than 0.01; n = 10). Aperistalsis during symptoms was mainly caused by non-conducted swallows rather than synchronous contractions (mean 5.8 (1.45) per minute compared with 1.2 (0.44]. Aperistalsis can be produced by rapid swallowing in the normal oesophagus through 'deglutitive inhibition'. These results suggest that some patients experience dysphagia associated with aperistalsis perhaps as a response to increased frequency of swallowing. Functional abnormalities of this nature will not be detected by conventional oesophageal manometry.
 ...
PMID:Oesophageal manometry during eating in the investigation of patients with chest pain or dysphagia. 280 85

A case of tetanus is described in a 71-year-old female. Her initial presentation was trismus and dysphagia following a tongue laceration by grossly carious teeth. Subsequently, she developed muscular spasm which led to the diagnosis of tetanus. This paper discusses tetanus generally, and the management of the condition.
 ...
PMID:Tetanus associated with dental sepsis. 315 23

Otolaryngological manifestations were examined in a series of 250 patients diagnosed as having ALS between 1976 and 1986. Surgical intervention was only required in 10 cases due to excessive drooling and aspiration. Five patients had submandibular gland excisions with only limited improvement in respect to drooling. One case having a unilateral tympanic neurectomy had significantly better drooling control. Cricopharyngeal myotomy is helpful when dysphagia is predominantly due to cricopharyngeal spasm. In our series, tympanic neurectomy and chorda tympanectomy provide the better control of drooling for these patients and has the added advantage of being performed under local anesthesia.
 ...
PMID:Otolaryngologic manifestations of amyotrophic lateral sclerosis. 334 21

Sudden esophageal obstruction after eating poorly chewed meat has been called the Steakhouse syndrome. Some cases have demonstrable esophageal narrowing above which food impacts, but in many patients with identical symptoms no underlying obstruction is demonstrated. We report four patients with acute dysphagia who were unable to swallow liquids or solids for as long as 72-96 h. Onset occurred after eating meat in three patients and after taking psyllium in one. All had a structurally normal esophagus demonstrated by x-ray and endoscopy, but motor disorders were defined by manometry in three. We hypothesize that an underlying motor abnormality led to food impaction and call this presumed spastic variant "Steakhouse spasm." We suspect that this is a common but frequently unrecognized manifestation of esophageal dysmotility.
 ...
PMID:Steakhouse spasm. 361 82

To evaluate function of the normal and pathologic esophageal body under more physiologic conditions than those utilized for traditional laboratory testing, manometry was performed before and during eating using a catheter assembly containing three peripheral transducers. Studies were evaluated from seven normal volunteers, 18 typical achalasia patients (eight before and 10 after esophagomyotomy), and eight patients with diffuse esophageal spasm (DES) as characterized by frequent simultaneous and repetitive contractions. In the preprandial period, all had similar frequencies of esophageal contractions, although there was a wide range. During eating, the frequency of contractions increased in all groups; however, the contraction frequency in unoperated achalasia patients, 12.7 +/- 5.0 contractions/min, significantly exceeded the frequency in normal volunteers of 4.9 +/- 1.3 contractions/min, p less than 0.01. The frequency was lower in operated achalasia patients, 9.4 +/- 6.5 contractions/min, but still exceeded that of normal volunteers, p less than 0.01. Patients with DES also had more frequent contractions, 10.5 +/- 9.7 contractions/min, than did the normal volunteers, p less than 0.01. The mean pressure of esophageal contractions for both achalasia groups was similar and was significantly lower than for the normal volunteers. Pressure in the DES patients was intermediate. It is concluded that patients with achalasia have lower pressure but more frequent contractions than normal volunteers during eating, and this spasm-like activity may be a more important pathophysiologic factor in their dysphagia than previously recognized. Esophagomyotomy does decrease the frequency of these contractions. Frequency, but not pressure, of contractions differs from normal in patients with DES.
 ...
PMID:Physiologic evaluation of esophageal function in patients with achalasia and diffuse esophageal spasm. 370 28

We prospectively evaluated 22 patients with manometrically proven "nutcracker esophagus" (high amplitude peristaltic contractions). All patients were symptomatic with angina-like chest pain, dysphagia, or both. Patients underwent barium esophagram with video-recording of the images. Video tapes were reviewed independently by a gastrointestinal radiologist who was unaware of the patients' manometric diagnoses. The video-esophagram was normal in 12 of 22 (55%) patients. Eight of 22 (36%) had dysmotility: either diffuse spasm (9%) or tertiary contractions (27%) (Fig. 2). A hiatal hernia was the only abnormality in two patients. Although the presence of diffuse spasm or tertiary contractions may suggest the presence of the underlying motor disorder in patients with nutcracker esophagus, we conclude that the "barium swallow" lacks sufficient sensitivity to screen adequately for this disorder in patients with atypical angina or dysphagia.
 ...
PMID:Radiology of the nutcracker esophagus. 373 53

Recurrent vomiting is common in children with severe mental retardation and leads to significant morbidity with malnutrition, anemia, and aspiration pneumonitis. Spasms of the abdominal muscles and diaphragm, uncoordinated peristalsis, and central nervous system disorders are causes of dysphagia and continuous gastroesophageal reflux. It is desirable that mentally retarded children with vomiting have a barium swallow and esophagoscopy as early as possible. Fundoplication should be performed before complications develop. Spasms with aspiration followed by apnea, in particular, are life-threatening situations. After surgery there is a definite improvement in mental and physical development.
 ...
PMID:Gastroesophageal reflux and severe mental retardation. 392 35

Chest pain due to esophageal spasm or esophagitis may mimic pain of variant angina. Differential diagnosis of the two diseases is often difficult and requires various tests, the value of which is discussed. These problems are illustrated by three cases. The esophageal investigation should preferably be preceded by coronary arteriography. Chest pain or dysphagia due to iced drinks is not specific for esophageal spasm but may be due to coronary spasm.
 ...
PMID:[Spontaneous precordial pain: coronary spasm or esophageal pathology?]. 395 80

Hemifacial spasm is usually an isolated symptom resulting from facial nerve root compression. Three patients had, in addition, tinnitus, hearing loss, facial sensory loss, diminished gag reflex, dysphagia, and dysarthria. Acoustic reflexes were abnormal, and facial nerve conduction studies showed evidence of ephaptic transmission and ectopic excitation. Brain CT and metrizamide cisternography were normal. Surgical exploration showed compression of cranial nerve roots by posterior inferior cerebellar artery branches. After decompression, symptoms abated, and electrical signs of hemifacial spasm disappeared. Vascular compression of nerve roots in the cerebellopontine recess may cause multiple cranial neuropathy.
 ...
PMID:Vascular compression, hemifacial spasm, and multiple cranial neuropathy. 399 Sep 69

Fifty-eight consecutive patients were investigated for spontaneous chest pain without symptoms of effort angina, previous myocardial infarction or other signs of cardiac disease, to determine the incidence of oesophageal spasm. The character of the chest pain, its context and the results of resting ECGs were analysed. An ECG recorded during chest pain was available in 23 cases and exercise stress testing was performed in 43 cases. Coronary angiography was carried out in all patients. The coronary arteries were normal or showed little change in 44 patients. Further investigations were ordered: oesophageal manometry (42 cases), echocardiography 44 cases) and ergometrine provocation tests (44 cases). The patients were then divided into 4 groups: 23 patients (40 p. 100) with coronary artery disease; either atheroma (14 cases) or spasm (9 cases); 8 patients (13,5 p. 100) with non-coronary cardiac pathology (myocardial hypertrophy or mitral valve prolapse); 15 patients (26 p. 100) with oesophageal spasm alone; 12 patients (20,5 p. 100) with no obvious organic disease. Often simulating spontaneous angina, clinically and electrocardiographically, oesophageal spasm may sometimes be distinguished (6 out of 15 cases) by the finding of painful dysphagia on swallowing ice-cold liquid. The condition is confirmed by oesophageal manometry which shows abnormalities of oesophageal contraction. In addition, 13 out of 15 patients in our series had hypotonia of the gastro-oesophageal sphincter. Dyskinetic phenomena and this hypotonia should be taken into consideration in the treatment of this condition.
 ...
PMID:[Esophageal spasm: a common cause of spontaneous precordial pain]. 643 62


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>