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)

Calcium antagonist relax smooth muscle, a possible useful concept in treatment of diffuse oesophageal spasm. Therefore the effects of oral diltiazem (60 mg t.d.s.) and placebo were compared in eight patients with diffuse oesophageal spasm in a 10-week double-blind crossover study. The patients recorded the severity of chest pain and/or dysphagia in daily pain diaries using visual analogue scales. Chest pain index and dysphagia index were calculated by multiplying frequency with daily intensity of each individual symptom. When compared to placebo, diltiazem did not significantly change the overall dysphagia index and chest pain index. An individual sizeable reduction of dysphagia was attained on diltiazem in four out of six patients and in six out of eight patients suffering from chestpain. Side effects were not seen during diltiazem therapy. Diltiazem, in our study, did not yield in a significant improvement of symptoms in diffuse oesophageal spasm. Diltiazem, however, can offer relief in selected individual patients suffering from diffuse oesophageal spasm.
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PMID:Efficacy of diltiazem in the treatment of diffuse oesophageal spasm. 210 59

FROM AN ETIOLOGICAL POINT OF VIEW: Thoracic pain is a frequent symptom. Before confirming the oesophageal origin of the pain, a coronary disease must be excluded. Two principle causes are source of thoracic pain of oesophageal origin: gastro-oesophageal reflux disease and oesophageal motility abnormalities. THE DIAGNOSTIC APPROACH: This must include the questioning of the patient and the usual paraclinical examinations. To confirm the diagnosis, these examinations must establish a chronological relationship between the symptoms and the abnormalities. For economic reasons, following a normal gastroscopy, there is a tendency to propose an empirical proton pump inhibitor (PPI) test rather than a 24 hour pH-metry antireflux as first line. The improvement or even the disappearance of the symptoms confirms the diagnosis; long-term treatment with a double dose of PPI should therefore be envisaged. The pH-metry with search for results should be proposed to the non-responders and to patients with atypical reflux manifestations. Dysphagia and odynophagia suggest an oesophageal motility disorder that basal manometry should confirm. A chronological relationship is rarely revealed, but the sensitivity of the pH-meter can be enhanced by provocation tests. REGARDING TREATMENT: Other than achalasia, treatment of the other spastic-like motor disorders is not well codified. Diltiazem is efficient. Some patients exhibit a hyperalgic oesophagus. The physiopathological mechanisms are still theoretical. Low dose tricyclic antidepressors and psychological management are useful.
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PMID:[Thoracic pain of oesophageal origin. Diagnostic management and treatment]. 1471 71