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

Achalasia is a primary motor disorder of the esophagus characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. This results in patients' complaints of dysphagia to solids and liquids, regurgitation, and occasional chest pain with or without weight loss. Endoscopic finding of retained saliva with puckered gastroesophageal junction or barium swallow showing dilated esophagus with birds beaking in a symptomatic patient should prompt appropriate diagnostic and therapeutic strategies. In this ACG guideline the authors present an evidence-based approach in patients with achalasia based on a comprehensive review of the pertinent evidence and examination of relevant published data.
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PMID:ACG clinical guideline: diagnosis and management of achalasia. 2424 18

Esophageal intramural pseudodiverticulosis (EIPD) is a rare condition often presenting with esophageal strictures. Treatment is often limited to endoscopic dilatation and treatment of the underlying esophageal pathology. We present a case of a patient with longstanding GERD on famotidine (she experienced anaphylaxis with proton pump inhibitors [PPIs]) who presented with dysphagia and weight loss. Work-up revealed a diagnosis of EIPD with a 5-mm mid-esophageal stricture. Therapy with dilatation was unsuccessful until the addition of sucralfate, after which dilatation was successful and symptoms resolved. In patients who are unable to take PPIs, the addition of sucralfate may enhance the success of dilatations of esophageal strictures and EIPD.
ACG Case Rep J 2014 Apr
PMID:A Treatment Option for Esophageal Intramural Pseudodiverticulosis. 2615 52

A 50-year-old man with a history of epilepsy controlled with phenytoin presented for evaluation of dysphagia. History revealed the patient was taking his phenytoin daily without water. Barium esophagram showed severe stricturing of the mid-esophagus. Upper endoscopy revealed diffuse gross mucosal abnormality with a thick stricture and occasional exudate. Biopsies were consistent with a drug-induced injury with lymphocytic infiltration and epithelial cell necrosis.
ACG Case Rep J 2015 Jan
PMID:Caustic Injury and Stricture of the Esophagus After Long-Term Phenytoin Use. 2615 21

Deglutition syncope (DS) is a rare, neurally-mediated syncopal syndrome arising from an aberrant vagotonic reflex during swallow-associated esophageal dilation. Its association with gastroesophageal disorders often prompts gastroenterology consultation. An 89-year-old man with recent dysphagia and otalgia was admitted after a syncopal episode occurred while eating. Esophageal imaging and endoscopy demonstrated no causative abnormalities. Maxillofacial imaging revealed chronic sinusitis and mastoiditis. Telemetry monitoring demonstrated high-grade atrioventricular block and pause associated with swallowing. His symptoms and swallow-associated arrhythmia resolved after dual chamber pacemaker implantation. DS is highly treatable once identified and multidisciplinary coordination is helpful in optimizing outcomes and avoiding superfluous testing.
ACG Case Rep J 2015 Oct
PMID:Deglutition Syncope: A Case Report and Review of the Literature. 2650 69

We present a case of proton pump inhibitor-responsive eosinophilic esophagitis (PPI-REE) in a patient with severe dysphagia and markedly elevated baseline esophageal eosinophilia that was previously deemed unresponsive to PPI. Upon reintroduction to PPI therapy with monthly endoscopy and dilation over the course of 4 months, the patient improved clinically and resolved her mucosal eosinophilia. Our case suggests that a longer duration of PPI therapy may be required for histologic improvement, especially in patients with very high mucosal eosinophil count.
ACG Case Rep J 2016 Jan
PMID:Esophageal Eosinophilia Treated With Long-Duration Proton Pump Inhibitor Therapy. 2695 57

Benign esophageal strictures leading to complete esophageal occlusion are well known. In the pre-endoscopic era, such cases required surgery, but over the last decade, various novel endoscopic techniques have been developed to prevent morbidity and mortality. A 37-year-old man presented after 1 year of dysphagia and weight loss, and was found to have complete esophageal obstruction, not allowing even passage of guidewire. We used a combination antegrade endoscopic abdominal procedures to deploy a stent, obviating the need for surgery. His symptoms improved dramatically, and the stent was successfully removed 12 weeks later. He is now swallowing normally and has gained significant weight.
ACG Case Rep J 2016 Apr
PMID:Endoscopic and Abdominal Management of Complete Benign Esophageal Obstruction. 2714 92

Inlet patches are sometimes seen during upper endoscopy, usually in the proximal esophagus. Complications of inlet patches can cause a wide array of symptoms and complications. A man presented with dysphagia and was found to have 2 rings in the upper esophagus, just above and below a circumferential inlet patch. The more distal ring caused a stenosis, which produced the symptoms. Savary dilation and treatment with a proton pump inhibitor led to symptom resolution. Pathology was missed on the patient's first endoscopy, highlighting the importance of looking for pathology throughout the entire esophagus, not just in the distal esophagus.
ACG Case Rep J 2016 Aug
PMID:Esophageal Rings and Stricture Related to a Circumferential Inlet Patch. 2780 76

A 38-year-old male with a history of colonic interposition for esophageal atresia as an infant presented with dysphagia and abdominal pain. On the basis of endoscopy findings, pathology, and response to therapy, he was found to have ulcerative colitis of the colonic conduit.
ACG Case Rep J 2016 Aug
PMID:Ulcerative Colitis in Colonic Interposition for Esophageal Atresia. 2784 35

The clinical significance of minor esophageal motility disorders is unclear, though they typically carry a benign course. Distal esophageal spasm progressing to achalasia has been reported, although it appears to be rare. We report a case of a patient with dysphagia and chest pain who was found to have ineffective esophageal motility on high-resolution manometry, which developed into distal esophageal spasm and then progressed to type III achalasia.
ACG Case Rep J 2016 Aug
PMID:Ineffective Esophageal Motility Progressing into Distal Esophageal Spasm and Then Type III Achalasia. 2811 34

A 69-year-old man with diabetes, peripheral vascular disease, and hypertension presented with 3 months of diffuse abdominal pain that worsened with meals, weight loss, and dysphagia. Esophagogastroduodenoscopy and computed tomography revealed findings consistent with chronic gastric ischemia secondary to atherosclerosis. Gastric ischemia eventually led to perforation. We discuss causes, symptoms, diagnosis, and management of gastric ischemia, an underdiagnosed and potentially fatal condition that requires urgent diagnosis and treatment.
ACG Case Rep J 2016 Aug
PMID:Chronic Gastric Ischemia Leading to Gastric Perforation. 2811 45


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