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Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anorexia nervosa (AN) and bulimia nervosa (BN) are potentially fatal eating disorders which primarily affect adolescent females. Differentiating eating disorders from primary gastrointestinal (GI) disease may be difficult. GI disorders are common in eating disorder patients, symptomatic complaints being seen in over half. Moreover, many GI diseases sometimes resemble eating disorders. Inflammatory bowel disease, acid peptic diseases, and intestinal motility disorders such as achalasia may mimic eating disorders. However, it is usually possible to distinguish these by applying the diagnostic criteria for eating disorders and by obtaining common biochemical tests. The primary features of AN are profound weight loss due to self starvation and body image distortion; BN is characterized by binge eating and self purging of ingested food by vomiting or laxative abuse. GI complications in eating disorders are common. Recurrent emesis in BN is associated with dental abnormalities, parotid enlargement, and electrolyte disturbances including metabolic alkalosis. Hyperamylasemia of salivary origin is regularly seen, but may lead do an erroneous diagnosis of pancreatitis. Despite the weight loss often seen in eating disorders, serum albumin, cholesterol, and carotene are usually normal. However, serum levels of trace metals such as zinc and copper often are depressed, and hypophosphatemia can occur during refeeding. Patients with eating disorders frequently have gastric emptying abnormalities, causing bloating, postprandial fullness, and vomiting. This usually improves with refeeding, but sometimes treatment with pro-motility agents such as metoclopromide is necessary. Knowledge of the GI manifestations of eating disorders, and a high index of suspicion for one condition masquerading as the other, are required for the correct diagnosis and management of these patients.
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PMID:Gastrointestinal and nutritional aspects of eating disorders. 840 9

The time interval between ingestion and regurgitation and the stage of digestion in regurgitated food may be factors helpful in diagnosing disease of the esophagus. In most cases diagnosis can be made by x-ray alone, but where x-ray evidence is insufficient esophagoscopy is often justified.X-ray investigation for foreign bodies should include films of the neck. Cough is a common symptom of the presence of foreign bodies; obstruction may result from inflammation or edema. Perforation is most often caused by foreign bodies or by instrumentation. Esophagoscopy is hazardous in this condition and the findings are not likely to affect the course of treatment. Hiatal hernia, although probably occurring to some degree in 10 per cent of adults, seldom causes symptoms. Inflammation resulting from hernial obstruction may be mistaken for carcinoma. Esophageal carcinoma occurs most frequently in elderly persons and in men more than in women. Operation is necessary in many cases to prevent starvation. The postoperative mortality rate is as low as 11 to 24 per cent, and the proportion of five-year survivals is increasing. Achalasia or cardiospasm can generally be recognized by x-ray appearance. Bouginage is the usual treatment, but operation may be necessary. Late regurgitation of food is a common symptom of esophageal diverticulum. Atresia in a newborn infant is a dangerous condition. The effect of any of the four types of anomaly is the same: diversion of fluids from the stomach to the bronchi. Coughing, choking and cyanosis are the common symptoms in a newborn infant. Hematemesis may arise from a number of causes; esophageal hemorrhage most commonly is owing to varicosity from portal hypertension. Esophagoscopy is the quickest and safest method of determining whether hematemesis is of esophageal origin.
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PMID:Differential diagnosis of operable disease of the esophagus. 1305 38