Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using 3 non-invasive tests, abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia. Abnormalities of heart rate responses to the Valsalva maneuver, deep breathing, and standing were noted in patients with autonomic neuropathy defect. The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.
Chin Med Sci J 1994 Sep
PMID:Abnormal cardiovascular reflexes in patients with achalasia. 786 44

Thirteen patients affected by achalasia of the esophagus, undergoing esophagocardiomyotomy with Dor gastroplasty, are reported. No postoperative deaths or complications occurred. Overall long-term results were satisfactory: excellent or good in 92.3% of cases, fair in 7.7%. Manometry after esophagocardiomyotomy as compared to preoperative assessment showed a decreased resting pressure in the esophageal body, in all patients in whom it was elevated, and the appearance of some peristaltic waves in 23.1% of them (3 patients). As for lower esophageal sphincter, some relaxation after deglutition was observed in one patient. The 24h pH monitoring showed signs of gastroesophageal reflux only in one patient. Based on the obtained results which compare well with those of the literature, the authors be believe that the procedure represents an effective treatment of esophageal achalasia.
Panminerva Med 1994 Sep
PMID:Esophagocardiomyotomy with Dor gastroplasty in the treatment of esophageal achalasia. 787 24

Botulinum toxin is a potent inhibitor of the release of acetylcholine from nerve endings. It has previously been shown that it can effectively reduce lower oesophageal sphincter pressures both in animals and humans with achalasia. This study examined the hypothesis that locally injected botulinum toxin could also reduce sphincter of Oddi pressure in patients with sphincter of Oddi dysfunction. Two patients with postcholecystectomy pain syndrome were diagnosed with sphincter of Oddi dysfunction (by biliary manometry in one patient and by hepatobiliary scanning criteria in the other). Botulinum toxin was injected into the sphincter of Oddi, by a sclerotherapy needle passed through a duodenoscope. In the first patient, intrasphincteric injection of botulinum toxin reduced sphincter pressure by about 50%, an effect that was sustained for at least four months. In the second patient, intrasphincteric injection caused about a 50% improvement in bile flow, with normalisation of scintigraphy. Neither patient showed any sustained improvement in pain despite these objective findings. Both patients eventually had endoscopic sphincterotomy, which also did not result in symptomatic improvement in either patient. No side effects were seen. Intrasphincteric botulinum toxin is a simple and effective means of lowering sphincter of Oddi pressure. This technique has potential for being useful clinically.
Gut 1994 Sep
PMID:Intrasphincteric injection of botulinum toxin for suspected sphincter of Oddi dysfunction. 795 45

Gastrointestinal disorders, including motor disorders of the esophagus, occur more frequently in patients with Down's syndrome than in the general population. We recently diagnosed achalasia in a man with Down's syndrome, an association reported only once before. Of the 643 patients with achalasia treated at our institution over a 30-year period (1962-1992), a total of three had Down's syndrome. We report their clinical, radiological, and manometric findings. Achalasia may be underdiagnosed in patients with Down's syndrome because their intellectual impairment may interfere with their ability to report symptoms adequately. All three patients responded well to conventional treatment.
J Clin Gastroenterol 1994 Sep
PMID:Achalasia in Down's syndrome. 796 53

A patient with a progressive, inherited disease of the CNS developed remarkable esophageal dilatation without the lower esophageal sphincter dysfunction characteristic of achalasia. Postmortem examination included neuropathologic study of the CNS and evaluation of esophageal myenteric plexus histology, but the pathogenesis of the megaesophagus remains unknown.
J Clin Gastroenterol 1994 Sep
PMID:Megaesophagus and hereditary nervous system degeneration. 796 58

Guillain-Barre' syndrome and achalasia are rare diseases of uncertain cause. However, viral etiologies have been postulated for each disorder. The concomitant presence of both disorders in a patient suggests a common etiology, because a coincidental association would be exceedingly rare. Indeed, to our knowledge, the concomitant appearance of Guillain-Barre' syndrome and achalasia has not been previously reported. We now report our observation of a patient who developed dysphagia shortly after onset of Guillain-Barre' syndrome. Achalasia was subsequently diagnosed by manometry and was successfully treated by pneumatic dilation. The concomitant appearance of Guillain-Barre' syndrome and achalasia in our patient supports the notion of a viral etiology for achalasia.
Am J Gastroenterol 1994 Sep
PMID:Guillain-Barre syndrome and achalasia: two manifestations of a viral disease or coincidental association? 807 48

It has been shown that nasal continuous positive airway pressure (nasal CPAP) significantly reduces nocturnal reflux both in patients with sleep apnea and in patients without sleep apnea but consistent abnormal nocturnal reflux. The mechanism by which CPAP is thought to reduce reflux includes the elevation of the resting lower esophageal sphincter (LES) pressure. In this study, we tested the effect of nasal CPAP in two groups of patients with aperistaltic esophagus but with different resting LES pressure. Seven patients with scleroderma esophagus and six patients treated for achalasia were tested over a 48-h period. On the first night, the patients were untreated; on the second night, both groups received applied nasal CPAP at 8 cm H2O pressure. The percentage of time the pH < 4.0, the number of reflux events > 5 min, and the length of the longest reflux event were all significantly reduced in the patients with achalasia (p < 0.03), but not in the scleroderma group (p > 0.20). These results suggest that a residual resting LES pressure greater than that demonstrated by patients with scleroderma (> 10 mm Hg) may be necessary for nasal CPAP to affect nocturnal reflux.
Chest 1994 Sep
PMID:The effect of nasal CPAP on nocturnal reflux in patients with aperistaltic esophagus. 808 51

Diseases of the gastrointestinal tract may result in radiographic changes in the thorax. An abnormal chest radiographic finding is often the initial clue to the diagnosis of gastrointestinal disease. This article presents the commonly recognized and some unusual thoracic manifestations of significant primary esophageal diseases including achalasia, diverticula, carcinoma, duplication cysts, varices, esophageal perforation, and postoperative changes. Intraabdominal gastrointestinal processes such as pancreatitis or pseudocysts, gastric and colonic abnormalities, pneumoperitoneum, liver abnormalities, intraabdominal abscesses, and diaphragmatic hernias, which are frequently associated with intrathoracic abnormalities, are also reviewed. Awareness of changes on the chest radiograph produced by gastrointestinal disease allows prompt diagnosis and facilitates the appropriate confirmatory diagnostic study, such as esophagography or computed tomography.
Radiographics 1993 Sep
PMID:Manifestations of gastrointestinal disease on chest radiographs. 821 May 87

For the management of persistent rectal achalasia after the Soave endorectal pull-through procedure, we have used posterior sagittal myectomy of the remaining aganglionic rectal muscular cuff, and have had satisfactory outcomes in five patients. Via a posterior sagittal skin incision, the posterior aspect of the rectal muscular cuff is reached. With the striated muscular complex retracted downward, the level of the dentate line is identified on the posterior wall of the rectum with the aid of the surgeon's finger inserted inside the anorectum. Two parallel longitudinal incisions are made on the rectal muscular cuff to create a muscular strip which is elevated and excised; the distal end of the myectomy strip is at the level of the dentate line and includes a part of the internal and sphincter muscle. During the last 4 years, we performed this procedure in 5 patients with remarkable relief of constipation, distension, and enterocolitis. The advantages of this procedure include: (1) less technical difficulty than the transanal approach, (2) avoiding colostomy, and (3) promising results.
J Pediatr Surg 1993 Sep
PMID:Posterior sagittal rectal myectomy for persistent rectal achalasia after the Soave procedure for Hirschsprung's disease. 830 92

Impaired lower esophageal sphincter (LES) relaxation is highly correlated with dysphagia. A variation of the impaired relaxation of the LES of achalasia has been described, characterized by premature closure after normal relaxation. With a microtransducer system, standard manometric testing followed by food ingestion identified 33 patients (12 male, 21 female, 18-79 yr old) who exhibited premature LES closure. Twenty-three (70%) of these patients had a presenting complaint of dysphagia. Of these, seven (30%) experienced dysphagia during food ingestion. Manometry documented a concurrent motor abnormality in the esophageal body in 28 (85%) patients. Of the five remaining patients who did not have a concurrent motor abnormality, all had a presenting complaint of dysphagia, and three (60%) experienced dysphagia during food ingestion. The incidence of dysphagia during testing reported by patients with premature LES closure is comparable to that reported by patients with achalasia (45%) or diffuse esophageal spasm (38%) who have been studied during food ingestion in our laboratory.
Am J Gastroenterol 1993 Sep
PMID:Premature lower esophageal sphincter closure as a cause of dysphagia. 836 34


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