Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two small infants with gastroesophageal reflux disease and esophagitis are reported. Esophageal manometry revealed in both patients severe abnormalities consisting of aperistalsis and simultaneous low-amplitude motor waves. In one of the patients, defective relaxation of lower esophageal sphincter was also noted. Short-term intensive treatment with H2 antagonists resulted in symptomatic and endoscopic improvement as well as in manometric normalization. It is suggested that severe esophagitis may affect control mechanisms of esophageal motility, resulting in loss of coordination and decreased amplitude of contractions.
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PMID:Esophageal aperistalsis due to reflux esophagitis: a report of two cases. 261 28

The Willmen gastric bubble has been used as an adjunct to weight loss in morbidly obese patients. 35 patients with morbid obesity were studied with routine manometry, esophageal 24-h-pH-measurement, and gastric emptying studies before and 4 weeks after bubble placement. During emptying studies blood samples were taken to measure gastrin, PP, CCK, VIP, neurotensin and insulin. No patient developed heartburn or regurgitation after bubble placement. Esophageal motility and LES function remained unchanged. There was no important pathological gastroesophageal reflux before and after gastric bubble. The gastric emptying time of solid food was unchanged by gastric bubble placement and the emptying time of liquids was accelerated up to normal. In patients with fasting gastrin levels less than 20 pg/ml at the beginning of the first test we found no differences in gastrin release before and after bubble insertion. In patients with primary high fasting values gastrin release was significantly increased. CCK, VIP, neurotensin and insulin levels were unchanged. With PP we measured significantly raised fasting levels after gastric bubble. We conclude that esophageal and LES functions are not altered by Willmen gastric bubble placement and that primary retardation of fluids is changed to normal. Bubble induced gastric tension increases fasting PP. In case of high fasting gastrin the bubble leads to an extremely high food response without any clinical signs.
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PMID:[Does the stomach balloon modify the function of the esophagus and lower esophageal sphincter, stomach emptying and release of gastrointestinal peptides?]. 266 61

Pain of esophageal origin includes heartburn, odynophagia, and spontaneous chest pain. The etiologic causes of esophageal chest pain are varied and include gastroesophageal reflux, esophagitis from radiation, infection, accidental ingestion, medication, and systemic disorders, and motility disorders. Useful tools in the evaluation of patients with suspected esophageal disease include endoscopy, manometry with provocative agents, and prolonged pH and pressure studies.
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PMID:Chest pain of esophageal origin. 266 69

Chronic hiccups may be a problem of great significance to the affected patient. A 62-year-old man with severe heartburn and persistent hiccups despite numerous diagnostic tests and therapeutic drug trials presented to our clinic. Esophageal motility and intraluminal pH studies demonstrated decreases in intraesophageal pressure during hiccups and acid exposure during 68% of the measured time. The patient underwent Nissen fundoplication, which improved his heartburn but not his hiccups. The association between gastroesophageal reflux and hiccups is discussed. Our experience suggests that the presence of hiccups and gastroesophageal reflux in the same patient may be coincidental rather than having a cause-and-effect relationship.
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PMID:Hiccups and gastroesophageal reflux: cause and effect? 275 74

Transient lower oesophageal sphincter relaxation (LOSR) is the major mechanism underlying gastro-oesophageal reflux. The mediation and control of LOSRs are incompletely understood but evidence suggests a neural inhibitory mechanism. In this study we have evaluated the effect of gastric distension on LOS function in 16 patients with untreated idiopathic achalasia and compared it with that in 10 healthy controls. With the subjects sitting, the stomach was distended with a liquid mixture that generated 750 ml CO2. Oesophageal pH and motility were monitored for 10 minutes before and after distension. In normal controls, gastric distension induced a four-fold increase in the rate of LOSRs and gas reflux episodes (as evidenced by oesophageal common cavities), whereas this response was absent in the achalasia patients. Basal LOS pressure did not change in either group. These findings are consistent with the notion that transient LOSRs induced by gastric distension are neurally mediated, probably by the same inhibitory nerves that govern swallow mediated LOS relaxation.
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PMID:Failure of transient lower oesophageal sphincter relaxation in response to gastric distension in patients with achalasia: evidence for neural mediation of transient lower oesophageal sphincter relaxations. 275 98

Oesophageal function was assessed in 52 patients with angina pectoris whose coronary angiograms were completely normal and in 21 patients with angina pectoris who had significant coronary artery disease. During a standard oesophageal manometric study, abnormalities were found in 23 (44%) patients with normal coronary angiograms but in only 2 (10%) patients with coronary artery disease (p less than 0.01). Twenty-four (46%) patients with normal coronary angiograms were found to have gastro-oesophageal reflux disease during 24-hour oesophageal pH monitoring. Of the 52 patients with normal coronary angiograms, 19 (37%) had gastro-oesophageal reflux disease and abnormal oesophageal motility, 5 (10%) had gastro-oesophageal reflux disease alone, and 7 (13%) had oesophageal motility disorder alone. The use of provocation procedures, including intravenous edrophonium during oesophageal manometry and treadmill exercise testing during pH monitoring, enabled the oesophageal abnormality to be demonstrated simultaneously with chest pain in 25 of these 31 patients. Typical angina pectoris, coincident with abnormal oesophageal motility, was precipitated in a subgroup of patients who had been shown to have oesophageal manometric abnormalities and gastro-oesophageal reflux disease by the infusion of hydrochloric acid into the oesophagus; both the chest pain and manometric abnormality resolved following the oral administration of antacid.
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PMID:Oesophageal function in patients with angina pectoris: a comparison of patients with normal coronary angiograms and patients with coronary artery disease. 276 42

Esophageal resection or replacement has become the standard therapy for severe esophageal strictures chiefly because less aggressive methods generally have failed. We hereby report our experience with 12 consecutive infants and children who have been managed successfully by means of Stamm gastrostomy and string-guided esophageal dilatation, coupled with endoscopically guided four-quadrant intralesional steroid injection, protected by Nissen fundoplication when gastroesophageal reflux has been demonstrated. In six patients, the stricture(s) were caused by ingestion of lye. In five, they were associated with repair of esophageal atresia. In one, the etiology was never determined. The strictures averaged 3.5 cm in length (range, 1 to 10 cm); the severity of the lesions was indicated by the fact that, in all instances, patients were completely intolerant of solids, and was confirmed fluoroscopically by demonstration of significant luminal narrowing. A mean of 4.3 steroid injections (range, 1 to 8) was required to obtain complete remission of symptoms; there have been no complications except in one lye ingestion patient who developed a tiny perforation following the initial dilatation, which responded to antibiotics alone. All patients remain symptom-free; the mean length of follow-up is 6.2 years (range, 1 to 11 years). We conclude that string-guided esophageal dilatation, when coupled with endoscopically guided steroid injection, is a safe and reliable method for treatment of severe esophageal strictures, which should obviate the need for esophageal resection or replacement in most patients. Moreover, even if treatment should ultimately fail, a procedure of lesser magnitude than esophageal replacement will likely be possible.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Successful management of esophageal strictures without resection or replacement. 259 65

Gastroesophageal reflux and its resultant esophagitis are common complications following removal of the middle and lower part of the esophagus as well as the gastric cardia with reconstruction by simple esophagogastrostomy. Twenty-one dogs were randomly divided into 3 groups: (1) LES preserving group; (2) Nissen's fundoplication group; (3) Sweet's esophagogastrostomy group. Results by esophageal manometry, X-ray video tape recorder, and pathological examination respectively, 3 months postoperatively were compared. Esophageal manometry showed that the pressure of the preserved LES was still present. X-ray video tape recorder revealed that antireflex function was present in the preserved LES. Pathological examination confirmed no signs of reflux esophagitis in the mucosal specimen of the preserved LES group. We concluded that LES is the main barrier of gastroesophageal reflux. The intrathoracic LES could still have the function of anti-reflux.
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PMID:[Experimental study of antigastroesophageal reflux by preservation of the lower esophageal sphincter]. 277 40

This study examined 46 children 5-9 years (mean 6.7) after Nissen fundoplication surgery for gastroesophageal reflux (GER). Eleven were deceased and ten of the 35 families declined objective evaluation. The remaining 25 children (71%) had a barium swallow examination. In 16 of the 25 patients the fundoplication was intact. In 2 patients a small portion of the fundoplication was displaced above the diaphragm. In 5 patients there was residual esophageal disease. In 3 patients (one with esophageal disease), with a hiatus hernia prior to surgery, despite immediate postoperative reduction, the barium swallow examination done for this study revealed recurrent hiatus hernia but no GER. Long-term results of the Nissen fundoplication reveal success in eliminating clinically significant gastroesophageal reflux. Those patients with esophageal disease prior to the surgery need close interval follow-up to monitor continuing problems.
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PMID:Long-term radiographic follow-up of the Nissen fundoplication in children. 279 36

Esophageal mucosal brushings from 51 consecutive patients with progressive systemic sclerosis (PSS) (group I), 18 PSS patients continuously treated with high-dose ranitidine or omeprazole (group II), 34 controls referred to the outpatient clinic for endoscopy (group III), and 10 patients receiving long-term potent antireflux therapy for idiopathic gastroesophageal reflux (group IV) were cultured for Candida albicans. There were 44%, 89%, 9%, and 0% Candida albicans culture-positive patients in groups I through IV, respectively. Fifteen patients with candida esophagitis from group II were treated with fluconazole systemically. Eleven and 14 patients became culture-negative after 2 and 4 weeks' treatment, respectively. Three months after fluconazole withdrawal the recurrence rate was 100%. It is concluded that esophageal dysmotility predisposes for candidosis. Adding gastric acid inhibitory treatment to dysmotility enhances the risk significantly (p less than 0.01). The efficiency of fluconazole treatment was close to 100%, but so was the recurrence rate within a short period.
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PMID:Esophageal candidosis in progressive systemic sclerosis: occurrence, significance, and treatment with fluconazole. 285 11


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