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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Following a hemorrhage, ten patients with esophageal varices were examined by means of gastroscopy and functional analysis of the esophagus with special regard to gastroesophageal reflux. A pathological gastroesophageal reflux was not confirmed. These results plus previously published findings lead to the assumption that reflux is of not importance in the initiation of esophageal variceal bleeding.
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PMID:[Gastroesophageal reflux: a factor eliciting esophageal variceal hemorrhage?]. 4 87

An operation to prevent reflux was carried out in 36 patients with oesophageal varices; its aim was to prevent ulceration of the oesophageal mucosa due to gastric or duodenal secretions. The anti-reflux plasty consists of a distal gastrectomy with orthograde, isoperistaltic interposition of 20 cm. of jejunum between the gastric remnant and the duodenum, and fixation of the fundus and fornix. During the first three months, and even somewhat later, there was a little passage of contrast from the interposed jejunum into the stomach and duodenum. The reflux from the duodenum was, however, very small and only reached the vicinity of the stoma so that a duodeno-gastric reflux could be practically excluded. The fundus-fornix fixation resulted in absence of radiologically demonstrable gastro-oesophageal reflux. The interposed jejunal loop took over in part the function of the stomach, regulated gastric emptying and acted as a valve during upper gastro-intestinal transport.
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PMID:[Anti-reflux plasty for oesophageal varices (author's transl)]. 15 Oct 5

Recurrent bleeding, the high occurrence of encephalopathy, and the impairment of hepatic function in the successful cases of portasystemic shunts have led to increasing dissatisfaction with these procedures in recent years. Between March 1974 and November 1990 we have operated on 15 children for bleeding esophageal varices using the Sugiura procedure (esophageal transection with paraesophagogastric devascularization). In two cases the entire procedure was performed via the thoracic approach. The spleen was left in place in five cases. We have had no mortality. Operative complications included bleeding in the early postoperative period in two children and partial leakage from the esophageal suture in two others. Follow-up was from 4 years 3 months to 16 years 8 months with an average of 10 years 4 months. Long-term results have been gratifying in 12 patients (80%) with disappearance of the varices and no evidence of recurrent bleeding. Three children (20% of the patients) had recurrent bleeding 4 1/2 years, 4 years 2 months, and 2 1/2 years after the surgical procedure. In all cases there was no evidence of esophageal stenosis, gastroesophageal reflux, or hiatal hernia, nor signs of encephalopathy nor impairment of hepatic function. In our opinion the Sugiura procedure is a valid procedure in the surgical treatment of esophageal varices bleeding in the pediatric age with a high rate of success (80%) and without late complications.
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PMID:Sugiura procedure in the surgical treatment of bleeding esophageal varices in children: long-term results. 147 3

The effect of sclerotherapy of esophageal varices on the gastroesophageal reflux was studied. Gastroesophageal reflux was monitored by a 24-h pH-monitoring catheter introduced into the distal esophagus. The results of pH monitoring of 16 patients who underwent sclerotherapy were compared with those of 21 patients with untreated varices. Seven of the 16 treated patients showed high occurrence rates of gastroesophageal reflux comparable to those observed in cases with severe reflux esophagitis. In the untreated group, only one patient showed pathological reflux (there was a significant difference between treated and untreated groups; p less than 0.01). When the level of reflux was compared with factors that might influence sclerotherapy-induced gastroesophageal reflux, there was a positive correlation between the magnitude of reflux and amount of sclerosant injected paravariceally in the submucosal tissue (p less than 0.05). The results indicate that the paravariceal injection of sclerosant for the treatment of esophageal varix may cause pathological gastroesophageal reflux after sclerotherapy is completed.
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PMID:Gastroesophageal reflux after endoscopic injection sclerotherapy. 153 60

An aim of the present study is to clarify the changes of esophageal function after surgical treatments of the esophageal varices or the congenital esophageal stenosis in children. Esophageal manometric studies were performed in sixteen children undergoing the esophageal transection with paraesophageal devascularization or the esophago-esophagostomy with partial esophagectomy before, within 1 month and over 7 months after the operation. The pressure of lower esophageal sphincter (LES), the length of LES, the LES relaxation test and the gastroesophageal reflux (GER) inducing test were measured. 1) Esophageal transection; The pressure dropped within 1 month and returned to the preoperative level over 11 months after the operation. Temporal deterioration of LES function was observed during the early postoperative days. However, return to the preoperative state was gained over 1 year. 2) Esophago-esophagostomy; The pressure and the length of LES were not changed after the operation. The LES function was disturbed preoperatively and moreover long postoperatively, in the case when congenital stenosis closely existed to the esophago-gastric junction. Degree of the postoperative disturbance of the LES function may be influenced by the distance to the part of the transection or the partial esophagectomy from the E-C junction.
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PMID:[Studies on changes in low esophageal sphincter function after esophageal transection or esophago-esophagostomy in children]. 163 Apr 33

Esophageal varices nearly always rupture at or just above the gastro-esophageal junction. Mucosal changes on top of the varices, the so-called red colour sign, are found in the majority of patients with a positive bleeding history. An increase of intraabdominal pressure and consequently a sudden pressure rise in the varices is thought of as a trigger cause. The larger the esophageal varices the higher the intravariceal and the transmural varix pressures. The portal pressure in patients with portal hypertension is subjected to considerable changes. Therefore, hemodynamic measurements at rest may have a prognostic value with regard to predisposition to hemorrhage, but they are less significant than endoscopic parameters. Disturbances of blood hemostasis and ascites indicating an impaired liver function are essential predisponable factors for the onset of bleedings. A peptic lesion caused by acid gastric-esophageal reflux is of less importance for the occurrence of variceal hemorrhage.
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PMID:[Pathogenetic factors of hemorrhage from esophageal varices]. 222 84

The development of esophageal stricture is common following endoscopic variceal sclerotherapy (EVS). Gastroesophageal reflux may be at least partly responsible. Twelve randomly selected male patients underwent chronic EVS for the management of bleeding esophageal varices. Six patients developed strictures during or after EVS, six did not. There were no significant differences between stricture and nonstricture patients during 24 hour esophageal pH monitoring. Three of the six stricture patients and four of the six nonstricture patients had an abnormal amount of reflux. Gastroesophageal reflux occurs frequently in patients undergoing EVS, and it is not likely to play a major role in EVS stricture formation.
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PMID:Gastroesophageal reflux and sclerotherapy strictures. 224 Aug 56

The purpose of this paper is to study the use of upper gastrointestinal (Gl) fiberoptic endoscopy in children. Two hundred consecutive patients referred to one of the authors were reviewed. The indications for performing upper gastrointestinal endoscopy in these 200 patients were: (1) recurrent abdominal pain (46.5%), (2) persistent vomiting (14.5%), (3) haematemesis (14.5%), (4) acute abdominal pain (13%) and (5) other indications such as foreign body removal, failure to thrive and unexplained chest pain (11.5%). The endoscopy was performed with the Olympus P3 or Olympus XP-10 gastroscopes. The sedation used was a combination of intravenous pethidine (2mg/kg) and diazepam (0.5 mg/kg). Among the patients with recurrent abdominal pain, upper Gl endoscopy showed duodenal ulcer in 7 patients (7.5%), duodenitis in 4 (4.3%), oesophagitis in 4 (4.3%) and gastric ulcer in 2 (2.2%). The rest of the patients were normal (81.7%). With regard to persistent vomiting, 37.9% of the patients showed gastroesophageal reflux and 6.9% had a hiatus hernia. Of 29 patients examined endoscopically for upper Gl bleeding, no focus of bleeding was identified in 27.6%. The remaining 72.4% were bleeding from acute gastric erosion (27.6%), oesophagitis (17.2%), oesophageal varices (13.8%), duodenal ulcer (10.3%) and Mallory-Weiss tear (3.5%). The Majority of the patients with acute abdominal pain were normal endoscopically (61.5%). The two common abnormal findings were acute gastritis (27.0%) and acute duodenitis (11.5%). No major complications were encountered during the procedure in these 200 patients. It was concluded that upper Gl endoscopy is useful for defining upper Gl mucosal pathology. The procedure can be performed safely in children under sedation.
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PMID:Upper gastrointestinal endoscopy in children. 237 74

From 1 January 1986 to 1 January 1988, 91 consecutive patients who had undergone repeated paravariceal endoscopic injection sclerotherapy (PEIS) for bleeding esophageal varices over a period of up to 10 years were followed up prospectively by endoscopy, manometry and 24-h pH monitoring. In 39% nonfatal complications occurred after two phases of PEIS. The number of complications tended to decrease with increasing phases and was only 12% after five or more phases of PEIS. Endoscopy is undoubtedly the most important method in the follow-up of these patients. Early and long-term complications are mostly diagnosed by direct view and thus can be managed or sometimes even prevented in the follow-up. No significant motility disorders were found. Only 12 patients showed significant gastroesophageal reflux. No correlation was found between the severity of reflux and the number of phases of PEIS. No correlation between clinical symptoms and changes in the manometric and pH metric results could be found. The effects and side effects of PEIS can be closely monitored by manometry and pH monitoring and therapy can be tailored accordingly. Our results suggest that PEIS is a superb method with a low complication rate, both short- and long-term. It has proven to be an effective long-term treatment of bleeding esophageal varices.
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PMID:Long-term endoscopic injection sclerotherapy of bleeding esophageal varices. A prospective analysis of results by endoscopy, manometry and 24-h pH-monitoring. 281 76

The oesophageal pH was recorded for 3 h after a test-meal in 27 healthy control subjects (group I), 40 patients with alcoholic cirrhosis (group II), and 22 patients with a normal liver and symptoms of gastro-oesophageal reflux (control refluxers). Gastro-oesophageal reflux was observed in 10 of the cirrhotic patients. Marked reflux episodes lasted longer in cirrhotic refluxers than in control refluxers (P less than 0.05). The frequency of ascites, bleeding from ruptured oesophageal varices, peripheral neuropathy and hepatic encephalopathy were not significantly different according to presence or absence of reflux. Plasma concentrations of gastrin, somatostatin, motilin and vasoactive intestinal peptide (VIP) were measured in groups I and II. Fasting plasma motilin levels, and the release of motilin and of VIP after the meal were higher in group II than in group I. Basal levels and post-prandial profiles of the four peptides tested did not differ between cirrhotics with or without gastro-oesophageal reflux. We conclude that in patients with alcoholic cirrhosis: gastro-oesophageal reflux is frequent (25%) and characterized by prolonged reflux episodes; reflux is not correlated with the degree of liver failure and plays no significant role in the rupture of oesophageal varices; and raised plasma motilin and VIP levels cannot account for the high incidence of reflux in cirrhotics.
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PMID:Gastro-oesophageal reflux and alcoholic cirrhosis. A reappraisal. 288 50


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