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)

Impairment of esophageal motor function is well recognized in connective tissue disease. We have investigated esophageal function, by manometric studies, presence of symptoms of esophageal involvement and antibodies pattern, in 18 female patients affected by systemic lupus erythematosus (SLE). Esophageal manometry showed motor abnormalities in 72.3% of the patients, especially hypokinetic abnormalities (hypotony of lower esophageal sphincter pressure, low amplitude or alterations of peristaltic waves) or, rarely, an increase of amplitude of peristaltic contractions. No significant correlation were found between antinuclear antibodies, esophageal symptoms and manometric findings. Hypoperistalsis or aperistalsis, may be due to an inflammatory reaction in the esophageal muscles or to an ischemic vasculitic damage of Auerbach plexus. High amplitude of peristaltic esophageal waves may be due to an early stage of reflux esophagitis: we have found gastro-esophageal reflux symptoms in more than half of our patients.
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PMID:[Changes in esophageal motility in patients with systemic lupus erythematosus: an esophago-manometric study]. 233 65

To assess the incidence of histological esophagitis in infants less than 2 yr old with symptoms of gastroesophageal reflux, 35 infants were studied with esophageal suction biopsy and pH probe monitoring. Intraepithelial and lamina propria inflammatory cells, basal cell layer thickness, and papillary height were quantitated. Distal esophageal sections from infant sudden death trauma victims were used to provide normal morphometric control values. The upper limit of normal for each of the four histological parameters of esophagitis was defined as the mean plus three standard deviations. The values thus derived were similar to established adult normal values. Seventy-seven percent of the patients had at least one abnormal histological parameter (intraepithelial eosinophils or neutrophils, thickened basal cell layer, or increased papillary height) and were thus considered to have esophagitis. These measures of esophagitis all correlated well with each other, providing an internal consistency to the histological interpretation. Lamina propria eosinophilia correlated highly with intraepithelial eosinophils (r = 0.98) and was found to have a sensitivity of 41% and specificity of 89% for diagnosing histological esophagitis, defined as abnormality of any of the four histological parameters. Ninety-three percent of the patients with histological esophagitis had significant reflux as determined by pH probe monitoring. However, there was generally poor correlation between the severity of the esophagitis as quantitated by morphometric parameters and severity of the reflux as measured by pH monitoring. Esophageal suction biopsies, which provide adequate specimens for morphometric interpretation, are appropriate for diagnosing reflux esophagitis in infants.
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PMID:Esophagitis in infants. Morphometric histological diagnosis and correlation with measures of gastroesophageal reflux. 233 84

The files of patients who underwent emergency endoscopy in a 2-yr period (January 1985 to January 1987) in the Heinz-Kalk Hospital were analyzed to establish the frequency, significance and therapy of the Mallory-Weiss syndrome associated with portal hypertension, an association observed in 55 of 339 patients (16.2%). Portal hypertension was caused by cirrhosis in 53 patients and by a prehepatic block in two patients. For 21 of these patients (37%) with portal hypertension, Mallory-Weiss syndrome was the first bleeding manifestation. They numbered 6.2% of the whole population. In the remaining 34 patients (63%) sclerotherapy treatment had been previously performed. No lesions that suggested peptic esophagitis were seen in these 55 patients, although in 25 of them (45.4%) a gastroesophageal reflux was observed. The frequency of bleeding from a Mallory-Weiss tear was significantly higher in patients with advanced liver disease, particularly with Child-Pugh classifications C and B. In patients with prehepatic block, a hemorrhage from a Mallory-Weiss tear may occur, but the frequency is significantly lower than it is in patients with cirrhosis. The bleeding tear was treated by transendoscopic esophageal and cardial wall sclerosis (paravariceal technique) and was, in all cases, successfully controlled. Mallory-Weiss syndrome is observed more frequently in patients with portal hypertension and cirrhosis. Gastroesophageal reflux apparently does not play a major role in the pathogenesis of this syndrome. It may simply be the manifestation of an abnormal gastroesophageal function. Mallory-Weiss syndrome can also be observed as a cause of rebleeding in patients treated with chronic sclerotherapy. Paravariceal endoscopic sclerotherapy is apparently the treatment of first choice to stop hemorrhage.
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PMID:Frequency, significance and therapy of the Mallory-Weiss syndrome in patients with portal hypertension. 202 86

Gastroesophageal reflux (GER) has been suggested as a cause of the lower esophageal (Schatzki) ring. We looked for the presence of GER and reflux injury in a series of 20 patients with lower esophageal ring and dysphagia, using a 24-hour esophageal pH monitoring and upper endoscopy with biopsy. Abnormal GER was documented in 13 of the patients (65%), 10 of whom had erosive reflux changes in the distal esophagus. Seven patients (35%) showed no evidence of pathologic GER or reflux esophagitis. All patients also underwent esophageal manometry. Nonspecific esophageal body motor dysfunction may have contributed to dysphagia in five patients, two of whom had no evidence of abnormal GER. We conclude that GER disease is a frequent cause of the gradually progressive ring stricturing and dysphagia seen in patients with lower esophageal ring. Antireflux therapy, as an adjunct to esophageal dilatation, may be appropriate for many symptomatic lower esophageal ring patients.
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PMID:Gastroesophageal reflux as a pathogenic factor in the development of symptomatic lower esophageal rings. 238 61

Omeprazole is the first acid-pump inhibitor. With its unique mechanism of action, it represents a new class of drugs in treatment of GERD, reflux esophagitis, and hypersecretory conditions. Overall, its adverse effects are mild and transient and found to be well-tolerated. Thus, omeprazole will serve as an important new agent in the management of some gastrointestinal disorders.
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PMID:Omeprazole. 239 98

This chapter reviews the pathologic aspects of gastroesophageal reflux and reflux esophagitis. High-grade and low-grade changes due to reflux are discussed in the context of peptic complications such as hemorrhage, ulcer, stricture, and acquisition of Barrett mucosa. The limitations of histopathologic criteria in squamous epithelium for the diagnosis of reflux esophagitis, such as elongated vascular papillae and widened basal zone, are described. The pathogenesis of and criteria for diagnosis of Barrett esophagus are addressed. The neoplastic complication of adenocarcinoma arising in Barrett esophagus is discussed. Finally, the implications of columnar epithelial dysplasia and potential markers in Barrett mucosa for surveillance of Barrett patients are reviewed.
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PMID:Reflux esophagitis and Barrett esophagus. 240 72

This study was designed to evaluate the utility of 99mTc pertechnetate esophageal scintigraphy for identifying Barrett's esophagus. Seventeen patients with Barrett's esophagus and seven patients with reflux esophagitis were studied. Eight of 17 patients with Barrett's esophagus had a positive image (sensitivity 47%). In contrast, none of the seven patients with esophagitis had a positive image (specificity 100%). Pentagastrin did not have a significant effect on the sensitivity. There was no correlation between the type of Barrett's epithelium and the sensitivity of the imaging results. However, the test is more frequently positive in those patients with more extensive disease. Our study indicates that technetium pertechnetate imaging should not be used as a screening test for the detection of Barrett's esophagus in patients with symptoms of gastroesophageal reflux, as the negative predictive value of the test is limited.
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PMID:Technetium pertechnetate esophageal imaging for detection of Barrett's esophagus. 254 24

Gastroesophageal reflux is a daily occurrence in the general population. Reflux esophagitis is less common but still a considerable clinical problem. The results of medical therapy are generally clearly inferior to those seen in peptic ulcer disease. After healing relapse is rapid and maintenance has not been proved superior to placebo. The promising results with omeprazole (inducing pronounced acid inhibition) and surgery (strengthening anti-reflux mechanisms) indicate that a more aggressive approach may be needed in future treatment. Additional studies also using combinations of drugs both in the healing stage and during maintenance is needed. These should be compared to the long-term results of surgery.
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PMID:Healing, relapse rates and prophylaxis of reflux esophagitis. 256 16

An alcoholic man with known reflux esophagitis and Barrett's esophagus developed fever, epigastric pain, subcutaneous crepitus, and leukocytosis from an esophageal perforation at a Barrett's ulcer. Possible risk factors for perforation in this patient included alcoholism, severe gastroesophageal reflux, corticosteroid therapy, noncompliance with antacid and H2 blocker therapy, and the presence of acid-secreting parietal cells in the Barrett's epithelium. Five cases of this complication have previously been reported in a review of the literature, which included 536 cases of Barrett's esophagus or esophageal perforation. This entity may present with a clinical triad of a patient (a) in acute distress with fever and epigastric or noncardiac chest pain and without signs of peritonitis, (b) with symptoms of or known gastroesophageal reflux, and (c) with chest examination revealing subcutaneous crepitus, or chest roentgenogram revealing subcutaneous emphysema, pneumomediastinum, or hydropneumothorax.
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PMID:Esophageal perforation at a Barrett's ulcer. 258 67

We evaluated the frequency with which Barrett's esophagus (BE) occurs in patients with symptomatic reflux esophagitis, and compared the clinical endoscopic and manometric features of patients with Barrett's esophagus with those of patients who had non-Barrett's esophagitis (NBE). The effect of 6 months' medical treatment on BE patients was reevaluated by repeating manometry, endoscopy, and biopsy. Esophageal manometry was performed by perfusion technique and endoscopic biopsies were obtained. There were 180 patients; 20 (11%) were found to have BE. The vast majority of BE patients were caucasians. BE patients had symptoms of gastroesophageal reflux for a longer time than did NBE patients. Mean lower esophageal sphincter pressure in BE patients was lower than that in NBE patients. On medical treatment, the severity of esophagitis as judged by endoscopic criteria in BE patients was reduced, but there was no increase in lower esophageal sphincter pressure and no regression of the columnar epithelium.
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PMID:Barrett's esophagus in patients with symptomatic reflux esophagitis. 235 2


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