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)

Hiatal hernia and/or gastroesophageal reflux are studied in 182 pediatric patients after surgical correction of esophageal atresia. Clinical and radiological aspects, along with postoperative complications, are reviewed. Special stress is given to late stenosis that does not cure with conventional treatment and are originated by undiagnosed reflux. Hiatal disfunction screening is proposed in following up patients of esophageal atresia in avoidance of disphagic and aspirative complications.
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PMID:[Hiatal hernia following T.E.F. repair (author's transl)]. 53 46

On the basis of 310 cases of hiatal hernia surgically treated, the anatomical, pathophysiological and clinical aspects are reviewed together with their surgical consequences. In rolling type hernia, gastroesophageal reflux and its sequelae do not occur: the treatment is based only on reduction and suture of the fundus to the undersurface of the diaphragm with repair of right crus. In sliding hiatal hernia the purpose of operation is functional one, that is satisfactory and lasting control of gastro-esophageal reflux. With one exception, the fundamental step of all successful procedures of repair is the creation of restoration of an infradiaphragmatic segment of esophagus: it puts the lower esophageal sphincter into the abdominal cavity with restoration of gastroesophageal competence.
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PMID:[Surgical treatment of hiatal hernia in adults. Indications, technical and tactical considerations on 310 operated cases]. 54 Mar 68

Eight cases of symptomatic hiatal hernia were investigated; four presented with respiratory symptoms simulating chronic asthmatic bronchitis or bronchopneumonia. Among 27 patients with gastro-oesophageal reflux but without radiologically visible hernia, six presented with fibrous stricture; no stricture was found in association with hiatal hernia. It is suggested that patients with gastro-oesophageal reflux should be offered surgical follow-up or surgery to prevent the development of a stricture before the more easily recognizable symptoms of heart burn and postural acid regurgitation get worse.
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PMID:Hiatal hernia in the African. 54 91

Forty four observations of patients with chronic or acute broncho-pulmonary affections were gathered over 6 years. All exploration tests for an obstructive etiology were negative. All these patients had a hiatal hernia by sliding with gastro-oesophageal reflux. In 27 patients the repeated pulmonary accidents, the importance of oesophageal symptomatology prompted a treatment of the hiatal hernia. In all these patients every pulmonary symptoms disappeared. In assessing some acute or chronic pulmonary affections, when etiology cannot by traced, besides considering anatomical, clinical and histological data, radiological and endoscopic examination should be undertaken to find gastro-oesophageal reflux.
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PMID:[Gastroesophageal reflux and chronic or acute broncho-pulmonary diseases in adults]. 61 78

In 196 cases of gastro-oesophageal reflux, simple or connected to a hiatal hernia or to a cardio-tuberous misplacement, the respiratory signs that are found in 1 patient out of 4, are analyzed. The nocturnal fits of coughing (39 cases, 20% of the reflux) is the most frequent sign of laryngo-tracheal aspiration of stomach content. This symptom of great diagnostic value, though neglected, should be looked for systematically. Other troubles are less frequent: bouts of recurring broncho-pulmonary infections, asthma attack, Mendelson's syndrome, pulmonary fibrosis. In absence of a patent cause, the symptoms should lead to suspect a reflux of stomach content in the airways. Similarly to oesophagitis, respiratory signs represent a complication sometimes serious, of gastro-oesophageal reflux, needing more frequently a surgical treatment of hiatal herniae or of the cardiac inefficiency.
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PMID:[Broncho-pulmonary manifestations and gastroesophageal reflux]. 61 79

Microscopic squamous cell carcinoma of the esophagus with early submucosal spread was diagnosed in two patients with hiatal hernia and evidence of esophageal reflux. The lesions were not suggestive of malignancy on endoscopic examination. Both patients are known to be alive more than one year after resection and presumably without recurrence. More liberal use of endoscopic brush cytology and biopsy or intubation cytology particularly in the cases at high risk, might substantially improve the chances of very early diagnosis and favorably alter the present grim mortality rate.
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PMID:The diagnosis of microscopic carcinoma of the esophagus. 62 79

A careful clinical investigation of 245 patients with hiatus hernia was performed. (History and physical examination, x-ray tests, oesophago-gastroscopy with biopsies, 3-point-manometry, rapid pull-through manometry with pentagastrintest). Classification of hiatus hernia was performed by x-ray test. (222 axial hiatus hernia, 14 mixed hiatus hernia, 9 paraoesophageal hiatus hernia) 3-point-manometry and rapid pull-through manometry with Pg-test were used to differentiate the function of the cardia. In spite of a strong selection in 84 out of 245 patients examined in our hospital, a sufficient cardia could be seen. 161 cases showed a gastro-oesophageal reflux which has been in accordance with a decompensated reflux disease in 97 patients. Solely in these 97 patients an operative correction of the gastro-oesophageal reflux seemed convenient. 84 patients showed a considerable variability of oesophageal disorders. In a final correlation between endoscopy, manometry and x-ray tests our opinion was confirmed that hiatus hernia must not lead inevitably to an insufficiency of the cardia. In the above investigations it could be shown that any therapeutic proceeding in the treatment of hiatus hernia first needs a careful analysis of the cardiac and oesophageal activity and second requires a careful indication for the surgical treatment of hiatus hernia.
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PMID:[Clinical significance of hiatal hernia]. 63 97

A problem of some complexity is the management of pathological gastro-esophageal reflux due to the presence of cardio-hiatal malformation, malposition of the cardia and gastric tuberosity, a congenitally short esophagus, and the like. Sometimes, however, there is no demonstrable morphological aleration and the condition, characterized by primitive hypotonia of the LES, goes under the name of infant chalasia of the esophagus. The general policy is to try first a conservative treatment consisting of dietary and postural measures and the administration of metoclopramide and d;ugs that protect the esophageal mucosa; this stage, however, should not be prolonged beyond 6 weeks. The presence of gastro-esophageal reflux associated with hiatal hernia; the presence of severe esophagitis or peptic stenosis of the esophagus and the persistence of symptoms after an adequate period of conservative therapy constitute as many indications for surgical correction. Good results can be obtained by restoring or strengthening the failing function of the LES, as is done quite successfully with funduplication after Nissen or with method of Belsey-Mark IV.
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PMID:[Current trends in the treatment of reflux esophagitis in childhood]. 69 26

One hundred patients with complications of severe gastroesophageal reflux were treated surgically by the Thal fundoplication. In all patients the symptoms of reflux were eliminated by the operation, although 4 recurred within 8 months. Two of these were due to disruption of the fundoplication and two were due to hiatus hernia not recognized and repaired at initial operation. There were 8 deaths, none related to gastroesophageal reflux or the operation. Four patients required re-operation for intestinal obstruction. The Thal fundoplication is a simple procedure which fixes the distal esophagus within the abdomen and produces an acute angle of His. It is effective in prevention of reflux and the patient is able to burp and vomit if necessary. It has not been associated with dysphagia or "gas bloat" which may follow the Nissen fundoplication.
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PMID:Thal fundoplication: a simple and safe operative treatment for gastroesophageal reflux. 73 65

Findings in this study correlated a low circulating gastrin level with an incompetent lower esophageal sphincter mechanism and abnormal reflux. Such reflux, in amounts causing esophagitis distally, was treated surgically by a mechanically simple method of fundoplication. The success of this reefing method of fundoplication was explained by using physiologically active sling fibers of the gastric fundus to augment the lower esophageal sphincter. Available gastrin was used more effectively in this manner. The high incidence of associated foregut diseases suggested an embryologic factor in the development of gastroesophageal reflux. The dilated hiatus and its attendant hernia had no apparent relationship to the development of reflux esophagitis. The term symptomatic sliding hiatal hernia, therefore, seemed to be a diagnostic and therapeutic misnomer.
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PMID:The role of gastrin in the treatment of sliding hiatal hernia with reflux using the reefing method of fundoplication. 78 38


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