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 dogs with tetanus developed transient megaesophagus and hiatal hernia associated with gastroesophageal reflux and regurgitation. The megaesophagus and hiatal hernia were diagnosed radiographically and resolved with resolution of the tetanus. These 2 cases, plus previously reported cases, indicate that tetanus can cause megaesophagus and esophageal dysfunction. Therefore, thoracic radiography should be included as part of the diagnostic evaluation of dogs suspected of having tetanus.
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PMID:Esophageal hiatal hernia and megaesophagus complicating tetanus in two dogs. 188 36

Clinical signs of esophageal hiatal hernia in four dogs and one cat included regurgitation, vomiting, hematemesis, hypersalivation, dysphagia, and dyspnea. Thoracic radiographs, esophagram, and fluoroscopy were used to demonstrate cranial displacement of the esophagogastric junction and part of the stomach through the esophageal hiatus. Other findings included megaesophagus, esophageal hypomotility, gastroesophageal reflux, and pneumonia. Medical therapy failed to resolve the clinical signs. Reduction in size of the esophageal hiatus, fixation of the esophagus to the diaphragmatic crus (esophagopexy), and a left fundic gastropexy were performed. Surgical results were considered good to excellent.
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PMID:Hiatal hernia repair by restoration and stabilization of normal anatomy. An evaluation in four dogs and one cat. 281 56

A 3-month-old foal with a history of persistent fever and leukocytosis was found to have pneumonia, ulceration of the squamous portion of the stomach, and dilatation of the distal portion of the esophagus. The foal was euthanatized and necropsied. The distal portion of the esophagus was severely dilated, and there was severe ulceration and mural thickening of the stomach at the cardia. Because of the severe gastric ulceration and mural thickening, the gastroesophageal junction was fixed in an open position, permitting gastroesophageal reflux. The megaesophagus and pneumonia were considered to have resulted from chronic gastroesophageal reflux.
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PMID:Megaesophagus and aspiration pneumonia secondary to gastric ulceration in a foal. 335 80

The results of a questionnaire answered by the European Members of the GEEMO concerning esophagectomy without thoracotomy are reported and discussed. 172 cases of esophagectomy without thoracotomy following benign lesions and 666 cases following various levels of esophageal neoplasia were grouped in the 26 Centers that have answered the questionnaire amounting to a total of 838 cases. The most frequent indications for benign lesions were as follows: decompensated or relapsed megaesophagus (83 cases), acute or stabilized lesions caused by caustic agents (59 cases), stenoses from gastroesophageal reflux (17 cases), scleroderma (7 cases) and spontaneous or iatrogenic perforation (6 cases). Concerning the esophageal site where the technique was employed with esophageal carcinoma, the most frequent was the cervical (201 cases), then the lower (150 cases), the middle (91 cases) and upper thirds of the esophagus (48 cases). Adenocarcinoma of the cardia seems to be an additional indication for many Surgeons to use esophagectomy without thoracotomy (142 cases). In general, the most frequent intra-surgical complications (from benign and malignant lesions) were as follows: pleural lesions (34.4%), lesions of the left recurrent nerve (7.8%), severe endo-mediastinic hemorrhages (8.5%), tracheo-bronchial (1.5%) and thoracic duct (0.5%) lesions. The intra-operative mortality was 0.36%. The post-operative complications were as follows: pleural effusion (17.8%), anastomotic fistulas (15.2%), hemothorax (5%) and post-operative mortality (10.3%). Cancer of the cervical esophagus and adenocarcinoma of the cardia were considered sensitive to this radical treatment whereas in intra-thoracic cancer it can have only a palliative effect.
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PMID:Total esophagectomy without thoracotomy: results of a European questionnaire (GEEMO). 377 Nov 19

Forty-six patients with esophageal achalasia required reoperation between January 1970 and January 1986. Three of these patients required a second reoperative procedure, for a total of 49 reoperations. Indications for reoperation were inadequate myotomy, 17; gastroesophageal reflux, 14; concomitant antireflux operation, six; incorrect diagnosis, four; carcinoma of the esophagus, four; megaesophagus, three; and paraesophageal hernia, one. Various procedures were employed at the time of reoperation, including revision of the myotomy, takedown or revision of a previously performed wrap, fundoplication, and resection. Of the 48 patients available for follow-up study over an average postoperative period of 5 years, the condition of 38 (79%) was considered to have been improved by reoperation. The best results were obtained by revision or takedown of a previous wrap (an improvement rate of 88.9%) and radical resective procedures (89% to 100%). We conclude that for good results to be achieved after reoperative achalasia procedures, the preoperative diagnosis must be accurate, the operation should be performed early before the development of megaesophagus, and a short but complete esophagomyotomy must be performed, preferably without the addition of an antireflux procedure. Elimination or revision of a previously performed fundoplication can be expected to be followed by good results. The precise indications for radical resective procedures have yet to be defined clearly, but their wider application to carefully selected patients with postoperative achalasia seems justified.
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PMID:Reoperative achalasia surgery. 377 41

While Heller's myotomy has become the accepted operation for achalasia, still, there is no agreement about the indications for and choice of complementary procedures to minimize subsequent acid esophageal reflux. In the instances described in this investigation Heller's operation was accompanied by proximal gastric, or highly selective, vagotomy and anterior fundoplication. Dysphagia was abolished and normal alimentation restored in all but one patient, who was elderly and had an advanced megaesophagus. In every patient after the operation, results of pH-manometry, acid reflux tests and endoscopy demonstrated the absence of both acid reflux and esophagitis.
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PMID:Proximal gastric vagotomy and anterior fundoplication as complementary procedures to Heller's operation for achalasia. 711 62

A 3-mo-old female presented with growth retardation, vomiting, reflux esophagitis, recurrent aspiration pneumonias, and was found to have megaesophagus and microgastria. After the failure of conservative therapy a double-lumen jejunal (Hunt-Lawrence) pouch with distal Roux-en-Y anastomosis was anastomosed to the stomach to increase the gastric reservoir. One year later, there has been progressive weight gain, the megaesophagus and gastroesophageal reflux have lessened significantly, pneumonia has not recurred, and the tracheobronchitis and esophagitis have resolved. This suggests that the gastroesophageal reflux and megaesophagus were due to an inadequate reservoir with a secondary gastric overflow as the esophagus dilated to enlarge the reservoir capacity of the upper gastrointestinal tract. Utilization of a jejunal pouch increased the size of the gastric reservoir, allowed resolution of the secondary esophageal changes, and permitted normal growth to proceed.
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PMID:Management of congenital microgastria with a jejunal reservoir pouch. 746 90

Esophageal hiatal hernia was diagnosed in 11 young Chinese Shar-Pei dogs between October 1985 and July 1991. The dogs ranged in age from 2 to 11 months and included 3 females and 8 males. The most common clinical signs were regurgitation, vomiting, and hypersalivation. Physical examination was normal in 6 dogs; abnormal physical examination findings in the other 5 dogs included fever, dehydration, hypersalivation, and pulmonary wheezes and crackles. Laboratory evaluation was significant only for neutrophilia in 5 dogs. A diagnosis of hiatal hernia was made on the basis of survey thoracic radiographic and/or barium esophagram findings of displacement of the esophagogastric junction and stomach into the thoracic cavity; the diagnosis was confirmed by surgery in 9 dogs and at necropsy in 2 dogs. Megaesophagus (n = 7), gastroesophageal reflux (n = 4), and esophageal hypomotility (n = 1) were additional findings in some dogs. Aspiration pneumonia was diagnosed in 7 of the dogs. Medical therapies formulated for the therapy of presumed reflux esophagitis generally failed to resolve the clinical signs associated with the hiatal hernia. Hiatal herniae were surgically repaired in 9 of the Shar-Peis by various combinations of diaphragmatic crural apposition, fixation of the esophagus to the diaphragmatic crus (esophagopexy), and left fundic tube gastropexy. Eight of the animals survived surgery, six of which have been asymptomatic since surgery (19 to 36 months). The megaesophagus, esophageal hypomotility, and bronchopneumonia resolved in all of these dogs.
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PMID:Congenital esophageal hiatal hernia in the Chinese shar-pei dog. 824 9

The association between upper gastrointestinal (GI) motility disorders and respiratory problems is reviewed. Upper GI motility disorders, such as gastroesophageal reflux disease, gastroparesis, and achalasia, have been associated with respiratory problems, including aspiration, airway obstruction, asthma, bronchospasm, chronic cough, and laryngitis. These associations, which had been based solely on clinical observation, have recently been supported by physiologic studies and treatment trials. The association of reflux disease with asthma has the most support. Up to 80% of persons with asthma have evidence of pathologic gastroesophageal reflux, and in several studies antireflux therapy with prokinetic agents, antisecretory drugs, or fundoplication surgery has been found to reduce asthma symptoms and the need for medication in some patients. Reflux has also been associated with chronic cough and laryngitis, and antireflux therapy can reduce respiratory symptoms. Gastroesophageal reflux, gastroparesis, and achalasia are all associated with aspiration. In addition, in rare instances, the megaesophagus associated with achalasia can produce mechanical airway obstruction. Effective therapy for these GI motility disorders can eliminate complicating respiratory problems.
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PMID:Upper gastrointestinal motility disorders and respiratory symptoms. 893 26

An accurate preoperative diagnosis of an esophageal motor disorder, including its location (the LES, the body of the esophagus, or both), is essential before proceeding with esophagomyotomy. The operative procedure should be performed with careful attention to certain technical details to ensure completeness of the myotomy, to prevent later healing of the myotomy, and to avoid radical cardiomyotomy that might facilitate the subsequent development of GER. Potential hazards are associated with performing a 360 degrees antireflux procedure in the presence of an aperistaltic esophagus. Early operation before the development of megaesophagus is recommended. The excellent results achieved by resection coupled with antrectomy and Roux-en-Y diversion suggest its wider application to patients with one or more previous failed myotomies, particularly patients with stricture and megaesophagus. Long-term surveillance of patients with achalasia is mandatory in view of the known risk of late development of squamous cell carcinoma.
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PMID:Failure after esophagomyotomy for esophageal motor disorders. Causes, prevention, and management. 924 98


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