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

Heller's myotomy for esophageal achalasia was performed on 64 patients in the 24 yr up to 1988. After follow-up averaging 13 yr, 46 patients were reexamined with endoscopy, biopsy, and manometry. Barrett's metaplasia of the distal esophagus was found in four patients 6, 13, 20, and 23 yr after the myotomy. These four also underwent ambulatory 24-h pH monitoring. They had the lowest distal esophageal sphincter pressures (1-5 mm Hg), and all four had symptoms of gastroesophageal reflux and pathologic pH values (< 4 in the distal esophagus for 32-62% of the total recording time). Because of heightened risk for the development of Barrett's metaplasia following cardiomyotomy for esophageal achalasia, with increased liability to carcinoma of the esophagus, regular endoscopic surveillance of these patients is advisable.
 ...
PMID:Barrett's esophagus after cardiomyotomy for esophageal achalasia. 798 Aug 29

An attempt is made to explore those aspects of the history of esophageal surgery relevant to pediatric practice. In some areas, the history is entirely focused on conditions of particular pediatric significance; esophageal atresia is a classic example of this group. In other areas there is considerable overlap, which varies in extent, with the history of esophageal surgery in adult. Conditions to be considered in this group include gastroesophageal reflux and peptic and corrosive esophagitis. Finally, there is a group that for all practical purposes is related to patients in the adult age group, exemplified by carcinoma of the esophagus, but some aspects of the history of surgery for esophageal cancer are relevant to pediatric practice, particularly in the area of reconstruction of the alimentary tract and esophageal replacement. Before the consideration of each of these groups, comments are directed toward the "early days"" or the beginnings.
 ...
PMID:The history of esophageal surgery: pediatric aspects 906 6

An attempt is made to explore those aspects of the history of esophageal surgery relevant to pediatric practice. In some areas, the history is entirely focused on conditions of particular pediatric significance; esophageal atresia is a classic example of this group. In other areas there is considerable overlap, which varies in extent, with the history of esophageal surgery in adult. Conditions to be considered in this group include gastroesophageal reflux and peptic and corrosive esophagitis. Finally, there is a group that for all practical purposes is related to patients in the adult age group, exemplified by carcinoma of the esophagus, but some aspects of the history of surgery for esophageal cancer are relevant to pediatric practice, particularly in the area of reconstruction of the alimentary tract and esophageal replacement. Before the consideration of each of these groups, comments are directed toward the "early days"" or the beginnings.
 ...
PMID:The history of esophageal surgery: pediatric aspects. 915 31

From April 1979 to December 1984, esophagectomy was performed in 552 cases of esophageal cancer of which 108 received cervical anastomosis and 444 intrathoracic anastomosis. The total postoperative complications and operative mortality rates of the two groups were very close. Leakage was significantly more frequent after cervical anastomosis, but mortality due to leakage was less frequent than that in thoracic anastomosis. The 1-, 3-, 5-, 10-year survival rates of cervical anastomosis were apparently higher than those of intrathoracic anastomosis, but the differences were not statistically significant. The 5-year survival rates of patients with the same TNM stage failed to demonstrate any significant difference between the two groups. The quality of life among the groups was satisfactory. There was no deterioration of the quality of life in cervical anastomosis. It caused less gastroesophageal reflux than did intrathoracic anastomosis. We hold that esophagectomy with cervical anastomosis and extensive lymphadenectomy is a better treatment of choice for carcinoma of the esophagus.
 ...
PMID:[A comparative study of cervical and thoracic anastomoses after esophagectomy for esophageal carcinoma]. 920 47

The incidence of esophageal adenocarcinoma and adenocarcinoma of the gastric cardia has increased so substantially in the last two decades that adenocarcinoma now accounts for approximately one half of esophageal malignancies seen in the United States and Europe. The reasons for this histological change may be related to a parallel increase in the incidence of gastroesophageal reflux disease in the Western world and the subsequent development of Barrett's metaplasia. Controversies surrounding carcinoma of the esophagus that are currently the focus of study are the relationship of Barrett's esophagus to the development of adenocarcinoma; whether adenocarcinoma of the esophagus and cardia is the same disease; the correct way to stage the disease; the treatment of disease confined to the mucosa; the extent of surgical resection to cure disease beyond the mucosa; the role of adjuvant chemotherapy in the treatment of the disease; and the methods of palliating patients with incurable disease.
 ...
PMID:Esophageal carcinoma: current controversies. 922 8

The survival of young patients (< or = 50 years of age) with carcinoma of the oesophagus or stomach has been reported to be poorer than that of their older counterparts. The aim of the current study was to review the outcome of such young patients with oesophagogastric cancer and to compare the outcome in patients with carcinoma of the oesophagus/cardia with patients with carcinoma of the more distal stomach. The study population was 50 patients. Tumour location was oesophagus/cardia (n = 33) and gastric body/antrum (n = 17). The most common presenting symptoms were weight loss (66%), epigastric pain (54%), dysphagia (50%), and heartburn (40%). Seventeen patients had experienced foregut symptoms for a period of > or = 6 months. These patients were more likely to have symptoms of gastro-oesophageal reflux disease and to have received acid suppression therapy than patients with shorter symptom durations. Only 20 patients underwent a potentially curative resection, while 10 underwent open and close laparotomy. The overall median survival was 7 months and the 5-year survival was 8%. Multivariate analysis revealed that surgical resection and UICC stage were the only factors that significantly influenced survival. There was no difference in the survival of patients with proximally situated tumours compared to those with distally located tumours. Wide variations in clinical practice were seen between different surgeons. Consequently, a multidisciplinary team designed to manage all patients with oesophagogastric cancer according to nationally agreed protocols has been established in our hospital. Earlier diagnosis of these tumours is to be encouraged, even if this necessitates the more liberal use of endoscopy in the evaluation of young patients with persistent foregut symptoms.
 ...
PMID:Outcome of oesophagogastric carcinoma in young patients. 1039 82

From 1992-1995 in Victoria Hospital Republic of Seychelles 1037 patients undergone esophago-gastro-duodenoscopic examination. Ulcer was find in 26% patients, gastritis in 23.5%, gastroesophageal reflux in 15.9%, upper gastro-intestinal bleeding in 13.5%., carcinoma of the esophagus in 6%, gastric ulcer in 2.8%, hiatus hernia in 3%, esophageal varices in 2.1%, gastric carcinoma in 2.1% and 0.3% with polyps.
 ...
PMID:[Endoscopy of the esophagus, stomach and duodenum at Victoria Hospital--Seychelles]. 1095 16

Barrett's oesophagus is a premalignant metaplastic change of the oesophageal mucosa. Due to its relationship with oesophageal reflux disease and the development of adenoma-carcinoma of the oesophagus the problem arouses increasing interest. In the wide pathogenesis of the disease most probably the composite effect of the refluxed HCl content and duodenal juices play a part. In the diagnosis in addition to fundamental methods--endoscopy and histology--increasingly chromoendoscopy and fluorescent endoscopy are involved. Dispensarization of patients is essential and depends on the degree of pathohistological epithelial changes. Treatment of Barrett's oesophagus can be divided into conservative, where the drug of choice are proton pump inhibitors, and surgical treatment. Promising is endoscopic ablation of the epithelium in combination with subsequent antisecretory therapy.
 ...
PMID:[Barrett's esophagus]. 1213 67

For a long time heartburn was not considered a symptom for serious illness. By now, however, it is accepted that the incidence of secondary carcinoma of the esophagus caused by chronic GERD has increased dramatically since the nineteen-seventies. Mechanisms leading to GERD are complex and its incidence is not necessarily pathological. However pathological reflux in the lower esophagus (pH lower than 4 in 6 % of 24 hours), caused by decreased sphinctertonus, impaired peristalsis and clearance of the esophagus, may lead to complications. Helicobacter pylori may play a key role in GERD. There is strong evidence for a protective effect of Hp-infection in the development of GERD. In pangastritis, caused by Hp-infection, gastric acid production is inhibited resulting in a reduction of stomach-acid-concentration. This may be caused by either the chronic infection itself and the resulting atrophy of the stomach-mucosa, by the ammonia-producing HP-bacteria, or an increase in acid re-absorbtion of gastric epithelium. Laryngopharyngeal reflux (LPR) often results in atypical manifestations with oral, pharyngeal, laryngeal, and pulmonary disorders. Laryngopharyngeal reflux is known to contribute to posterior acid laryngitis and laryngeal contact ulceration or granuloma formation, laryngeal cancer, chronic hoarseness, pharyngitis, asthma, pneumonia, nocturnal choking, and dental diseases. Today, PPI are the medication of choice in both acute and long-term (prophylactic) therapy of GERD. The so called "step-up-strategy" of medication is no longer recommended. Here, patients were first treated with antacids, then prokinetics followed by H2-blockers and finally low-dose PPI. Only in the case of persisting symptoms medication was further increased to high-dose PPI therapy. In the past this increase in medication lead to a prolonged healing process and consequently to higher medication costs. Studies have shown that a "step-down"-therapy, beginning with high dose PPI, is highly preferable, since it is much more effective. Depending on the degree of the symptoms, however, medication may also be applied "on-demand". The BfArM has approved this kind of medication application only for Esomeprazol (Nexium mups 20 mg).
 ...
PMID:[Gastroesophageal reflux -- a common illness?]. 1262 41

Esophageal carcinoma is a highly lethal disease with increasing prevalence and an equally dramatic epidemiologic shift. Its causal association with gastroesophageal reflux disease and adenocarcinoma of the esophagus is well established, and the molecular events underlying this progression from mucosal injury to metaplasia to dysplasia to carcinoma are now becoming clear. Current diagnostic modalities and preoperative staging systems have significant limitations. The extent of surgical resection for esophageal carcinoma remains controversial. Disease confined to the mucosa and submucosa is more common, and endoscopic ablative techniques have been proposed. However, preoperative evaluation of tumor depth and regional nodal metastases remains inadequate in these very early lesions and urges caution before adoption of therapies that may compromise cure. Patients with disease confined to the mucosa or submucosa should undergo resectional therapy aimed at removing the entire esophageal wall, including the periesophageal and perihiatal lymph nodes. For disease penetrating the submucosa, the extent of surgical therapy must be tailored to the objectives of treatment (cure vs palliation) and preoperative stage. Although data from seven prospective, randomized trials are encouraging, no clear survival benefit has been documented for neoadjuvant combined-modality therapy. Surgical resection remains the standard of care and best chance for cure in the treatment of esophageal malignancy, with combined-modality therapy reserved for prohibitive surgery candidates.
 ...
PMID:Surgical management of esophageal malignancy. 1273 40


<< Previous 1 2 3 Next >>