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)

In attempting to solve the problem of gastroesophageal reflux esophagitis, we tested an experimental technique in 1967. In the past 13 years we have applied that intercostal pedicle method to prevent reflux in 43 patients. Thirty-four patients had esophagogastrectomy and esophagogastrostomy for cancer. Six additional patients underwent palliative, nonresective esophagogastrostomy. In another two patients the lower esophagus was resected for complete full-wall thickness fibrous stricture. One patient had severely symptomatic reflux. Six patients treated by resection for cancer are long-term survivors. The two patients with benign stricture were followed for 2 years and the last patient with severe reflux symptoms was followed for 13 years. History, esophagography, fluoroscopy, and fiberoptic esophagoscopy were used for follow-up in 40 of 43 patients. Motility and pH studies were used for follow-up in 21 instances. There have been no symptoms of regurgitation and reflux. No stricture has been seen though one patient needed a few dilatations for the first 2 years and none in the last 2 years. The esophagogram shows a typical slinglike appearance. The lower esophageal sphincter-like pressure has been as high as 26 mm Hg in the immediate postoperative period, settling to 12 to 15 mm Hg in the long-term follow-up. The pH is definitely alkaline in the esophagus. Competence has also been observed in the only two patients who had an ephemeral anastomotic leak. We recommend the intercostal pedicle technique in all cases of esophagogastrostomy performed in the chest.
 ...
PMID:Intercostal pedicle method for control of postresection esophagitis. Thirteen-year clinical study. 743 64

Tailored surgical antireflux procedures were done in 104 patients during a 7-year period. Presenting symptoms included heartburn in 95 patients (91%), regurgitation in 83 patients (80%), and dysphagia in 61 patients (60%). Evaluation before operation included video barium esophagography, endoscopy, 24-hour esophageal pH monitoring, and esophageal motility studies. On the basis of anatomic and functional findings, the following procedures were performed: 15 laparoscopic and 49 open transabdominal Nissen fundoplications, 23 transthoracic Nissen fundoplications, seven Belsey partial fundoplications, and 10 Collis gastroplasty and Belsey partial fundoplications. The severity of symptoms was assessed before and after operation according to a previously published grading score. Eighty-five of the 104 patients (82%) were able to be contacted for a follow-up evaluation by means of a standardized questionnaire. Median length of follow-up was 4 years, with 40 patients having follow-up beyond 5 years. The tailored operation cured the symptoms of heartburn in 97%, regurgitation in 91%, and dysphagia in 92%. Ninety-eight percent of the patients reported that operation had cured their preoperative symptoms and 93% were satisfied with the outcome of the operation. To obtain optimal results, surgical treatment of gastroesophageal reflux disease should be tailored to the patient's anatomic and functional assessments. For early, uncomplicated disease a transabdominal Nissen fundoplication is done, laparoscopically when expertise exists. Patients with complicated disease should undergo an open antireflux procedure tailored to specific anatomic or functional abnormalities.
 ...
PMID:A tailored approach to antireflux surgery. 760 37

Spitting is a common occurrence in infants and is usually of no consequence. When regurgitation is accompanied by the return of gastric acids into the esophagus, however, it is considered to be gastroesophageal reflux. Failure to thrive, esophagitis, aspiration, chronic respiratory disease, and apnea can all be associated with pathologic gastroesophageal reflux. This paper discusses the causes, symptoms, and treatment modalities for pathologic gastroesophageal reflux. Health care practitioners can play a major role in providing direct care as well as coordinating and evaluating treatment interventions for infants with gastroesophageal reflux. In addition, health care providers can supply the families of these infants with the necessary education and emotional support required to care for their infant.
 ...
PMID:Gastroesophageal reflux in infants. 761 22

A 4-year-old very debilitated boy, who suffered from recurrent vomiting (regurgitation) since birth, is described. At the age of 18 months, partial obstruction of the esophagus was apparent, and only semisolid food could be swallowed. The signs of obstruction progressed, and the child was admitted urgently, at the age of 4 years, to the authors' department because of severe dehydration. After resuscitation, a barium swallow and esophagoscopy showed a complete obstruction of the esophagus between its middle and lower third. Through a left thoracotomy incision, 4 cm of the diseased esophagus were resected and continually established by end-to-end esophagoesophageal anastomosis. Pathological examination showed complete obstruction of the esophagus with Barrett's epithelium above and below the stricture. Severe periesophagitis was also present because of sealed perforation of the esophagus. One week after the operation the child was on a normal diet. On follow-up, 6 months later, he has no signs of obstruction and is gaining weight. It is postulated that the presence of Barrett's epithelium in the esophagus in congenital, but the complications, such as stricture formation, are usually caused by chronic irritation, such as gastroesophageal reflux. Barrett's epithelium alone infrequently will cause
 ...
PMID:Barrett's epithelium with complete stricture of the esophagus: hypothesis of its etiology. 766 34

Symptoms suggestive of gastro-oesophageal reflux disease are very common. The aim of the study was to assess the prevalence of these symptoms and factors influencing them in an unselected adult population. A questionnaire was mailed to a random sample of 2500 people aged > or = 20 years. The questions concerned heartburn, regurgitation, dysphagia, chest and upper abdominal pain, as well as medication and medical consultations for these symptoms. Of the 1700 (68%) responders, 9% had experienced heartburn on the day of response and 15%, 21% and 27% during the preceding week, month and year, respectively. The corresponding figures for regurgitation were 5, 15, 29 and 45%. During the past year 43% of the study group had had no such symptoms. Age, overweight, pregnancy and cigarette smoking significantly influenced the prevalence of symptoms. Using daily heartburn and/or regurgitation as dominant indicators 10.3% (95% CI 12-11.7) of the responders had gastro-oesophageal reflux disease. Medication (most commonly antacids) was used by only 16% of the symptomatic people, and only 5.5% had sought medical advice for symptoms during the past year. Thus, despite commonness of symptoms suggestive of gastro-oesophageal reflux disease only a minority of the individuals suffering from such symptoms use medication or have medical consultation.
 ...
PMID:Prevalence of symptoms suggestive of gastro-oesophageal reflux disease in an adult population. 774 2

The purpose of this study was to correlate the effects of different coffees on esophageal acid contact, heartburn, and regurgitation in patients with coffee-sensitivity. Twenty volunteers with coffee-sensitivity were studied in a double-blind, 3 period, crossover study examining the effect of three regular (caffeinated) coffees (a coffee from the USA--"A"; a "treated" coffee from Europe--"B"; and an "untreated" coffee from Europe--"C") before and after a high-fat test meal. The median acid contact times for coffees A, B, and C were 6.5%, 9%, and 10.5%, respectively (A vs. C, p = 0.005). Significantly fewer patients reported any symptoms with coffee A compared with coffee C (p < 0.05). Symptoms were usually more frequent and severe after the test meal. There was a trend toward fewer and less severe symptoms with the treated coffee (B) compared with its untreated counterpart (C). Our conclusions are as follows: (a) Different coffees induce variations in gastroesophageal reflux in coffee-sensitive individuals. (b) Coffee can be treated in a manner which decreases heartburn symptoms by 75% while decreasing acid contact by only 14%. (c) Gastroesophageal reflux and symptoms of coffee sensitivity increase with the concomitant ingestion of food. (d) Symptoms of dyspepsia appear to be influenced by variations in both the coffee itself and characteristics of susceptible individuals. (e) Although gastroesophageal reflux is important in the genesis of coffee-sensitivity, there must be other factors which act in concert with reflux to produce symptoms of coffee-sensitivity.
 ...
PMID:Effect of different coffees on esophageal acid contact time and symptoms in coffee-sensitive subjects. 775 95

Chronic Esophageal reflux induces reflux esophagitis, which is a common finding in gastroenterological practice. Reflux esophagitis produce symptoms like pirosis, regurgitation and in some cases respiratory complains resembling asthma or angina-like chest pain. The pathophysiology of this disease is based on a multifactorial origin, which usually results in the chronic evolution of the disease. In recent years, there have appeared new evidences pointing out to alterations in the relaxing mechanisms of the lower esophageal sphincter; however, some patients having reflux esophagitis show normal shincteric pressure. The sweep action of esophageal smooth muscle is a key point for sending back to stomach the eventually refluxed material; it has been demonstrated that this sweeping action is impaired in many patients having reflux esophagitis. Incompetence of lower esophageal sphincter seems to be related a local to neural alteration rather than to smooth muscle functional disturbance. Recent findings stablis a link between local nitric oxide release and relaxation of the lower esophageal sphincter. Esophageal mucosaldisplay an intrinsic resistance to HCL, pepsin, bilis and enzymes deleterious action by a blockade of back-defusion of hydrogen ions contained in the refluxed material. Nevertheless, some other luminal and non-luminal factors are involved in this mucosalprotection. When these intrinsic resistance factors are abated, tisular lesions like ersion, ulcer and Barret's mucosal changes can occur; is of particular interest because its potential malignant evolution. Esophageal reflux usually resolves with medical treatmen, but in some particular cases surgical correction is indicated for improving the antireflux barrier.
 ...
PMID:[Reflux esophagitis]. 776 23

Rapid-sequence induction of anesthesia and the application of cricoid pressure are the two most common maneuvers performed when patients requiring general anesthesia are at risk of pulmonary aspiration. However, these procedures are quite elaborate and entail risks and dangers in themselves. A new disposable nasogastric balloon tube was developed to prevent the reflux of gastric contents by blocking the cardia with a balloon. The effectiveness of this tube was investigated in animals and healthy volunteers. In addition, we describe the initial experience with the tube during ventilation via a mask in patients with an increased risk of aspiration. Twelve pigs with a blocked cardia did not show any gastroesophageal reflux under six different procedures to provoke vomiting and regurgitation (gastric fluid filling with different volumes, head-down positioning, drug-induced vomiting, external gastric compression before and after surgical ligation of the pyloric orifice), whereas 37 of 48 provocation maneuvers led to a reflux in eight additional pigs with an unblocked cardia. In 26 test subjects with a blocked cardia, reflux of gastric contents was not observed when vomiting was provoked. After elimination of the cardia blockade, a reflux could be triggered in 24 of the 26 subjects. Among 42 patients in danger of aspiration, anesthesia could be induced without any problems using a nasogastric balloon tube with ventilation via a mask. The present experimental findings in animals and test subjects show that the nasogastric balloon tube can prevent gastroesophageal reflux under provocation of vomiting and regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Can pulmonary aspiration of gastric contents be prevented by balloon occlusion of the cardia? A study with a new nasogastric tube. 748 36

To identify behaviors associated with the onset of gastroesophageal reflux episodes in infants both systematically and prospectively, each of 10 patients (aged 2 to 32 weeks) was studied during 2 hours of intraluminal esophageal pH probe monitoring, using a split-screen audiovisual recording technique. Videotape analysis of eight infants who had scoreable reflux events revealed six discrete behaviors closely associated temporally (P < .001 to < .05) with the onset of reflux events: "discomfort" (crying or frowning), "emission" (of liquid or gas, i.e., regurgitation, drooling, or burping), yawning, stridor, stretching, and mouthing. Three behaviors (hiccuping, sneezing, and thumb-sucking) were infrequent but were significantly associated with onset of reflux events in one or two patients each. A tenth behavior, coughing or gagging, was significantly associated with onset of reflux events in two patients, but not in the rest, despite relatively frequent occurrence. Exploration of temporal relations between reflux and each behavior suggested that discomfort, emission, mouthing, and cough-gag may have caused reflux episodes, and that all 10 of the behaviors may have been caused by reflux episodes. These findings and a "quiet period" immediately preceding episodes in six of the infants suggest interesting pathophysiologic mechanisms in infants which require further evaluation.
 ...
PMID:Behaviors associated with onset of gastroesophageal reflux episodes in infants. Prospective study using split-screen video and pH probe. 785 24

The frequency of gastroesophageal reflux disease in pediatrics has increased. There is not a clear explanation, some believe there is more awareness of the disease, others believe that new formulas, which are richer in nutrients, may irritate the gastrointestinal tract of the infant. Clinically, children present with regurgitation-malnutrition, respiratory disease, and esophagitis. The medical treatment aims to improve the eating techniques, to decrease the gastric acid output, and to improve the motility function of the esophago-gastrointestinal tract. Surgical treatment is rarely needed.
 ...
PMID:[Gastroesophageal reflux in pediatrics]. 799 63


<< Previous 1 2 3 4 5 6 7 8 9 10