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)

Two patients with intraluminal esophageal diverticulum are described and illustrated. Both had chronic esophagitis. One had a distal esophageal stricture, while the other showed persistent retrograde gastroesophageal reflux following hiatal hernia repair. Possible causes are considered, based on the presumption of intermittently or chronically increased intraluminal pressure associated with an area of congenital or acquired weakness of the esophageal wall.
 ...
PMID:Intraluminal diverticulum of the esophagus. 40 28

A 36-year-old woman suffered from bone pain, muscle weakness, and renal stones after prolonged ingestion of antacids for esophageal reflux. Investigation disclosed hypophosphatemia, hypercalciuria, and osteomalacia by bone biopsy. All symptoms and abnormal laboratory findings reversed with a regimen of oral phosphate supplementation and cessation of antacid intake.
 ...
PMID:Antacid-induced osteomalacia and nephrolithiasis. 64 54

Since December 1984 303 patients have undergone examination in our Multidisciplinary Consultation Service for Swallowing Disorders; 117 of them were suffering from typical globus symptoms. We were able to increase the yield of detection of organic lesions by use of the technique of 35 mm film cineradiography with a rate of 50 frames/s. Frame-by-frame analysis and computer-assisted evaluation showed that 80% of the patients with globus symptoms suffered from one or more underlying organic diseases, which could often be treated later with success. We found an increased incidence of early hypopharyngeal diverticula, webs, and motility disorders of the upper esophageal sphincter often associated with gastro-esophageal reflux or weakness of the pharyngeal wall. Cineradiography proved to be a very important tool in the analysis of the pharyngeal swallow in globus pharyngis.
 ...
PMID:[Detection of a higher incidence of pathologic somatic findings in globus sensation by use of high frequency cinematography]. 362 20

Aspiration can result from muscular weakness or paralysis of laryngopharyngeal muscles after lower motor neuron disorders (e.g., stroke) or unchecked gastroesophageal reflux. We submit that rehabilitation of the finely tuned swallowing mechanism should provide at least restoration of the normal dynamic relationships between glottic closure and cricopharyngeal relaxation. In three dogs under general endotracheal anesthesia, the recurrent laryngeal nerves and the pharyngeal musculature were exposed through a midline cervical incision. A tracheotomy was performed to allow unhindered laryngoscopic exposure of the vocal cords. A no. 9 endotracheal tube passed through the upper esophageal sphincter was used as a pressure transducer by saline inflation of its cuff and linked to an oscilloscope. The cricopharyngeus was placed under baseline tension with pulse trains administered by an intramuscular needle with a circuit previously used for agonist/antagonist coupling of reinnervated facial musculature. A second output channel was linked to the contralateral recurrent laryngeal nerve by a bipolar electrode. As the pulse width of the current to the recurrent laryngeal nerve increased, that to the cricopharyngeus was reciprocally decreased, producing snug glottic closure and synchronous cricopharyngeal relaxation. Results were documented on videotape. These findings were highly reproducible. We believe that the novel approach proposed in the current model offers an attractive solution to long-term aspiration problems resulting from an imbalance between vocal cord and cricopharyngeal activities.
 ...
PMID:Electronic integration of glottic closure and circopharyngeal relaxation for the control of aspiration: a canine study. 787 Apr 44

Chiari malformation, also called Arnold-Chiari deformities, are rare hindbrain herniations that may present in children or adults. The most common symptoms include headache, syncope, disordered eye movement, sensory loss, weakness, and cerebellar features such as ataxia. Dysphagia occurs in 5-15% of patients, although only a few reports describe dysphagia as the only presenting symptom. We report a case of a 27-year-old woman who presented with a three-year history of dysphagia, chest pain, and weight loss. Esophageal manometrics revealed markedly disordered esophageal motility and gastroesophageal reflux. Her symptoms failed to respond to high doses of omeprazole, prokinetics, and eventually surgical fundoplication. The subsequent onset of neurological symptoms led to the diagnosis of Chiari type I malformation. Following posterior craniotomy with decompression, her dysphagia and chest discomfort completely resolved. Repeat esophageal manometrics revealed complete resolution of prior abnormalities.
 ...
PMID:Esophageal dysphagia as the sole symptom in type I Chiari malformation. 861 24

Gastroesophageal reflux disease (GERD) is a complex, multifactorial disease for which the initiating factors are unknown. Acid in contact with the esophageal epithelium, however, is a central event in the development of the disease--the disease developing when acid overwhelms the intrinsic esophageal epithelial defenses. Acid breakdown of the tissue defenses is what ultimately leads to symptom production, ulceration, and other complications of GERD. Patients with GERD generally, although not always, have more episodes of reflux than healthy subjects; this is due to more frequent transient lower esophageal sphincter relaxations in the disease group. GERD patients may also have some impairment in peristaltic frequency on swallowing and/or weakness in the strength of peristaltic contractility. Contributions from other components of the acid clearance and tissue-defensive mechanisms are possible but remain to be adequately established as contributing to GERD. It is likely that one reason for the wide clinical spectrum observed with GERD results from differences in types and degrees of defects within the tripartite esophageal defensive system against damage from the phenomenon of gastroesophageal reflux.
 ...
PMID:The pathogenesis of gastroesophageal reflux disease: the relationship between epithelial defense, dysmotility, and acid exposure. 912 20

Our objectives are to report (1) methods for decreasing infectious complications and excessive weakness associated with the period of sedation and neuromuscular blockade (NMB) following single-stage laryngotracheal reconstruction (SSLTR); (2) an association between gastroesophageal reflux (GER) and subglottic stenosis (SGS); (3) results of 21 SSLTRs and 15 two-stage LTRs (TSLTRs). A retrospective chart review was performed for the period January, 1990-August, 1995, including 36 patients who had 38 LTRs for SGS and/or posterior glottic stenosis at a tertiary care center. Our most recent post-SSLTR protocol included: (1) prophylactic antimicrobials (clindamycin plus antipseudomonal agents = C + A); (2) GER treatment; (3) titrated infusion NMB with daily recovery of neuromuscular function; (4) avoidance of prolonged simultaneous administration of NMB and corticosteroids. Patients who had prophylactic antimicrobials (C + A) during intubation following SSLTR had fewer (1/13, 8%) postoperative infectious complications than patients who received other/no antibiotics (4/8, 50%) (P < 0.05). Avoidance of prolonged simultaneous administration of NMB and corticosteroids and use of titrated infusion of NMB with daily recovery of neuromuscular function was associated with less weakness following extubation (0/11, 0% vs. 4/6, 66%) (P < 0.002). Of 26 patients tested for GER, 21 (81%) had at least one positive test, suggesting a significant association between GER and SGS (P < 0.05). The overall success rate for LTR was 33/36 or 92%. SSLTR had a 95% success rate while two-stage LTR had an 87% success rate, although two revisions were required. Prophylactic antimicrobials, improved postoperative management and GER treatment allowed successful LTRs with decreased infectious complications and less weakness.
 ...
PMID:Decreasing morbidity following laryngotracheal reconstruction in children. 930 71

Zenker's diverticulum is a pouch protruding posteriorly above the upper esophageal sphincter, in the Killian's triangle, an area of relative weakness. Zenker's diverticulum was thought, for many years, to occur as a result of cricopharyngeal incoordination but more recent evidence points to poor upper sphincter compliance with diminished sphincter opening and increased hypopharyngeal pressures. Small Zenker's diverticula may be asymptomatic. As they become larger, symptoms include dysphagia, food regurgitation, and a sensation of globus. The best diagnostic method is a barium swallow with attention to the cricopharyngeal area. Although gastroesophageal reflux may be responsible for many throat symptoms, the relationship of reflux to the pathogenesis of Zenker's diverticulum is speculative. The treatment of Zenker's diverticulum is surgical. There have been many variations in technique over the years. Diverticulectomy with cricopharyngeal myotomy remains the most frequently performed operation. Endoscopic treatment with or without laser stapling has been reported but is not popular in the United States.
 ...
PMID:Zenker's diverticulum. 961 33

Type I spinal muscular atrophy (SMA) is a rapidly progressive, degenerative neuromuscular disease of infancy. In severe SMA, weakness, hypotonia, and bulbar involvement lead to progressive respiratory insufficiency and swallowing dysfunction, which are frequently complicated by aspirations. There are few studies reported in the literature that address the respiratory management of type I SMA. This article reports the results of treating four patients with infantile SMA with noninvasive positive pressure ventilation and gastrostomy feeding. All patients had gastroesophageal reflux disease, which was managed medically. Despite these therapies, survival was only 1 to 3.5 months after presenting with severe aspirations. The treatment strategy, which can be effective in less rapidly progressive neuromuscular diseases, did not alter the very poor prognosis of type I SMA. The treatment options are reviewed, and a strategy designed to optimize quality of life for infants with this fatal disease is presented.
 ...
PMID:Treatment of type I spinal muscular atrophy with noninvasive ventilation and gastrostomy feeding. 965 Jun 80

Dysphagia is related to the impairment of food passage from the mouth to the stomach. Globus pharyngis implies the frequent and often painful sensation of a lump in the throat that usually does not interfere with swallowing and may even be relieved by food intake. The diagnosis is based upon a careful history, clinical examination, endoscopy, dynamic imaging (videofluoroscopy, cinematography, videosonography) and electrophysiologic procedures (including pharyngoesophageal manometry, electromyography and pH determinations). Structural lesions of the cervical spine such as diffuse idiopathic skeletal hyperostosis are rare causes of dysphagia. Dysphagia following anterior cervical fusion as well as globus and dysphonia due to dysfunction of the vertebral joints are more likely. Symptoms with swallowing fluids indicate a neurogenic origin. Dyscoordinated swallowing, nasal reflux, dysphonia or general weakness may also occur. Chronic aspiration with respiratory compromize is the main consequence in a variety of neurological disorders as well as in cases of postsurgical dysphagia. Relaxation of the upper esophageal sphincter indicates coordinated muscle movement between the pharynx and esophagus. Dysfunction of the pharyngoesophageal segment may lead to cricopharyngeal achalasia. A dyskinetic sphincter commonly represents an extrapharyngeal cause: i.e., disease associated with gastroesophageal reflux. Disorders of the esophageal phase of deglutition can produce retrosternal pain, heartburn, regurgitation and vomiting, as well as laryngeal and respiratory signs. Esophageal motility disorders include lower achalasia, tumors, peptic strictures, inflammatory diseases, drug-induced ulcers, rings and webs. Motility disorders present with aperistaltic, spontaneous contractions, diffuse esophagospasm, or a hypermotile esophagus. Gastroesophageal reflux with esophagitis must always be excluded, especially in patients with a globus sensation. The multiple features of the appearance of the symptoms of dysphagia and globus makes multidisciplinary approach necessary in order to establish a diagnosis and begin effective treatment.
 ...
PMID:[Deglutition disorders]. 977 28


1 2 3 Next >>