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)

By means of esophageal transit scintigram using 99mTc-DTPA, 15 patients (13 esophageal carcinomas and 2 cardia carcinomas) were studied, in whom esophagogastric anastomosis was done according to the posterior invagination anastomosis technique we had devised. In all 8 patients with anastomosis at cervical region, gastroesophageal reflux was not seen on both scintigrams before and after meals, and the average pressure gradient of high pressure zone at anastomosis was 39.8 cmH2O. In 2 of 7 patients with intrathoracic anastomosis, the scintigram before meals showed severe reflex, and the endoscopic findings showed diffuse and moderate erosion in the esophageal mucosa. The average pressure gradient across the anastomosis was 6.5 cmH2O. In these 2 patients, the new fornix with a sharp angle of His was not formed. In the remaining 5 patients with intrathoracic anastomosis, reflux was not seen on the scintigram before meals. However, in 2 of them, the scintigram after meal and endoscopic examination revealed mild reflux and mild esophagitis respectively. Furthermore in one patient very mild reflux was observed only on the scintigram after meals but the endoscopic findings showed the normal esophageal mucosa. In these 5 patients, the average pressure gradient across the anastomosis was 17.0 cmH2O, which was significantly higher (p less than 0.01) than that in 2 patients with severe reflux and was significantly lower (p less than 0.01) than the mean value of high pressure zone in 8 patients with cervical anastomosis. In conclusion, it is presumed that the formation of a large fornix enough to store food and a sharp angle of His are important factors in maintaining an anti-reflux mechanism. The esophageal transit scintigram was proved to be an excellent technique in detecting and evaluating quantitatively gastroesophageal reflux.
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PMID:[Gastroesophageal reflux after esophageal surgery--evaluations based on esophageal transit scintigram]. 267 Nov 95

Gastric emptying has an important role in the pathophysiology of gastroesophageal reflux disease. We investigated the effect of metoclopramide, a gastric prokinetic agent, in gastroesophageal reflux patients with normal as well as delayed emptying. Twenty-six patients with subjective and objective evidence of gastroesophageal reflux ingested an egg salad sandwich meal labeled with 99mtechnetium-DTPA for a baseline study, and then again on a separate day after receiving oral metoclopramide, 10 mg, 30 min prior to the test meal. The mean percent isotope remaining in the stomach after 90 min improved significantly (P less than 0.001) from 70.3 +/- 3.9% (SEM) to 55.2 +/- 4.2% after metoclopramide. Fourteen (54%) had a basal emptying in the normal range of 34-69% retention of isotope at 90 min, (means +/- 2 SD), while it was slow in 12 (46%). For those with delayed basal gastric emptying, the mean retention of 88.9 +/- 2.9% at 90 min was significantly (P less than 0.005) decreased by metoclopramide to 68.6 +/- 6.1%. In those patients with a normal basal gastric emptying and a mean retention of 54.4 +/- 2.3% at 90 min, there was also significant improvement (P less than 0.025) to 43.6 +/- 3.6% after metoclopramide. These data indicate that metoclopramide increased gastric emptying in gastroesophageal reflux patients with normal as well as delayed gastric emptying. Therefore on a patient management level a trial of metoclopramide is warranted in patients with gastroesophageal reflux disease and is not limited by the gastric emptying status of the patient.
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PMID:Effect of metoclopramide on normal and delayed gastric emptying in gastroesophageal reflux patients. 636 May 97

Thirty-six patients with achalasia were examined by gastroesophageal scintiscan after esophagomyotomy (Heller's myotomy) in order to survey esophageal emptying ability and gastroesophageal reflux. Sixteen of the 36 patients had additional antireflux procedures. After oral intake of orange juice containing 5mCi99mTc-DTPA, the patients were examined for esophageal emptying ability by ECT. Gastroesophageal reflux was observed under variant intraabdominal pressure. In sole Heller's myotomy group, esophageal emptying rates at 1 and 2 minutes were better than those of Heller plus antireflux group (P < 0.05). However, there was no significant difference in occurrence of gastroesophageal reflux between the two groups (P > 0.05). In this series, Heller's myotomy plus antireflux procedures obstructed esophageal emptying rather than hindered gastroesophageal reflux, so that any antireflux procedure should not be undertaken after Heller's myotomy.
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PMID:[Estimation of surgical results of achalasia by gastro-esophageal scintiscan]. 765 4