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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-three patients with scleroderma were evaluated by history, barium swallow, and esophageal function tests. The most common esophageal symptoms were heartburn and dysphagia. Abnormal motility was seen radiologically in 43 patients, gastroesophageal reflux in only 9. Esophageal function tests demonstrated: (1) abnormal motility in 51 patients and lack of a distal esophageal high-pressure zone in 18; (2) moderate to severe gastroesophageal reflux in 38; and (3) abnormal acid-clearing ability in 50. Eleven patients, including 8 with peptic stricture, underwent the combined Collis-Belsey operation. Symptomatically, reflux was abolished in all and dysphagia in 10. Roentgenograms showed that regression of strictures was complete in 5 and partial in 3. Postoperative esophageal function tests in 9 patients demonstrated a competent distal esophageal valvular mechanism in 7. Gastroesophageal reflux, not impaired motility, is the major cause of esophageal symptoms in scleroderma. Its effecitve operative control is not contraindicated by systemic disease in these patients.
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PMID:Gastroesophageal reflux in esophageal scleroderma: diagnosis and implications. 0 16

Primary repair of esophageal atresia restores gastrointestinal continuity, but does not ensure normal esophageal function. To date 22 patients, six to 32 (average 15) years after repair of their esophageal atresias, have been evaluated by personal interview and esophageal manometrics and acid reflux testing. Previous barium swallow examinations had demonstrated varying degrees of anastomotic narrowing (12 patients), abnormal esophageal motor function (11 patients), gastroesophageal reflux (two patients), and hiatal hernia (one patient). Ten patients experience intermittent dysphagia for solid foods. Seven have typical symptoms of gastroesophageal reflux. Esophageal function tests including manometry and intraesophageal pH recording, have demonstrated varying abnormalities of esophageal motility in 21 patients and moderate to severe gastroesophageal reflux in 13. Two patients have required reconstruction of the esophagogastric junction for control of severe reflux esophagitis. The unexpected high incidence of gastroesophageal reflux in these patients, coupled with their abnormal esophageal motility which impairs normal acid clearing, renders them more prone to reflux esophagitis. Careful long-term evaluation for gastroesophageal reflux and its complications is indicated following primary repair of esophageal atresia. Evaluation of esophageal function with intraesophageal pressure and pH recordings is a far more sensitive indicator of esophageal physiology than the barium swallow examination.
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PMID:Long-term esophageal function following repair of esophageal atresia. 2 Aug 56

Intraoperative lower esophageal sphincter (LES) pressures and lenghts were measured in 10 pediatric patients requiring surgery for compications of gastroesophageal reflux. LES pressure changed significantly pre- and post-Nissen fundoplication (9.8 +/- 1.51 mm Hg vs. 32.8 +/- 2.68 mm Hg, p less than 0.001). LES length also showed a significant change (1.3 +/- 0.13 cm vs. 2.8 +/- 0.26 cm, p less than 0.001). One week postoperatively LES pressures were significantly greater than preoperative values (26.4 +/- 1.74 mm Hg vs. 15.6 +/- 2.64 mm Hg, p less than 0.01). Eight of 10 patients have been evaluated 6 mo post fundoplication. None has gastroesophageal reflux by acid reflux testing or water siphon barium esophagram. None of the 10 patients has had gas bloat syndrome during the follow-up period.
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PMID:Use of intraoperative esophageal manometrics in surgical treatment of gastroesophageal reflux in pediatric patients. 3 35

Fifty-nine symptomatic children were radiologically evaluated for gastroesophageal reflux with the water siphon test and also with the acid reflux test and esophageal manometry. Of those with reflux on pH testing, 95% had positive water siphon tests, and 38% also had spontaneous barium reflux. Of those with negative acid reflux tests, 29% had positive water siphon tests. Lower esophageal sphincter pressure did not correlate with either test unless the pressure was less than 10 mm Hg. Barium esophagography with the water siphon test is the appropriate initial examination in symptomatic patients, but the false-positive rate is high.
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PMID:Gastroesophageal reflux in children: evaluation of the water siphon test. 3 15

Following Nissen fundoplication, there is incomplete correlation between the radiological appearances and the patients' subjective symptoms. Radiology is nevertheless an important method of examination after operation. Conventional barium examination with fluoroscopy readily demonstrates the anatomical changes. Dynamic changes, such as oesophageal reflux or delayed contrast passage, are also demonstrated by cine radiography.
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PMID:[Cine radiography and manometry after Nissen fundoplication (author's transl)]. 14 4

Two children have been found to have partially obstructing lesions beyond the esophagus in association with mid-esophageal stricture. Both were found to have columnar epithelium-lined (Barrett) esophagus, and gastro-esophageal reflux. The more distal obstruction, in the pylorus and descending duodenum respectively, may have contributed to the development of the Barrett esophagus. It is recommended that any barium study of the esophagus which reveals an unexplained stricture should include visualization through the duodenojejunal junction as an aid to diagnosis, management, and understanding.
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PMID:Postesophageal narrowing associated with Barrett esophagus. 17 15

Gastroesophageal reflux was tested for with a pH telemetry capsule. In 29 individuals in whom no hiatus hernia was demonstrated on barium esophagram, the transverse diameter of the intrahiatal esophagus was compared to that of the intrathoracic. When the width of the intrahiatal esophagus was two-thirds or less that of the intrathoracic, pH-proven reflux was an infrequent event. When wider, reflux occurred with high frequency.
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PMID:pH-tested reflux without hiatus hernia. 41 15

A radiologic method for the demonstration of gastroesophageal reflux in children is described, and, while recognizing limitations and pitfalls of any classification, a clinically useful system of grading of reflux is presented. The system is based primarily on the extent of retrograde flow of barium, ranging from reflux into the distal esophagus only (grade 1) to reflux with aspiration into the trachea or lungs (grade 5). The availability of a standardized radiologic technique for the demonstration of gastroesophageal reflux and a system for grading its severity may be useful in understanding the true incidence and significance of this disorder.
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PMID:Gastroesophageal reflux in infants and children: a useful classification and reliable physiologic technique for its demonstration. 41 16

Eighty-three infants and children underwent surgical correction of gastroesophageal reflux (GER) from 1973 to 1978. Fifty-four patients had coexistent brain damage (most commonly due to cerebral palsy), eight were previously treated for esophageal atresia, and four had gastroschisis or omphalocele repair. Clinical presentation included failure to thrive in 64 patients, vomiting in 59, and recurrent bouts of aspiration pneumonitis in 43. Barium roentgenography showed GER in 61 patients, whereas additional tests (particularly pH monitoring) were required for detection of GER in 22 patients. After failure of medical management, transabdominal Nissen fundoplication was performed in 80 cases and a Hill repair in three cases. The surgical mortality was zero, but there were five late deaths. Results were considered excellent in 54 patients, good in 22 patients, and poor in seven. Ten of 12 patients with preoperative stricture responded to dilation after fundoplication. Nissen fundoplication was a safe and effective antireflux procedure in 76 of the 83 cases.
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PMID:Gastroesophageal reflux in infants and children. Diagnosis and management. 43 65

Twenty-five infants and children with proved gastroesophageal reflux were studied by radionuclide gastroesophagography to determine its sensitivity in detecting reflux. Patients swallowed an inert radiotracer (Tc-99m sulfur colloid) and gamma camera images of the stomach and esophagus were made with and without abdominal pressure. The test was easy to perform and was well tolerated. Reflux was demonstrated in 20 patients (80%); this compared favorably with barium gastroesophagography.
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PMID:Demonstration of gastroesophageal reflux in children by radionuclide gastroesophagography. 44 40


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