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)

The incidence of severe duodenal anomalies (MD) has been investigated in 458 patients submitted to barium meal examination and in 176 subjects comprising various clinical subgroups. The incidence of MD in patients submitted to barium meal examination was 11.6%. The incidence of MD in 25 normals was 4%, which was not significantly different from the incidence (10%) of MD in patients with gastroesophageal reflux symptoms. Compared with in normals, MD occurred with a significantly higher incidence in 45 patients with X-ray-negative dyspepsia (24%), in 36 patients with the irritable bowel syndrome (44%), and in 37 patients with asthma (38%). It is concluded that demonstration of MD in a patient is only indicative of a possible disorder.
 ...
PMID:The incidence of severe duodenal anomalies in patients submitted to barium meal examination, in normals, and in different clinical subgroups. 343 6

Respiratory tract disease was the main indication for surgery in 45 out of the 102 children operated upon for GER in the last 7 years: twenty-four had recurrent bronchitis and pneumonia, 18 had bronchitis with constriction (true asthma in 10), 2 had unbearable cough and 1 apnoeic crises. All had been medically treated before without success. The diagnosis of GER has been accepted only in patients with abnormal results in three or more of the following tests: barium swallow, extended pH-metering, manometry, endoscopy-biopsy and gastro-oesophageal scintigraphy. Nissen fundoplication cured GER in all cases, and its effect on respiratory tract disease after an average follow-up of 17 months (range 6 to 48) was rather encouraging: twenty-six children cured (57%), 9 improved (21%) and 10 remained unchanged (22%). Failures were more frequent in children with bronchoconstriction (45%) and in those without prior digestive symptoms (36%). Surgery is probably indicated more often in the treatment of respiratory tract diseases associated with GER in children than it was previously thought, but indications remain difficult and the results are uncertain in children with either asthma or bronchoconstriction.
 ...
PMID:[Results of surgical treatment of gastroesophageal reflux with respiratory manifestations]. 360 85

To examine a possible esophageal basis for cervical symptoms, we studied 63 patients with persistent cervical complaints, 36 patients with gastroesophageal reflux but no cervical symptoms, and ten normal subjects. Patients were evaluated for a history of pyrosis and regurgitation and underwent otolaryngologic examination, barium esophagram, upper endoscopy, esophageal biopsy, standard esophageal manometrics, acid reflux testing, and Bernstein examination, as well as tests of esophageal dysmotility and acid clearance time before and after bethanechol (50 micrograms/kg, two doses). Standard diagnostic examinations usually were normal in patients with cervical symptoms. Pyrosis, regurgitation, and a positive Bernstein examination were uncommon in patients with cervical symptoms. This occurred despite frequent acid reflux (68%) and poor acid clearance (79%). Esophageal dysmotility also was common (63%). Patients with reflux but no cervical symptoms and normal subjects had a normal acid clearance time, and dysmotility was unusual (8%). We conclude that patients with cervical symptoms have diminished esophageal sensitivity despite frequent and long acid exposure. The pathophysiologic significance of this observation is discussed.
 ...
PMID:Esophageal reflux and dysmotility as the basis for persistent cervical symptoms. 361 82

Some degree of gastroesophageal reflux is very common in infants and tends to reverse with time. Therefore, the indications for an antireflux operation are not well defined. Furthermore, the complication rate and the ability of the fundoplication to grow remain to be determined. To answer these questions, we reviewed the records of patients 6 months of age or younger who underwent a Nissen fundoplication with gastrostomy tube placement between 1979 and 1985. There were 45 patients (25 boys and 20 girls) with birth weights of 0.65 to 4.3 kg. The consequences of gastroesophageal reflux were more varied than in older children. Severe respiratory problems were common, including recurrent aspiration or bronchopulmonary dysplasia in 60% and frequent apneic and bradycardiac spells in 17%. Failure to gain weight was present in 20% and intractable vomiting in 2.0%. As expected, 78% of these patients had congenital anomalies or acquired problems which, in many cases, were important to the prognosis. The diagnosis was confirmed by barium swallow in all but one patient in whom gross reflux during feedings was present. Initially, medical management was tried for 3 to 4 weeks. In one patient, however, the severity of the respiratory problems precluded trial beyond 12 days. The recommendation for operation was based only on the severity of symptoms attributed to gastroesophageal reflux. All patients underwent Nissen fundoplication with gastrostomy tube placement at 2 weeks to 6 months of age and weighing 1.02 to 6.95 kg. The only surgical complication was one gastrostomy leak. Prematurity or preexisting anomalies led to a 20% incidence of late unrelated deaths between 2 weeks and 23 months postoperatively. Improvement in symptoms occurred in our survivors with follow-up of 5 to 72 months. We conclude: Significant gastroesophageal reflux in infancy most frequently produces respiratory problems that can be life threatening. Nissen fundoplication can be a safe and effective procedure in infants 6 months of age or younger. Fundoplication appears to have good growth potential, and no late complications or feeding problems have occurred. Consequently, surgical correction can be recommended for infants not responding to conservative medical therapy.
 ...
PMID:Nissen fundoplication for gastroesophageal reflux in infants. 363 72

Esophageal pH monitoring is now the most reliable test in the diagnosis of gastroesophageal reflux (GER) in infants and children. A 18-24 hr esophageal pH monitoring is undertaken in 26 newborns to validate this test for this age group where GER is frequent with fair correlation of clinical presentation. In 19 infants with suspicion of GER, this test give a positive diagnosis in 12 of them. Seven out of these 12 infants have another investigations (barium- esophagram - scintigraphy - esophagoscopy) with only a positive diagnosis of GER in 4 cases. Esophageal pH monitoring in 7 control infants show that the percent of monitoring time with pH below 4.0 is one of the best discriminative values (upper limit: 4.2%) for the diagnosis of GER. Unusual symptoms of GER in the neonatal period as apneic spells, dyspnea, cyanosis or neurological signs are indications for esophageal pH monitoring.
 ...
PMID:[Esophageal pH measurements in newborn infants. Value and indications]. 364 8

Proximal pouch esophagomyotomy (Livaditis) allows for repair of long gap esophageal atresia (EA). Postoperative esophageal functional studies in these patients are lacking. Six such infants were followed for up to 42 months. Esophageal function was assessed clinically and by barium swallow, manometry, 24 hr pH monitoring, esophagoscopy, and biopsy. Operative complications included two minor anastomotic leaks and two asymptomatic diverticula at the myotomy site. All patients had dysmotility on barium swallow. Gastroesophageal reflux (GER) was seen in four. Manometry showed a variable aperistaltic segment in each infant but lower esophageal sphincter pressures and relaxation were retained. Twenty-four hour pH monitoring showed an increase in frequency and duration of GER. All four patients biopsied had esophagitis. Five of the six patients showed normal growth velocity. Livaditis modified repair of EA was not associated with significant surgical complications. Esophageal motility showed abnormalities similar to those reported after the standard repair of EA. Myotomy did not adversely affect the esophageal function.
 ...
PMID:Esophageal function following Livaditis repair of long gap esophageal atresia. 365 32

Gastro-oesophageal reflux (GER) in children, causes sometimes aspecific symptoms in children. Not only in the case of regurgitation but also in respiratory problems or even in the 'near missed' - Sudden Infant Death Syndrome GER is to be considered. The most important method of investigation is pH-monitoring during 24 hours preceded by a barium meal and followed by endoscopy, in most cases. Operative treatment is necessary for a hiatal hernia, or after failure of conservative treatment of an oesophagitis. In mentally retarded children, who continue to vomit, a fundoplication can be necessary to improve general care.
 ...
PMID:[Gastroesophageal reflux]. 367 86

A 30-yr-old white female with a history of focal dermal hypoplasia (Goltz syndrome), chronic gastroesophageal reflux, and dysphagia was found to have, by barium esophagram and esophagogastroduodenoscopy, multiple 2- to 3-mm papillary projections in the distal esophagus and an esophageal stricture. Biopsy of these lesions revealed squamous papillomas and a benign stricture. Although chronic irritation from gastroesophageal reflux has been suggested as a possible etiology of acquired esophageal papillomas, the previous association of congenital papillomas of the oral mucosa in Goltz syndrome suggests that the multiple papillomas in this patient are congenital in origin.
 ...
PMID:Multiple squamous papillomas of the esophagus associated with Goltz syndrome. 367 98

From January 1, 1981 to July 1, 1981, ten patients underwent immediate reconstruction utilizing split jejunal free-tissue transfers following resection of large oropharyngeal neoplasms. All 10 flaps were successfully transferred. Three patients were irradiated preoperatively and six patients were irradiated 2 to 3 weeks postoperatively. Nine patients were available for follow-up until their death from 10 to 39 months postoperatively (average 26 months). All but two patients died of their original tumor. Six of the nine patients had a good early functional result; taking semisoft or soft diets allowed them to maintain or gain weight. Three patients had poor early results with limited oral feedings due to repeated aspiration in two and severe gastroesophageal reflux in another. Postoperative graft biopsies were obtained in five patients, showing normal mucosa or mild chronic inflammation histologically even following irradiation. Postoperative barium studies showed varying degrees of graft peristalsis. Complication rates were acceptable, and donor-site morbidity was minimal. Neither preoperative nor postoperative radiation affected the viability of the grafts. Therefore, this technique should continue to find application as a reliable method of providing like tissue for reconstructing a variety of large oropharyngeal defects.
 ...
PMID:Split jejunal free-tissue transfer in oropharyngoesophageal reconstruction. 370 96

Two groups of newborns and infants with gastroesophageal reflux (GER) were retrospectively analyzed for the diagnostic accuracy and therapeutic guidance offered by extended intraesophageal pH monitoring. There were 28 patients in group I whose major presenting sign was recurrent pneumonia due to GER, and 22 patients in group II, with apnea caused by GER. The pH probe was 100% accurate in identifying the presence of GER. Barium esophagram was accurate 46% of the time. The pH probe accurately identified the appropriate mode of therapy in all patients. In the medically treated GER/Pneumonia group, the mean number of episodes of GER per 24 hours was 24, whereas in the surgical group the mean number was 63. Similarly, in the medically treated GER/Apnea group, the mean number of reflux episodes per 24 hours was 26, whereas the surgical group experienced 64. Had the pH probe been used to guide therapy, no patient would have been treated inappropriately. The number of patients in this report is not large. Prospective verification of these observations is required before this methodology can be utilized routinely in patients with GER.
 ...
PMID:Gastroesophageal reflux. pH probe-directed therapy. 370 32


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