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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Whereas a burning retrosternal pain irradiating upward is the main symptom of reflux esophagitis in the adult, this symptom is usually not extant in children. Rather, the child will show unaccountable vomiting, stunted growth, anemia of unknown etiology, and respiratory disturbances. The pathologic condition more often associated with reflux esophagitis is hypertrophic stenosis of the pylorus, which is in fact regarded as one of the causes of the esophageal disorder. Reflux esophagitis may lead to ulceration and hemorrhage, and may evolve into cicatricial retraction and esophageal stenosis, the latter sometimes quite tight. The condition is diagnosed in light of radiological examination and endoscopy. Whit older children, one may add the Bernstein test and pressure and pH readings. The paper concludes by pointing out the different diagnostic approach in the newborn and small baby on the one hand and in older children on the other.
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PMID:[Clinical picture and diagnosis of reflux esophagitis in children]. 69 25

The etiology, pathogenesis, diagnosis, and treatment of reflux esophagitis are reviewed. Reflux esophagitis is the subjective or objective response to gastroesophageal reflux (GER), which is defined as the entrance of gastroduodenal contents into the esophagus not associated with vomiting or belching. The pathogenesis of reflux esophagitis may involve a number of mechanisms, including changes in lower esophageal sphincter pressure, gastric volume, composition of the refluxate, esophageal acid clearance, and esophageal tissue resistance. The most common symptom of reflux esophagitis is heartburn. Regurgitation of fluid into the mouth, usually after bending or during the night, is an unequivocal symptom of GER. Treatment can be divided into three phases. Phase 1 involves the avoidance of certain foods and habits, elevation of the bed head, antacid, and alginic acid-antacid therapy. Phase 2 involves drug therapy with agents not yet approved by the FDA for this indication: bethanechol chloride, cimetidine, and metoclopramide hydrochloride. Bethanechol chloride 25 mg is generally given four times daily. Cimetidine is given in doses of 300-400 mg after meals and at bedtime. Metoclopramide hydrochloride is administered in doses of 10 mg before meals and at bedtime. Phase 3 is antireflux surgery. Clinical experience has shown that phase 1 therapy is successful for about 75% of all patients. Of the 25% that do not respond to phase 1 therapy, about 90% will respond to phase 2 therapy, leaving only 5-10% of all patients with this disorder who will require phase 3 treatment. Current data favor cimetidine and bethanechol over metoclopramide. The least proof of efficacy and the most frequent adverse side effects are seen with metoclopramide. Cimetidine and bethanechol appear to have similar efficacy and relatively infrequent side effects. Evidence confirming the superiority of cimetidine over bethanechol is lacking. Further research is needed to determine the optimal pharmacologic combinations and treatment regimens.
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PMID:Current concepts in the pathogenesis and treatment of reflux esophagitis. 636 Apr 95

A patient with persistent vomiting in pregnancy due to oesophageal stricture secondary to reflux oesophagitis is reported. Reflux oesophagitis is common during pregnancy but usually responds to small frequent meals, the avoidance of certain positions and simple antacid therapy. Where symptoms are persistent and become worse in late pregnancy we suggest that more energetic therapy in the form of cimetidine or alginate antacid mixture (Gaviscon) should be considered to prevent oesophageal stricture formation.
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PMID:Oesophageal stricture due to reflux oesophagitis in pregnancy. Case report. 730 80

Many forms of gastric banding have been described and high reoperation rates reported. These can be mainly attributed to excess vomiting associated both with and without stenosis. Reflux esophagitis and the 'sump' effect may be other causes. This paper examines the problems associated with banding leading to revisional surgery and introduces a new technique, 'fundal supporting suture', to correct these problems. Preliminary results on 126 bandings without the modification and 22 with the modification are presented.
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PMID:Modification of Gastric Banding, Using a Fundal Suture. 1077 33

Esophagitis in cats and dogs is a consequence of increased exposure of the esophageal mucosa to gastroduodenal reflux. Causes can include anesthesia-related reflux, frequent vomiting, or lodged foreign bodies. An exception is eosinophilic esophagitis, an emerging primary inflammatory disease of the esophagus with a presumed allergic etiology. Reflux esophagitis owing to lower esophageal sphincter incompetence is often suspected; a tentative diagnosis can be made by endoscopic assessment, wireless esophageal pH-monitoring, or histologic examination. Because it can be difficult to distinguish diet-responsive upper gastrointestinal disease from esophagitis, response to treatment with gastric acid suppressants is needed to confirm the tentative diagnosis.
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PMID:Esophagitis in Cats and Dogs. 3318 19