- Esophageal achalasia and pregnancy: own observations in 43 patients and a review of the literature. [Journal Article]
- AGArch Gynecol Obstet 2018 Jun 21
- CONCLUSIONS: It is advisable to clarify the diagnosis if symptoms suspicious of an achalasia are present before a planned pregnancy. In case of manifest achalasia, surgical treatment should be performed before pregnancy and the improvement in the state of health should be anticipated, as, otherwise, a considerable deterioration of the symptoms during pregnancy may occur. Scientific impact of our observations is very limited and prospective clinical trials are required.
- [Heller myotomy by transthoracic procedure, a single center experience in Mali with 21 cases]. [Journal Article]
- MMMali Med 2015; 30(3):46-49
- CONCLUSIONS: Oeso-cardio-myotomy of Heller by transthoracic procedure associated with the establishment of an anti reflux system by diaphragmatic flap has goods results.
- Incidence, morbidity and mortality of patients with achalasia in England: findings from a study of nationwide hospital and primary care data. [Journal Article]
- GutGut 2018 Jun 20
- CONCLUSIONS: The incidence of achalasia is 1.99 per 100 000 population in secondary care data and 1.53 per 100 000 person-years in primary care data. Subjects with achalasia have an increased incidence of oesophageal cancer, aspiration pneumonia, lower respiratory tract infections and higher mortality. Clinicians treating patients with achalasia should be made aware of these associated morbidities and its increased mortality.
- The Esophageal Manometry with Gas-perfused Catheters. [Journal Article]
- OMOpen Med (Wars) 2018; 13:232-236
- The well-established methods for esophageal manometry have some disadvantages: the-water-perfused catheters needs calibration by gravity and measuring in supine position, and the solid-state catheter...
The well-established methods for esophageal manometry have some disadvantages: the-water-perfused catheters needs calibration by gravity and measuring in supine position, and the solid-state catheters are very expensive. Manometry using gas-perfused catheters is a suitable alternative. There have been only a few publications about this.
- Mechanisms of visceral pain in health and functional gastrointestinal disorders. [Review]
- SJScand J Pain 2017 Dec 29; 5(2):51-60
- Background and aims Chronic visceral pain is common both in patients with identifiable organic disease and also in those without any structural, biochemical or immunological abnormality such as in th...
Background and aims Chronic visceral pain is common both in patients with identifiable organic disease and also in those without any structural, biochemical or immunological abnormality such as in the functional gastrointestinal disorders (FGIDs). We aim to provide a contemporaneous summary of pathways involved in visceral nociception and how a variety of mechanisms may influence an individual's experience of visceral pain. Methods In this narrative review, we have brought together evidence through a detailed search of Medline in addition to using our experience and exposure to recent research developments from ourselves and other research groups. Results FGIDs are a heterogeneous group of disorders whose aetiology largely remains an enigma. The germane hypothesis for the genesis and maintenance of chronic visceral pain in FGIDs is the concept of visceral hypersensitivity. A number of peripheral and central mechanisms have been proposed to account for this epiphenomenon. In the periphery, inflammatory mediators activate and sensitize nociceptive afferent nerves by reducing their transduction thresholds and by inducing the expression and recruitment of hitherto silent nociceptors culminating in an increase in pain sensitivity at the site of injury known as primary hyperalgesia. Centrally, secondary hyperalgesia, defined as an increase in pain sensitivity in anatomically distinct sites, occurs at the level of the spinal dorsal horn. Moreover, the stress responsive physiological systems, genetic and psychological factors may modulate the experience of visceral pain. We also address some novel aetiological concepts in FGIDs, namely the gastrointestinal microbiota, connective tissue abnormalities and the gastrointestinal neuromuscular disorders. Firstly, the gastrointestinal microbiota is a diverse and dynamic ecosystem, that safeguards the host from external pathogens, aids in the metabolism of polysaccharides and lipids, modulates intestinal motility, in addition to modulating visceral perception. Secondly, connective tissue disorders, which traditionally have been considered to be confined largely to the musculoskeletal system, have an increasing evidence base demonstrating the presence of visceral manifestations. Since the sensorimotor apparatus of the GI tract is embedded within connective tissue it should not be surprising that such disorder may result in visceral pain and abnormal gut motility. Thirdly, gastrointestinal neuromuscular diseases refer to a heterogeneous group of disorders in which symptoms arise from impaired GI motor activity often manifesting as abnormal transit with or without radiological evidence of transient or persistent dilation of the viscera. Although a number of these are readily recognizable, such as achalasia or Hirschsprung's disease, the cause in a number of patients is not. An international working group has recently addressed this "gap", providing a comprehensive morphologically based diagnostic criteria. Conclusions/implications Although marked advances have been made in understanding the mechanisms that contribute to the development and maintenance of visceral pain, many interventions have failed to produce tangible improvement in patient outcomes. In the last part of this review we highlight an emerging approach that has allowed the definition and delineation of temporally stable visceral pain clusters, which may improve participant homogeneity in future studies, potentially facilitate stratification of treatment in FGID and lead to improvements in diagnostic criteria and outcomes.
- Anal Achalasia: The Rat Tail Gas Sign. [Journal Article]
- CGClin Gastroenterol Hepatol 2018 Jun 15
- Cricopharyngeal achalasia associated with laryngomalacia as a cause of failure to thrive. [Journal Article]
- JLJ Laryngol Otol 2018 Jun 18; :1-4
- CONCLUSIONS: Functional endoscopic evaluation of swallowing and videofluoroscopic evaluation of swallowing are complimentary in the evaluation of paediatric patients with failure to thrive and suspected oropharyngeal dysphagia. Both supraglottoplasty and botulinum toxin injection are effective for definitive management in cases of combined pathology, and can be safely performed in a single surgical setting.
- Whose patient is it? The path to multidisciplinary management of achalasia. [Review]
- JSJ Surg Res 2018; 228:8-13
- In the past decade, the introduction of high-resolution manometry and the classification of achalasia into subtypes has made possible to accurately diagnose the disease and predict the response to tr...
In the past decade, the introduction of high-resolution manometry and the classification of achalasia into subtypes has made possible to accurately diagnose the disease and predict the response to treatment for its different subtypes. However, even to date, in an era of exponential medical progress and increased insight in disease mechanisms, treatment of patients with achalasia is still rather simplistic and mostly confined to mechanical disruption of the lower esophageal sphincter by different means. In addition, there is partial consensus on what is the best form of available treatments for patients with achalasia. Herein, we provide a comprehensive outlook to a general approach to the patient with suspected achalasia by: 1) defining the modern evaluation process; 2) describing the diagnostic value of high-resolution manometry and the Chicago Classification in predicting treatment outcomes and 3) discussing the available treatment options, considering the patient conditions, alternatives available to both the surgeon and the gastroenterologist, and the burden to the health care system. It is our hope that such discussion will contribute to value-based management of achalasia through promoting a leaner clinical flow of patients at all points of care.
- S093: pneumatic balloon dilation for palliation of recurrent symptoms of achalasia after esophagomyotomy. [Journal Article]
- SESurg Endosc 2018 Jun 15
- CONCLUSIONS: Serial PBD is safe and effective in treatment of recurrent symptoms of achalasia after esophagomyotomy.
New Search Next
- Relief of dysphagia due to advanced achalasia by endoscopic creation of an esophagogastric bypass anastomosis through an epiphrenic diverticulum. [Journal Article]
- VVideoGIE 2017; 2(8):201-202