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Gender,medication use and other factors associated with esophageal motility disorders in non-obstructive dysphagia

Gastroenterology Report 2018年第3期6卷 177-183,I0002页

作者： Afrin Kamal Sampurna Shakya Rocio Lopez Prashanthi N.Thota Department of Gastroenterology and Hepatology Digestive Diseases and Surgical InstituteCleveland Clinic9500 Euclid AvenueClevelandOH 44195USA Department of Qualitative Health Sciences Cleveland Clinic9500 Euclid AvenueClevelandOH 44195USA

Background:High-resolution esophageal manometry(HREM)is the diagnostic test of choice for evaluation of nonobstructive *** regarding the predictors of esophageal dysmotility are ***,our aim was to study the prevalence of and factors associated with esophageal motility disorders in patients with non-obstructive ***:We performed a retrospective review of all patients with non-obstructive dysphagia who underwent HREM in a tertiary center between 1 January 2014 and 31 December *** obtaining IRB approval(16–051),clinical records were scrutinized for demographic data,symptoms,medication use,upper endoscopic findings and esophageal pH *** plots were classified per Chicago Classification version *** outcome was prevalence of esophageal motility disorders;secondary outcomes assessed predictive ***:In total,155 patients with non-obstructive dysphagia(55616 years old,72%female)were *** diagnosis was normal in 49%followed by ineffective esophageal motility in 20%,absent contractility in 7.1%,achalasia type II in 5.8%,outflow obstruction in 5.2%,jackhammer esophagus in 4.5%,distal esophageal spasm in 3.9%,fragment peristalsis in 1.9%,achalasia type I in 1.9%,and achalasia type III in 0.6%.Men were five times more likely to have achalasia than women[odds ratio(OR)5.3,95%confidence interval(CI):2.0–14.2;P=0.001].Patients with erosive esophagitis(OR 2.9,95%CI:1.1–7.7;P=0.027)or using calcium channel blockers(OR 3.0,95%CI:1.2–7.4;P=0.015)were three times more likely to have hypomotility ***:From this study,we concluded that HREM diagnosis per Chicago Classification version 3.0 was normal in 49%of patients with non-obstructive *** gender,erosive esophagitis and use of calcium channel blockers were predictive of esophageal motility disorders.

关键词： Impaired swallowing high-resolution esophageal manometry esophageal motility disorders

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Manometric findings in patients with isolated distal gastroesophageal reflux

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World Journal of Gastroenterology 2009年第43期15卷 5461-5464页

作者： Yasemin Ozin Ulku Dagli Sedef Kuran Burhan Sahin Gastroenterology Department Turkey Yuksek Ihtisas Training and Research HospitalKizilay Sokak06040 SihhiyeAnkara Turkey

AIM： To analyze manometric abnormalities in patients with isolated distal reflux and compare these findings in patients with erosive and non-erosive disease, METHODS： Five hundred and fifty patients who presented to the outpatient clinic of Turkiye Yuksek Ihtisas Hospital with gastroesophageal reflux disease-like symptoms were enrolled, Each individual was evaluated with esophageal manometry, 24-h ambulatory pH monitoring, and upper gastrointestinal endoscopy, Manometric findings for the patients with isolated distal reflux were compared to findings in controls who were free of reflux disorders or hypersensitive esophagus, Findings for isolated distal reflux patients with and without erosive reflux disease were also compared, RESULTS： Of the 550 subjects enrolled, 97 （17.6%, mean age 48 years） had isolated distal reflux and i00 had no abnormalities on ambulatory pH monitoring （control group, mean age 45 years）. There were no significant differences between the isolated distal reflux group and control group with respect to age, body mass index, and esophageal body contraction amplitude （EBCA）. Mean lower esophageal sphincter pressure was significantly higher in the control group （12.7 ± 10.3 mmHg vs 9.6 ± 7.4 mmHg, P = 0.01）. Fifty-five （56.7%） of the 97 patients with isolated distal reflux had erosive reflux disease. There were no statistical differences between the erosive reflux disease and non-erosive reflux disease subgroups with respect to mean EBCA, lower esophageal sphincter pressure, or DeMeester ***, 13% of patients with gastroesophageal reflux disease had distal wave amplitudes ≤ 30 mmHg, whereas none of the patients with non-erosive reflux disease had distal wave amplitudes in this low category. CONCLUSION： Patients with erosive and non-erosive disease present with similar manometric abnormalities. The only striking difference is the observation of very low EBCA exclusively in patients with erosive disease.

关键词： esophageal motility disorders Isolated distal reflux Gastroesophageal reflux disease Manometry Esophagitis

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Changes in the esophagogastric junction outflow obstruction manometric feature based on the Chicago Classification updates

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World Journal of Gastroenterology 2022年第30期28卷 4163-4173页

作者： Yue-Yuan Li Wen-Ting Lu Jian-Xiang Liu Li-Hong Wu Meng Chen Hong-Mei Jiao Department of Geriatrics Peking University First HospitalBeijing 100034China Department of Gastroenterology and Hepatology Peking University First HospitalBeijing 100034China

BACKGROUND The critical diagnostic criteria for esophagogastric junction outflow obstruction(EGJOO)were published in the latest Chicago Classification version 4.0(CCv4.0).In addition to the previous criterion[elevated integrated relaxation pressure(IRP)in supine position],manometric diagnosis of EGJOO requires meeting the criteria of elevated median-IRP during upright wet swallows and elevated intrabolus ***,with the diagnostic criteria modification,the change in manometric features of EGJOO remained *** To evaluate the esophageal motility characteristics of patients with EGJOO and select valuable parameters for confirming the diagnosis of *** We performed a retrospective analysis of 370 patients who underwent highresolution manometry with 5 mL water swallows×10 in supine,×5 in upright position and the rapid drink challenge(RDC)with 200 mL water from November 2016 to November 2021 at Peking University First ***-one patients with elevated integrated supine IRP and evidence of peristalsis were enrolled,with 24 patients meeting the updated manometric EGJOO diagnosis(CCv4.0)as the EGJOO group and 27 patients not meeting the updated EGJOO criteria as the isolated supine IRP elevated group(either normal median IRP in upright position or less than 20%of supine swallows with elevated IBP).Forty-six patients with normal manometric features were collected as the normal high-resolution manometry(HRM)*** esophageal sphincter(UES),esophageal body,and lower esophageal sphincter(LES)parameters were compared between *** Compared with the normal HRM group,patients with EGJOO(CCv4.0)had significantly lower proximal esophageal contractile integral(PECI)and proximal esophageal length(PEL),with elevated IRP on RDC(P<0.05 for each comparison),while isolated supine IRP elevated patients had no such *** with EGJOO also had more significant abnormalities in the esophagogastric junction than isolated supine IRP elevate

关键词： Esophagogastric junction outflow obstruction High-resolution manometry esophageal motility disorders Upper esophageal sphincter Proximal esophagus

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Dysphagia,reflux and related sequelae due to altered physiology in scleroderma

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World Journal of Gastroenterology 2021年第31期27卷 5201-5218页

作者： Anusri Kadakuntla Ankit Juneja Samantha Sattler Anusha Agarwal Drishti Panse Nardin Zakhary Anusha Pasumarthi Lee Shapiro Micheal Tadros Albany Medical College AlbanyNY 12208United States Department of Dentistry Ministry of HealthAlexandria 21500Egypt Division of Rheumatology Albany Medical CenterAlbanyNY 12208United States Division of Gastroenterology Albany Medical CenterAlbanyNY 12208United States

Systemic sclerosis is a connective tissue disease that presents with significant gastrointestinal involvement,commonly in the *** is a common clinical manifestation of systemic sclerosis and is strongly related to esophageal ***,there are multiple other contributing factors in each step in the physiology of swallowing that may contribute to development of severe *** oral phase of swallowing may be disrupted by poor mastication due to microstomia and poor dentition,as well as by *** the pharyngeal phase of swallowing,pharyngeal muscle weakness due to concurrent myositis or cricopharyngeal muscle tightening due to acid reflux can cause *** esophageal phase of swallowing is most commonly disturbed by decreased peristalsis and esophageal ***,it can also be affected by obstruction from chronic reflux changes,pill-induced esophagitis,or Candida *** contributing factors to dysphagia include difficulties in food preparation and *** the anatomy and physiology of swallowing and evaluating systemic sclerosis patients presenting with dysphagia for disturbances in each step can allow for development of better treatment plans to improve dysphagia and overall quality of life.

关键词： Systemic sclerosis esophageal motility disorders Deglutition Deglutition disorders Gastroesophageal reflux Esophagitis

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Oesophageal surgery

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World Journal of Gastroenterology 2001年第6期7卷 760-765页

作者： ErikJ.Simchuk DerekAlderson University Department of Surgery Bristol Royal InfirmaryBristol BS2 8HWUK

INTRODUCTIONThe origins of oesophageal surgery ,like most surgical treatments ,are based in the treatment of traumatic injury .The Smith Surgical Papyrus describes the examination, diagnosis and treatment of 'a gaping... 详细信息

关键词： esophageal motility disorders esophageal Neoplasms Esophagus Gastroesophageal Reflux Hernia, Hiatal Humans

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Therapeutic efficacy observation of acupuncture plus medicine for laryngopharyngeal reflux due to liver-qi stagnation and spleen deficiency

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Journal of Acupuncture and Tuina Science 2021年第3期19卷 226-230页

作者： Zhao Jing Wang Yi Yang Cui-rong Lou Qing Zhang Fu-qing First Affiliated Hospital of Chengdu Medical College Chengdu610500China 不详

Objective To observe the clinical efficacy of acupuncture plus medicine in treating laryngopharyngeal reflux due to liverqi stagnation and spleen *** A total of 70 patients were divided into a control group and an observation group by the random number table method,with 35 cases in each *** groups were treated with conventional medications,and the observation group was treated with additional acupuncture *** reflux symptom index(RSI)and reflux finding score(RFS)were *** motility indicators such as lower esophageal sphincter pressure(LESP)and upper esophageal sphincter pressure(UESP),and salivary pepsin level were *** clinical efficacy was also *** The total effective rate of the observation group was higher than that of the control group(P0.05),while LESP and UESP in the observation group increased significantly(both Pesophageal motility and salivary pepsin *** efficacy is more significant compared with medicine alone.

关键词： Acupuncture Therapy Acupuncture Medication Combined Laryngopharyngeal Reflux Liver-qi Stagnation and Spleen Deficiency esophageal motility disorders Randomized Controlled Trial

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Water-jet vs traditional triangular tip knife in peroral endoscopic myotomy for esophageal dysmotility:A systemic review and metaanalysis

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World Journal of Gastrointestinal Endoscopy 2022年第10期14卷 608-615页

作者： Yuliya Belopolsky Srinivas R Puli Division of Gastroenterology and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States

BACKGROUND Peroral endoscopic myotomy is an increasingly used less invasive modality to treat esophageal ***,triangular tip knife with integrated water jet function has been introduced to mitigate multiple instrument *** To compare traditional triangular tip knife and water jet knife in terms of procedural success,duration,instrument exchanges,coagulation forceps use,and adverse *** We conducted a systemic review and meta-analysis with two authors independently in electronic databases(PubMed,Embase,and Cochrane Library)from inception through May *** addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://***).A fixed-effects model was used to calculate weighted mean,odds ratio(OR),and confidence intervals(CI).RESULTS We included 7 studies involving 558 *** knife and water jet knife were similar in odds of procedural success with ratio of 4.78(95%CI=0.22-102.47)and odds of clinical success with ratio of 0.93(95%CI=0.29-2.97),*** jet knife had fewer instrument exchanges compared to triangular knife(2.21,95%CI=1.98-2.45 vs 11.9,95%CI=11.15-12.70)and usage of coagulation forceps(1.75,95%CI=1.52-1.97 vs 2.63,95%CI=2.37-2.89).Adverse events were higher in triangular knife group(OR:2.30,95%CI=1.35-3.95).CONCLUSION Peroral endoscopic myotomy using water jet knife is comparable in terms of pro cedural success to triangular tip *** jet knife also required shorter procedural duration,less instrument exchanges,coagulation devices,and overall adverse events.

关键词： Gastroenterology Endoscopy gastrointestinal esophageal motility disorders Water jet knife Dysmotility

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