1,430 results match your criteria Achalasia Imaging


Achalasia subtypes can be identified with functional luminal imaging probe (FLIP) panometry using a supervised machine learning process.

Neurogastroenterol Motil 2020 Jul 1:e13932. Epub 2020 Jul 1.

Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: Achalasia subtypes on high-resolution manometry (HRM) prognosticate treatment response and help direct management plan. We aimed to utilize parameters of distension-induced contractility and pressurization on functional luminal imaging probe (FLIP) panometry and machine learning to predict HRM achalasia subtypes.

Methods: One hundred eighty adult patients with treatment-naïve achalasia defined by HRM per Chicago Classification (40 type I, 99 type II, 41 type III achalasia) who underwent FLIP panometry were included: 140 patients were used as the training cohort and 40 patients as the test cohort. Read More

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http://dx.doi.org/10.1111/nmo.13932DOI Listing

Intraoperative FLIP distensibility during POEM varies according to achalasia subtype.

Surg Endosc 2020 Jun 29. Epub 2020 Jun 29.

Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: The functional luminal imaging probe (FLIP) can be used to measure the esophagogastric junction distensibility index (DI) during myotomy for achalasia and increased DI has been shown to predict superior clinical outcomes. The objective of this study was to determine if the intraoperative DI and the changes produced by per oral endoscopic myotomy (POEM) differed between achalasia subtypes.

Methods: FLIP measurements were performed during POEM for achalasia at a single institution. Read More

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http://dx.doi.org/10.1007/s00464-020-07740-zDOI Listing

How to approach esophagogastric junction outflow obstruction?

Ann N Y Acad Sci 2020 Jun 17. Epub 2020 Jun 17.

Center of Excellence on Neurogastroenterology and Motility, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

The diagnosis of esophagogastric junction outflow obstruction (EGJOO) is currently based on high-resolution esophageal manometry and is characterized by impaired EGJ relaxation with preserved esophageal peristalsis. This condition has been defined by the Chicago Classification as a major esophageal motility disorder, although its clinical significance is controversial since heterogeneous and irrelevant presentations have been reported. EGJOO commonly has a benign clinical course, with spontaneous resolution, but it can also be associated with opioid usage, early achalasia, and mechanical obstruction. Read More

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http://dx.doi.org/10.1111/nyas.14412DOI Listing

Impedance in the evaluation of the esophagus.

Ann N Y Acad Sci 2020 Jun 17. Epub 2020 Jun 17.

GIOME, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.

The aim of this paper is to review esophageal electrical impedance technologies and to discuss the use of these technologies for physiological measurements, diagnostics, and therapy of esophageal disease. In order to develop a better understanding of the pathophysiology of and improve the diagnosis of esophageal disorders, such as gastroesophageal reflux disease (GERD) and achalasia, several new diagnostic tests, including intraluminal impedance, esophageal mucosal impedance, and the functional luminal imaging probe, have been developed. These technologies have proven valuable for assessment of the esophagus in recent years. Read More

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http://dx.doi.org/10.1111/nyas.14408DOI Listing

Experience-based expert consensus on the intra-operative usage of the Endoflip impedance planimetry system.

Surg Endosc 2020 Jun 16. Epub 2020 Jun 16.

Department of Surgery, Northshore University HealthSystem, GCSI Suite B665, 2650 Ridge Ave, Evanston, IL, 60201, USA.

Introduction: The Endoluminal Functional Lumen Imaging Probe (Endoflip™) is a balloon-based catheter that provides real-time, objective feedback regarding the distensibility of any sphincter in the gastrointestinal tract. Usage of the Functional Lumen Imaging Probe (FLIP) has not been standardized, which has limited the interpretation and generalizability of published data. The purpose of this consensus statement is to provide a standardized protocol for obtaining FLIP measurements in order to create a more uniform approach to data collection. Read More

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http://dx.doi.org/10.1007/s00464-020-07704-3DOI Listing

Clinical usefulness of esophagogastric junction distensibility measurement in patients with achalasia before and after peroral endoscopic myotomy.

Turk J Gastroenterol 2020 May;31(5):362-367

Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

Background/aims: This study aimed to determine the clinical efficacy of measuring the esophagogastric junction (EGJ) distensibility index (DI) in patients with achalasia before and after peroral endoscopic myotomy (POEM).

Materials And Methods: Retrospective data were collected from 195 patients who underwent POEM from November 2014 to November 2017 at our clinic. The Eckardt score, high-resolution manometry, and EGJ distensibility were measured before and six months after POEM. Read More

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http://dx.doi.org/10.5152/tjg.2020.19105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289165PMC

Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review.

PLoS One 2020 9;15(6):e0234295. Epub 2020 Jun 9.

Department of Internal Medicine, Digestive Disease Center and Research Institute, Soonchunhyang University College of Medicine, Bucheon, Korea.

Aim: The functional lumen imaging probe (FLIP) is a recently developed technique to evaluate the esophagogastric junction (EGJ) distensibility. Unlike timed barium esophagogram (TBE) and high-resolution manometry (HRM), FLIP can be used during peroral endoscopic myotomy (POEM). The aim of this study was to evaluate the association of intraoperative FLIP parameters with clinical outcomes as recorded in a single-center database and to investigate a systematic review of literatures. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234295PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282640PMC

Clinical profile of patients presenting with dysphagia - an experience from a tertiary care center in North India.

JGH Open 2020 Jun 29;4(3):472-476. Epub 2019 Nov 29.

Department of Gastroenterology, Sir Sunderlal Hospital, Institute of Medical Sciences Banaras Hindu University Varanasi India.

Background And Aim: Dysphagia can lead to substantial morbidity and mortality, especially in the elderly. It has both benign and malignant causes. Despite having a varied etiology, there have been few studies in India. Read More

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http://dx.doi.org/10.1002/jgh3.12284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273703PMC

Case report of a familial triple: a syndrome and review of the literature.

Medicine (Baltimore) 2020 May;99(22):e20474

Pediatric Unit, Maternal and Child Department, Azienda USL of Reggio Emilia, Sant'Anna Hospital, Castelnovo ne' Monti, Italy.

Rationale: Triple-A syndrome, or Allgrove syndrome (AS), is a rare autosomal recessive disorder characterized by the alacrimia, achalasia, and adrenal insufficiency triad. Alacrimia usually starts at early infancy, while achalasia and adrenal insufficiency appear later during childhood or adulthood. Some patients may also present with the so-called Double-A syndrome (i. Read More

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http://dx.doi.org/10.1097/MD.0000000000020474DOI Listing

Functional Luminal Imaging Probe Assessment in Postfundoplication Patients Changes Management Beyond Manometry.

J Pediatr Gastroenterol Nutr 2020 Jun;70(6):e119-e123

Division of Gastroenterology, Hepatology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Boston, MA.

Objectives: Fundoplication is a commonly performed pediatric surgery but the surgery can result in nonspecific symptoms that merit further evaluation. The goal of this study was to determine the utility of Functional Luminal Imaging Probe (FLIP) compared with high-resolution manometry with impedance (HRIM) in the evaluation of fundoplication symptoms.

Methods: We reviewed the FLIP and HRIM tracings of symptomatic fundoplication patients. Read More

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http://dx.doi.org/10.1097/MPG.0000000000002658DOI Listing

Short-term outcome after singular hydraulic EsoFLIP dilation in patients with achalasia: A feasibility study.

Neurogastroenterol Motil 2020 May 11:e13864. Epub 2020 May 11.

Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.

Background: Achalasia is a chronic esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter, determined by an elevated integrated relaxation pressure (IRP > 15 mm Hg) and absent peristalsis. Goal of treatment is facilitation of flow across the EGJ but minimizing postinterventional reflux. A new advanced hydraulic dilation technology, the esophageal functional luminal imaging probe (EsoFLIP), allows dynamic monitoring of hollow organ dimensions while performing hydraulic dilation. Read More

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http://dx.doi.org/10.1111/nmo.13864DOI Listing

Anticholinergic, anti-depressant and other medication use is associated with clinically relevant oesophageal manometric abnormalities.

Aliment Pharmacol Ther 2020 Jun 7;51(11):1130-1138. Epub 2020 May 7.

Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Background: Medications can affect gastrointestinal tract motility. However, their effects on oesophageal motility in particular are often not as widely known or may be underestimated.

Aim: To review the effect of existing medication use on high-resolution oesophageal manometry (HRM) in a 'real-world' setting. Read More

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http://dx.doi.org/10.1111/apt.15758DOI Listing
June 2020
5.727 Impact Factor

Corkscrew Esophagus in Achalasia.

N Engl J Med 2020 04;382(18):e42

University of Colorado Denver School of Medicine, Aurora, CO

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http://dx.doi.org/10.1056/NEJMicm1911516DOI Listing

Cracking the Case of Achalasia-induced Syncopal Episode.

Cureus 2020 Mar 23;12(3):e7379. Epub 2020 Mar 23.

Otolaryngology, Louisiana State University Health Sciences Center Shreveport, Shreveport, USA.

Achalasia is an uncommon disease that occurs due to inability of lower esophageal sphincter from relaxing, leading to dysphagia to liquids and solids. Clues to this diagnosis include: failed treatment with proton pump inhibitors, and changes on imaging studies including chest X-ray and barium esophagogram. Ultimately it is a diagnosis made on esophageal manometry. Read More

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http://dx.doi.org/10.7759/cureus.7379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7176328PMC

Esophagogastric Junction Opening Parameters are Consistently Abnormal in Untreated Achalasia.

Clin Gastroenterol Hepatol 2020 Apr 11. Epub 2020 Apr 11.

Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address:

Achalasia is a disorder of impaired lower esophageal sphincter (LES) relaxation and failed peristalsis traditionally characterized by manometry. As impaired LES relaxation is a mechanism of reduced esophagogastric junction (EGJ) opening, abnormally reduced EGJ distensibility assessed with functional luminal imaging probe (FLIP) was reported among patients with untreated achalasia. Therefore, we aimed to describe the performance characteristics of EGJ opening parameters on FLIP panometry among a large cohort of treatment-naïve achalasia patients. Read More

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http://dx.doi.org/10.1016/j.cgh.2020.03.069DOI Listing

Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry.

World J Clin Cases 2020 Mar;8(6):1026-1032

Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA 30303, United States.

Distal esophageal spasm (DES) is a rare major motility disorder in the Chicago classification of esophageal motility disorders (CC). DES is diagnosed by finding of ≥ 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. Read More

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http://dx.doi.org/10.12998/wjcc.v8.i6.1026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103967PMC

European guidelines on achalasia: United European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations.

United European Gastroenterol J 2020 02;8(1):13-33

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.

Introduction: Achalasia is a primary motor disorder of the oesophagus characterised by absence of peristalsis and insufficient lower oesophageal sphincter relaxation. With new advances and developments in achalasia management, there is an increasing demand for comprehensive evidence-based guidelines to assist clinicians in achalasia patient care.

Methods: Guidelines were established by a working group of representatives from United European Gastroenterology, European Society of Neurogastroenterology and Motility, and the European Association of Endoscopic Surgery in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Read More

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http://dx.doi.org/10.1177/2050640620903213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005998PMC
February 2020

Meglumine diatrizoate esophagogram after peroral endoscopic myotomy (POEM): identification of imaging findings associated with clinical complications and longer hospital stay.

Eur Radiol 2020 Mar 13. Epub 2020 Mar 13.

University of Paris, Descartes Paris 5, 75006, Paris, France.

Objectives: Esophageal peroral endoscopic myotomy (POEM) is the treatment of reference of major obstructive esophageal motility disorders but the detection of early complications remains challenging. Our aim was to report the radiological findings on meglumine diatrizoate esophagograms after esophageal POEM and identify variables associated with patient outcomes.

Methods: The imaging and clinical files of 106 patients who underwent POEM for achalasia or other major obstructive esophageal motility disorders were retrospectively analyzed. Read More

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http://dx.doi.org/10.1007/s00330-020-06758-0DOI Listing

Endoscope presence during endoluminal functional lumen imaging probe (FLIP) influences FLIP metrics in the evaluation of esophageal dysmotility.

Neurogastroenterol Motil 2020 Jun 25;32(6):e13823. Epub 2020 Feb 25.

Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.

Background: The functional lumen imaging probe (FLIP) system is an FDA-approved tool for dynamic evaluation of the esophagogastric junction (EGJ). Even though commercially available since 2009, FLIP utilization remains low, partly due to lack of consensus in methodology and interpretation. Therefore, we aimed to analyze the influence of concurrent endoscopy on FLIP measurements. Read More

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http://dx.doi.org/10.1111/nmo.13823DOI Listing

Laparoscopic repair of late perforation following Heller myotomy due to overeating.

Ann R Coll Surg Engl 2020 May 21;102(5):e97-e99. Epub 2020 Feb 21.

Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Laparoscopic Heller myotomy is the mainstay surgical treatment of oesophageal achalasia and has proven to be safe and effective over the course of time. Oesophageal perforation after myotomy can be a serious complication with devastating outcomes. Most commonly, mucosal perforation are detected intraoperatively or early postoperatively. Read More

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http://dx.doi.org/10.1308/rcsann.2020.0021DOI Listing

Allgrove Syndrome: A Report of New Pathological Variants in the AAAS Gene.

Cornea 2020 Jun;39(6):782-783

Department of Ophthalmology, Centre Hospitalier Universaite Sainte-Justine, Montreal, QC, Canada.

Purpose: To report 2 novel variants in the AAAS gene consistent with the diagnosis of Allgrove syndrome.

Methods: A 12-year-old girl was referred to our clinic for progressive bilateral decrease in visual acuity. She was known for achalasia that had been surgically treated at a very early age. Read More

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http://dx.doi.org/10.1097/ICO.0000000000002287DOI Listing

Integrated MR Analytical Approach and Reporting of Pelvic Floor Dysfunction: Current Implications and New Horizons.

Radiol Clin North Am 2020 Mar;58(2):305-327

Cairo University MRI Pelvic Floor Center of Excellency and Research Lab Unit, Department of Radiology, Cairo University Hospitals, Kasr El Ainy Street, Cairo 11956, Egypt. Electronic address:

Reporting MR imaging of pelvic floor dysfunction can be made easy if radiologists understand the aim of each MR sequence and what to report in each set of MR images. For an MR imaging report that is critical in decision making for patient management, it is of paramount importance to the radiologist to know what to look for and where to look for it. This article presents a new term, integrated MR analytical approach. Read More

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http://dx.doi.org/10.1016/j.rcl.2019.11.007DOI Listing

Applying the Functional Luminal Imaging Probe to Esophageal Disorders.

Curr Gastroenterol Rep 2020 Feb 10;22(3):10. Epub 2020 Feb 10.

Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University, NMH/Arkes Family Pavilion Suite 1400, 676 N Saint Clair, Chicago, IL, 60611, USA.

Purpose Of Review: The functional luminal imaging probe (FLIP) uses high-resolution planimetry to provide a three-dimensional image of the esophageal lumen by measuring diameter, volume, and pressure changes. The goal of this review is to summarize the most recent advances in applying the (FLIP) to esophageal disorders.

Recent Findings: The FLIP has been studied in esophageal disease states including gastroesophageal reflux disease (GERD), achalasia, and eosinophilic esophagitis. Read More

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http://dx.doi.org/10.1007/s11894-020-0749-7DOI Listing
February 2020

Esophagogastric Junction Outflow Obstruction: Current Approach to Diagnosis and Management.

Curr Gastroenterol Rep 2020 Feb 5;22(2). Epub 2020 Feb 5.

Stanford Multidimensional Program for Innovation and Research in the Esophagus (S-MPIRE), Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 430 Broadway Street, Pavilion C, 3rd Floor, GI suite, Redwood City, CA, 94063, USA.

Purpose Of Review: We summarize the current epidemiology, presentation, diagnostic workup, and treatment of esophagogastric junction outflow obstruction (EGJOO). We also propose a treatment algorithm based upon the literature and our personal clinical experience.

Recent Findings: EGJOO can be caused by functional obstruction (akin to achalasia), mechanical obstruction, medications, or artifact. Read More

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http://dx.doi.org/10.1007/s11894-020-0743-0DOI Listing
February 2020

Videofluoroscopic and Manometric Evaluation of Oropharyngeal and Esophageal Motility Disorders.

Curr Med Imaging Rev 2020 ;16(1):65-69

Department of Radiology, Medical Faculty, Istanbul University Cerrahpasa, Kocamustafapasa, Istanbul, Turkey.

Background: Esophageal motility studies are performed in patients who have dysphagia that is not explained by stenosis. Diagnosis can be challenging and requires expertise in the interpretation of tests and symptoms.

Aims: Our aim is to investigate the diagnostic value of videofluoroscopic swallowing study (VFSS) in combination with esophageal manometry. Read More

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http://dx.doi.org/10.2174/157340561501190611154916DOI Listing
January 2020

Using Impedance Planimetry (EndoFLIP) to Evaluate Myotomy and Predict Outcomes After Surgery for Achalasia.

J Gastrointest Surg 2020 Apr 14;24(4):964-971. Epub 2020 Jan 14.

Department of Surgery, Northshore University HealthSystem, 2650 Ridge Ave, GCSI Suite B665, Evanston, IL, 60201, USA.

Background: The functional lumen imaging probe (FLIP) is an innovative tool that uses impedance planimetry to assess esophageal geometry in real time. It has been used to diagnose achalasia and evaluate treatment failure after laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy (POEM). We hypothesize that impedance planimetry can be utilized intra-operatively to assess adequacy of myotomy and assist in predicting patient outcomes. Read More

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http://dx.doi.org/10.1007/s11605-020-04513-wDOI Listing
April 2020
2.798 Impact Factor

The rhythm and rate of distension-induced esophageal contractility: A physiomarker of esophageal function.

Neurogastroenterol Motil 2020 05 9;32(5):e13794. Epub 2020 Jan 9.

Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: Distention of the esophagus elicits a unique pattern of repetitive contractions in healthy controls. We aimed to assess the rhythm and rate of distension-induced contractile patterns between achalasia and controls and identify factors that distinguish the normal contractile response to distension.

Methods: Twenty asymptomatic controls and 140 adult patients with treatment-naïve achalasia defined by HRM (29 type I, 81 type II, 30 type III) were prospectively evaluated with functional luminal imaging probe (FLIP) during sedated endoscopy. Read More

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http://dx.doi.org/10.1111/nmo.13794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182495PMC

Functional Luminal Imaging Probe Panometry Identifies Achalasia-Type Esophagogastric Junction Outflow Obstruction.

Clin Gastroenterol Hepatol 2019 Nov 25. Epub 2019 Nov 25.

Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Background & Aims: The etiologies of esophagogastric junction outflow obstruction (EGJOO) vary, as do their therapeutic implications. We aimed to identify patients with EGJOO most likely to benefit from achalasia-type treatment, based on findings from functional luminal imaging probe (FLIP) panometry.

Methods: We performed a retrospective study of 34 patients who received a diagnosis of EGJOO from January 2015 through July 2017. Read More

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http://dx.doi.org/10.1016/j.cgh.2019.11.037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246143PMC
November 2019

Esophageal Dysphagia in the Elderly.

Curr Treat Options Gastroenterol 2019 Dec;17(4):534-553

Department of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, 2nd floor, Columbus, OH, USA.

Purpose Of Review: With a globally aging population, dysphagia is a growing health concern among elderly. Increasing reflux disease has contributed to an increased prevalence of dysphagia from peptic strictures and esophageal cancer. Dysphagia can lead to malnutrition and aspiration pneumonia, causing considerable morbidity and mortality. Read More

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http://dx.doi.org/10.1007/s11938-019-00264-zDOI Listing
December 2019

A Patient with Metastatic Lung Cancer and Dysphagia.

Gastroenterology 2020 02 15;158(3):485-487. Epub 2019 Nov 15.

Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland; Digestive Function: Basel, Laboratory and Clinic for Motility Disorders and Functional GI diseases, Center for integrative Gastroenterology, Klinik Arlesheim, Arlesheim, Switzerland. Electronic address:

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http://dx.doi.org/10.1053/j.gastro.2019.10.047DOI Listing
February 2020

Distal esophageal sphincter achalasia in a Labrador retriever dog with polypoid gastric mucosal hyperplasia and pyloric stenosis.

Can Vet J 2019 Nov;60(11):1183-1188

Pride Veterinary Centre, Riverside Road, Derby, Derbyshire DE24 8HX, United Kingdom.

An 11-year-old, neutered female, Labrador retriever dog was presented with a history of intractable vomiting, regurgitation, and coughing. Computed tomography (CT) imaging identified marked hypertrophy of the distal esophagus with a suspicion of distal esophageal achalasia, based on the observation of a "bird beak" appearance. This was later confirmed on a fluoroscopic swallow study. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805033PMC
November 2019
1 Read

Clinical Usefulness of Endoscopy, Barium Fluoroscopy, and Chest Computed Tomography for the Correct Diagnosis of Achalasia.

Intern Med 2020 Feb 7;59(3):323-328. Epub 2019 Oct 7.

Department of Education and Support for Regional Medicine, Tohoku University Hospital, Japan.

Objective The definite diagnosis of esophageal achalasia is established using manometry, which is performed in patients with suspected achalasia based on the findings of screening examinations, such as upper gastrointestinal endoscopy, chest computed tomography (CT), or a barium swallow test. However, the exact values of test characteristics in these supportive diagnostic examinations remain unclear. Methods We estimated the sensitivity and specificity of characteristic findings in the supportive diagnostic examinations for achalasia by comparing the data of a large number of achalasia patients and others with digestive symptoms. Read More

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http://dx.doi.org/10.2169/internalmedicine.3612-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028409PMC
February 2020
1 Read

Contribution of magnetic resonance imaging to the management of esophageal diseases: A systematic review.

Eur J Radiol 2019 Nov 20;120:108684. Epub 2019 Sep 20.

Gastroenterology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France; Paris Descartes University, Paris, France. Electronic address:

Purpose: Currently available imaging modalities used to investigate the esophagus are irradiating or limited to the analysis of the esophageal lumen. Magnetic resonance imaging (MRI) is a non-invasive and non-radiating imaging technique that provides high degrees of soft tissue contrast. Newly developed fast MRI sequences allow for both morphological and functional assessment of the esophageal body and esophagogastric junction. Read More

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http://dx.doi.org/10.1016/j.ejrad.2019.108684DOI Listing
November 2019
4 Reads

Esophagogastric junction outflow obstruction on manometry: Outcomes and lack of benefit from CT and EUS.

Neurogastroenterol Motil 2019 12 15;31(12):e13712. Epub 2019 Sep 15.

Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada.

Background: Esophagogastric junction outflow obstruction (EGJOO) is a manometric diagnosis based on the Chicago Classification defined by inadequate relaxation of the gastroesophageal junction (GEJ) with swallowing, but with sufficient peristalsis such that the criteria for achalasia are not met. Possible causes include anatomical and functional etiologies. Further investigations, including computed tomography (CT) of the chest and endoscopic ultrasound (EUS), to help elucidate the etiology of EGJOO have been suggested, but the utility of this approach has not been proven. Read More

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http://dx.doi.org/10.1111/nmo.13712DOI Listing
December 2019
6 Reads
3.587 Impact Factor

Anesthesia for Patients Undergoing Peroral Endoscopic Myotomy Procedures: A Review of the Literature.

Anesth Analg 2020 05;130(5):1331-1340

Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine.

Idiopathic achalasia is a motility disorder of the esophagus with important implications on anesthesia and periprocedural management. As new and more complex treatment options develop, anesthesiologists are increasingly involved with these patients. The cardinal symptoms of achalasia are as follows: dysphagia, regurgitation, chest pain, and weight loss. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004420DOI Listing
May 2020
3 Reads

How to Perform a High-Quality PerOral Endoscopic Myotomy?

Gastroenterology 2019 11 9;157(5):1184-1189. Epub 2019 Sep 9.

Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Milan, Italy.

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http://dx.doi.org/10.1053/j.gastro.2019.09.001DOI Listing
November 2019

Achalasia in a Patient with Myotonic Dystrophy.

Intern Med 2020 Jan 11;59(1):67-68. Epub 2019 Sep 11.

Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, Japan.

Myotonic dystrophy is a progressive disorder mainly affecting the voluntary muscles. We herein report a rare case of myotonic dystrophy complicated with high-resolution manometry-defined achalasia, the pathology of which is absent relaxation of the smooth muscles of lower esophageal sphincter (LES). In the present case, achalasia was considered a complication of myotonic dystrophy instead of sporadic achalasia, as on performing high-resolution manometry, the finding of an impaired LES relaxation (myotonic phase) changed to a totally emaciated LES function (muscle weakness phase) as myotonic dystrophy progressed. Read More

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http://dx.doi.org/10.2169/internalmedicine.3360-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995719PMC
January 2020
3 Reads

Functional lumen imaging probe in gastrointestinal motility diseases.

J Dig Dis 2019 Nov 16;20(11):572-577. Epub 2019 Oct 16.

Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA.

Dysfunction of gastrointestinal (GI) sphincters, including the lower esophageal sphincter (LES) at the esophagogastric junction (EGJ) and the pyloric sphincter, plays a vital role in GI motility disorders, such as achalasia, gastroesophageal reflux disease (GERD), gastroparesis, and fecal incontinence. Using multi-detector high-resolution impedance planimetry, the functional luminal imaging probe (FLIP) system measures simultaneous data on tissue distensibility and luminal geometry changes in the sphincter in a real-time manner. In this review we focus on the emerging data on FLIP, which can be used as an innovative diagnostic method during endoscopic or surgical procedures in GI motility disorders. Read More

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http://dx.doi.org/10.1111/1751-2980.12818DOI Listing
November 2019
7 Reads
1.924 Impact Factor

A surprising chest radiograph.

Br J Hosp Med (Lond) 2019 Sep;80(9):549

Consultant, Department of Care of the Elderly, Central Middlesex Hospital, London.

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http://dx.doi.org/10.12968/hmed.2019.80.9.549DOI Listing
September 2019

Aerodigestive disorders in dogs evaluated for cough using respiratory fluoroscopy and videofluoroscopic swallow studies.

Vet J 2019 Sep 27;251:105344. Epub 2019 Jul 27.

University of Missouri, College of Veterinary Medicine, Department of Veterinary Medicine and Surgery, 900 East Campus Drive, Columbia, MO 65211, USA. Electronic address:

Aerodigestive diseases, hybrid disorders representing a pathologic link between respiratory and alimentary tracts, may manifest with respiratory signs without gastrointestinal signs. These are underdiagnosed in dogs due to poor clinical recognition and diagnostic limitations. We hypothesize that a subset of dogs presenting for cough without gastrointestinal signs would have occult aerodigestive disorders identified using videofluoroscopic swallow study (VFSS). Read More

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http://dx.doi.org/10.1016/j.tvjl.2019.105344DOI Listing
September 2019
7 Reads

Peripheral T-Cell Lymphoma Presenting as Pseudoachalasia.

Am J Gastroenterol 2020 02;115(2):161

Division of Gastroenterology, Department of Internal Medicine, Wayne State University, Detroit, Michigan, USA.

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http://dx.doi.org/10.14309/ajg.0000000000000353DOI Listing
February 2020

Unusual cause of dysphagia.

BMJ Case Rep 2019 Aug 26;12(8). Epub 2019 Aug 26.

Upper Gastrointestinal Surgery, Monash Health, Clayton, Victoria, Australia.

In this case, we describe a unique case of large renal hydronephrosis in a 79-year-old Indian male patient who had initially presented with 3 months of progressive dysphagia and loss of weight. His dysphagia was initially thought to be related to the atypical diagnosis of achalasia and was being considered for an elective laparoscopic Heller myotomy. On performing CT of the abdomen, a large renal mass was discovered. Read More

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http://dx.doi.org/10.1136/bcr-2018-227610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721079PMC
August 2019
1 Read

Early Phase of Achalasia Manifested as an Esophageal Subepithelial Tumor.

Korean J Gastroenterol 2019 Aug;74(2):110-114

Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.

The Chicago classification (CC) defines an esophagogastric junction outflow obstruction (EGJOO) as the presence of several instances of intact or weak peristalsis, elevated median integrated relaxation pressure above 15 mmHg, and a discrepancy from the criteria of achalasia. The revised CC addresses the potential etiology of EGJOO, including the early forms of achalasia, mechanical obstruction, esophageal wall stiffness, or manifestation of hiatal hernia. A 58-year-old woman visited the Presbyterian Medical Center with swallowing difficulty. Read More

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http://dx.doi.org/10.4166/kjg.2019.74.2.110DOI Listing
August 2019
4 Reads

How I Approach Dysphagia.

Curr Gastroenterol Rep 2019 Aug 20;21(10):49. Epub 2019 Aug 20.

Feinberg School of Medicine, Department of Medicine, Northwestern University, 676 St Clair St, 14th floor, Chicago, IL, 60611-2951, USA.

Purpose Of Review: This review presents an overview of the diagnostic approach to esophageal dysphagia and summarizes recent epidemiological trends and technical advancements.

Recent Findings: The evaluation of dysphagia begins with a detailed history followed by endoscopy to evaluate for any structural abnormalities including malignancy. This is especially true given the emergence of eosinophilic esophagitis (EoE) as a dominant cause of esophageal dysphagia. Read More

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http://dx.doi.org/10.1007/s11894-019-0718-1DOI Listing
August 2019
4 Reads

Videofluoroscopic swallow study features of lower esophageal sphincter achalasia-like syndrome in dogs.

J Vet Intern Med 2019 Sep 5;33(5):1954-1963. Epub 2019 Aug 5.

Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri.

Background: Megaesophagus (ME) carries a poor long-term prognosis in dogs. In people, lower esophageal sphincter (LES) disorders causing functional obstruction are rare causes of ME that may respond to targeted treatment. Functional LES disorders are reported rarely in dogs because of challenges in diagnostic methodologies. Read More

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http://dx.doi.org/10.1111/jvim.15578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766503PMC
September 2019
5 Reads

Intraoperative assessment of esophageal motility using FLIP during myotomy for achalasia.

Surg Endosc 2020 Jun 2;34(6):2593-2600. Epub 2019 Aug 2.

Department of Surgery, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 650, Chicago, IL, 60611, USA.

Background: The functional luminal imaging probe (FLIP) can evaluate esophagogastric junction (EGJ) distensibility and esophageal peristalsis in real time. FLIP measurements performed during diagnostic endoscopy can accurately discriminate between healthy controls and patients with achalasia based on EGJ-distensibility and distinct motility patterns termed repetitive antegrade contractions (RACs) and repetitive retrograde contractions (RRCs). We sought to evaluate real-time motility changes in patients undergoing surgical myotomy for achalasia. Read More

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http://dx.doi.org/10.1007/s00464-019-07028-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995437PMC
June 2020
2 Reads

Peroral endoscopic myotomy regains anatomical structure and improves emptying for achalasia with multiple esophageal diverticula.

Endoscopy 2019 12 25;51(12):E392-E393. Epub 2019 Jul 25.

Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.

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http://dx.doi.org/10.1055/a-0969-1757DOI Listing
December 2019
2 Reads

Gradually Progressive Dysphagia, Reflux, Weight Loss, and Chest Discomfort.

Am Fam Physician 2019 07;100(2):113-114

Morehouse School of Medicine, Atlanta, GA, USA.

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July 2019
1 Read

Esophageal motility classification can be established at the time of endoscopy: a study evaluating real-time functional luminal imaging probe panometry.

Gastrointest Endosc 2019 12 4;90(6):915-923.e1. Epub 2019 Jul 4.

Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Background And Aims: A novel device that provides real-time depiction of functional luminal image probe (FLIP) panometry (ie, esophagogastric junction [EGJ] distensibility and distension-induced contractility) was evaluated. We aimed to compare real-time FLIP panometry interpretation at the time of sedated endoscopy with high-resolution manometry (HRM) in evaluating esophageal motility.

Methods: Forty consecutive patients (aged 24-81 years; 60% women) referred for endoscopy with a plan for future HRM from 2 centers were prospectively evaluated with real-time FLIP panometry during sedated upper endoscopy. Read More

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http://dx.doi.org/10.1016/j.gie.2019.06.039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875629PMC
December 2019
4 Reads