7,536 results match your criteria esophageal sphincter


Functional luminal imaging probe in the evaluation of esophago-gastric junction outflow obstruction.

Curr Opin Gastroenterol 2022 Jul;38(4):388-394

Division of Gastroenterology, Center for Esophageal Diseases, Baylor University Medical Center, Baylor Scott & White, Dallas, Texas, USA.

Purpose Of Review: Esophagogastric junction outflow obstruction (EGJOO) comprises a heterogeneous group of conditions that demonstrate impaired deglutitive relaxation of the esophagogastric junction (EGJ) with intact esophageal peristalsis on high-resolution manometry. Functional luminal imaging probe (FLIP) panometry is a powerful tool that can help to clarify the etiology of this manometric diagnosis. The aim of this review is to summarize the use of FLIP for the evaluation and management of EGJOO. Read More

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Impact of esophageal mucosal permeability markers on provocation-induced esophageal reflexes in high-risk infants.

Physiol Rep 2022 Jun;10(12):e15366

Innovative Infant Feeding Disorders Research Program, Nationwide Children's Hospital, Columbus, Ohio, USA.

Esophageal distal baseline impedance (DBI) is an indicator of mucosal integrity; lower values suggest increased permeability. Aims were to characterize the (1) effect of DBI category (<900 Ω, 900-2000 Ω, and >2000 Ω) on sensory-motor characteristics of mid-esophageal provocation-induced motility reflexes, and (2) clinical outcomes among high-risk human infants evaluated for gastroesophageal reflux disease. Symptomatic infants (N = 49, 41 ± 3 weeks postmenstrual age) underwent pH-impedance testing to characterize acid reflux index (ARI) and DBI, and pharyngo-esophageal manometry to examine upper esophageal sphincter (UES), peristaltic, and lower esophageal sphincter (LES) functions. Read More

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GASTROESOPHAGEAL SYMPTOMS AFTER LAPAROSCOPIC GASTRIC BYPASS: MISTAKES IN PERFORMING THE PROCEDURE?

Arq Bras Cir Dig 2022 17;35:e1657. Epub 2022 Jun 17.

Department of Surgery, Hospital "Dr. José J Aguirre", Faculty of Medicine, University of Chile, Santos Dumont 999, Santiago, Chile.

Aim: Laparoscopic Roux-en-Y gastric bypass (LGB) is the recommended procedure for morbidly obese patients with gastroesophageal reflux disease (GERD). However, there have been reported gastroesophageal reflux symptoms or esophagitis after LGB. Few functional esophageal studies have been reported to date. Read More

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THE DYSPHAGIA INVESTIGATION: IS THERE STILL SPACE FOR THE VIDEOFLUOROSCOPIC METHOD?

Arq Bras Cir Dig 2022 17;35:e1650. Epub 2022 Jun 17.

Federal University of Rio de Janeiro, Digestive Motility Laboratory - Gastroenterology Division of HUCFF-UFRJ, Rio de Janeiro, RJ, Brazil.

Aim: Dysphagia can lead to aspiration pneumonia, impacting the nutritional status and quality of life of the patient. The videofluoroscopy is highlighted for allowing both a real-time evaluation and the recording of the images for later review and analysis. This study aimed to describe the characteristics of the population referred for videofluoroscopy and its value as an investigation method. Read More

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Tolerability and Feasibility of the Upper Esophageal Sphincter Assist Device in Preventing Acute and Chronic Allograft Rejection Among Lung Transplant Recipients.

J Clin Gastroenterol 2022 Jun 7. Epub 2022 Jun 7.

Gastrointestinal Motility and Physiology Program, Division of Gastroenterology.

Goals: We aimed to evaluate a novel upper esophageal sphincter (UES) assist device loaner program for the prevention of acute cellular rejection and chronic lung allograft dysfunction among lung transplant (LTx) recipients.

Background: Laryngopharyngeal reflux can lead to chronic microaspiration and LTx rejection. The UES assist device applies external pressure at the level of UES to decrease reflux. Read More

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The role of hormones in symptoms and pathophysiology of reflux and esophageal motility disorders.

Z Gastroenterol 2022 Jun 13. Epub 2022 Jun 13.

Department for Surgery, University Hospital Salzburg, Salzburg, Austria.

Purpose: A few studies suggest that hormones play a role in the motility of the lower esophagus, but data is rare. In this prospective study we evaluated the correlation between hormones (TSH, fT3, fT4, calcitonin, gastrin, and VIP) and gastroesophageal reflux disease (GERD), esophageal motility disorders, and gastrointestinal symptoms.

Methods: 100 consecutive patients with reflux symptoms and dysphagia were hospitalized for diagnostic evaluation. Read More

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Association between endoscopic pressure study integrated system (EPSIS) and high-resolution manometry.

Endosc Int Open 2022 Jun 10;10(6):E762-E768. Epub 2022 Jun 10.

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.

The endoscopic pressure study integrated system (EPSIS), a novel diagnostic tool for gastroesophageal reflux disease (GERD), allows evaluation of the anti-reflux barrier using endoscopy by monitoring the intragastric pressure (IGP) during insufflation. In this study, we evaluated the association between EPSIS results and lower esophageal sphincter (LES) function measured by high-resolution manometry (HRM) to elucidate whether EPSIS can evaluate the LES function. A retrospective, single-center study of patients with GERD symptoms who underwent endoscopy, pH-impedance monitoring, EPSIS, and HRM was conducted. Read More

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Impact on swallowing functions of arytenoid adduction in patients with unilateral vocal fold paralysis.

Auris Nasus Larynx 2022 Jun 9. Epub 2022 Jun 9.

Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

Objective: Although the pathophysiology of swallowing dysfunction in patients with unilateral vocal fold paralysis (UVFP) remains uncertain, glottal insufficiency is known to be a possible major cause, and other factors due to vagus nerve or recurrent laryngeal nerve damage may contribute to dysphagia or aspiration. This study aimed to evaluate the effect of arytenoid adduction (AA) surgery on the swallowing functions of UVFP patients and to investigate the important role of glottic closure during swallowing.

Methods: We prospectively analyzed the data of thirteen patients with UVFP who underwent AA in combination with medialization laryngoplasty (ML) for improving voice quality. Read More

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Successful D-POEM after failed surgical myotomy and diverticulectomy.

VideoGIE 2022 Jun 20;7(6):211-215. Epub 2022 Mar 20.

University of Maryland Medical Center, Department of Gastroenterology, Baltimore, Maryland.

Video 1Case series showing 2 patients with prior failed Heller myotomy and diverticulectomy, with subsequent success with POEM, diverticulotomy, and closure with endoscopic suturing. Case 1 also depicts closure of an esophagopleural fistula. Read More

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Sleeve Gastrectomy with Rossetti Fundoplication Increases Lower Esophageal Sphincter Tone Preventing Gastroesophageal Reflux Disease: High-Resolution Manometry Assessment.

J Laparoendosc Adv Surg Tech A 2022 Jun 8. Epub 2022 Jun 8.

General and Oncologic Surgery Department, Centre of Advanced Laparoscopic Surgery, Centre of Bariatric Surgery, San Marco Hospital GSD, Osio Sotto, Italy.

Laparoscopic sleeve gastrectomy (LSG) is associated with the long-term development of gastroesophageal reflux disease (GERD). Recent studies on LSG with fundoplication showed a lower rate of postoperative GERD than LSG alone; however, there is a lack of objective instrumental data in the literature. This study aimed to evaluate whether and how fundoplication associated with Sleeve Gastrectomy affects the esophagogastric physiology. Read More

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Pharyngeal tongue base augmentation for dysphagia therapy: A prospective case series in patients post head and neck cancer treatment.

Head Neck 2022 Jun 4. Epub 2022 Jun 4.

Flinders Health and Medical Research Institute, College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia.

Background: Dysphagia post head and neck cancer (HNC) multimodality treatment is attributed to reduced pharyngeal strength. We hypothesized that pharyngeal tongue base augmentation for dysphagia (PAD therapy) would increase pharyngeal pressures during swallowing thereby improving swallow symptoms.

Methods: Adults with moderate-severe dysphagia post-HNC treatment had PAD therapy using a temporary filler (hyaluronic acid [HA]), with follow-up long-lasting lipofilling. Read More

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Childhood esophageal achalasia: Case report from Afghanistan with literature review.

Int J Surg Case Rep 2022 May 2;94:107112. Epub 2022 May 2.

Department of Pediatric Surgery, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan.

Introduction And Importance: Esophageal achalasia is a motility disorder of the esophagus with unknown etiology characterized by the failure of lower esophageal sphincter relaxation. Diagnosis is made by barium esophagography, endoscopy, and esophageal manometery. Heller Esophagomyotomy along with Dor's fundoplication is the treatment of choice. Read More

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Temporal Sequence of Laryngeal Vestibule Closure and Reopening is Associated With Airway Protection.

Laryngoscope 2022 Jun 3. Epub 2022 Jun 3.

Edward S. Rogers Department of Electrical and Computer Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Ontario, Canada.

Background: Upper esophageal sphincter opening (UESO), and laryngeal vestibule closure (LVC) are two essential kinematic events whose timings are crucial for adequate bolus clearance and airway protection during swallowing. Their temporal characteristics can be quantified through time-consuming analysis of videofluoroscopic swallow studies (VFSS).

Objectives: We sought to establish a model to predict the odds of penetration or aspiration during swallowing based on 15 temporal factors of UES and laryngeal vestibule kinematics. Read More

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Evaluating intramuscular neural distribution in the cricopharyngeus muscle for injecting botulinum toxin.

Auris Nasus Larynx 2022 May 29. Epub 2022 May 29.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, College of Dentistry, Yonsei University, Seoul, South Korea. Electronic address:

Objectives: The objective of this study was to determine the area in the cricopharyngeus muscle (CPM) where botulinum neurotoxin (BoNT) can be injected safely and effectively by evaluating neural distribution in the CPM.

Methods: Eleven specimens of the CPM were gathered from human cadavers. The anatomical relationship between the posterior cricoarytenoid muscle (PCAM) and the CPM was evaluated. Read More

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The role of Ivor Lewis esophagectomy in the treatment of achalasia with megaesophagus: A case report.

Ann Med Surg (Lond) 2022 May 14;77:103630. Epub 2022 Apr 14.

Division of Thoracic Surgery, Department of Experimental, Diagnostic and Specialty Medicine - DIMES Alma Mater Studiorum - University of Bologna, G.B. Morgagni-L. Pierantoni Hospital, Via Carlo Forlanini 34, Forlì, Italy.

Introduction: Achalasia with megaesophagus is a pathology characterized by widespread and irregular dilation of the esophageal lumen. In most cases, this dilation is caused by contraction and subsequent failed relaxation of the lower esophageal sphincter (LES). It may be associated with a partial or complete slowing of the esophageal peristalsis. Read More

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Achalasia - position of surgery in current management.

Rozhl Chir 2022 ;101(4):148-153

Oesophageal achalasia is a serious cause of dysphagia. Therapeutic options for achalasia include endoscopic and surgical methods. Indications for individual methods overlap to a certain extent and require careful diagnosis. Read More

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Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction.

Authors:
Pengxu Wei

Toxins (Basel) 2022 04 30;14(5). Epub 2022 Apr 30.

Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Neuro-Functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, No. 1 Ronghuazhong Road, Beijing Economic and Technological Development Zone, Beijing 100176, China.

Dysphagia associated with upper esophageal sphincter (UES) dysfunction remarkably affects the quality of life of patients. UES injection of botulinum toxin is an effective treatment for dysphagia. In comparison with skeletal muscles of the limb and trunk, the UES is a special therapeutic target of botulinum toxin injection, owing to its several anatomical, physiological, and pathophysiological features. Read More

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The effect of age and sex on esophageal hiatal surface area among normal North American adults using multidetector computed tomography.

Surg Radiol Anat 2022 May 24. Epub 2022 May 24.

Department of Biomedical Education and Data Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.

The size of the esophageal hiatus is clinically important for preserving the integrity of the lower esophageal sphincter mechanism. The purpose of this study was to systematically establish the mean hiatal surface area (HSA) for normal North American adults under physiologic conditions and assess the relationship between sex and age on HSA. Multi-Detector Computer Tomogram (MDCT) images of the esophageal hiatus in 119 healthy adult subjects (61 males and 58 females with an age range of 24-88 years) were retrospectively analyzed using the multi-planar reconstruction (MPR) technique to directly measure their hiatal length (long axis), width (short axis) and surface area at end inspiration. Read More

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Intralesional steroid injection after endoluminal esophageal stricture dilatation in a cat.

Open Vet J 2022 Mar-Apr;12(2):192-196. Epub 2022 Mar 25.

Gedyt, Gastroenterología Diagnóstica y Terapéutica, CABA, Argentina.

Background: Benign esophageal strictures arise from various etiologies, mostly severe esophagitis. Although endoscopic balloon dilation is still the first-line therapy, refractory or recurrent strictures do occur and remain a challenge to the endoluminal treatment. The aim of this report was to communicate a recurrent esophageal stricture resolution in a cat treated with balloon dilatation and steroid injections in Ciudad de Buenos Aires, Argentina. Read More

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Laparoscopic Heller Myotomy and Dor Fundoplication.

World J Surg 2022 Jul 21;46(7):1527-1530. Epub 2022 May 21.

Department of Surgery, Stony Brook Medicine, Stony Brook, NY, USA.

Introduction: Achalasia is an esophageal motility disorder characterized by disordered esophageal peristalsis with failed relaxation of the lower esophageal sphincter resulting in a functional obstruction.Treatment can include medical, endoscopic, or surgical interventions. Although none of these are curative, they each offer methods to create esophageal outflow. Read More

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Clinical outcomes of surgical and imatinib treatment for rectal gastrointestinal stromal tumours: retrospective cohort study.

BJS Open 2022 05;6(3)

Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.

Background: Rectal gastrointestinal stromal tumours (GISTs) are rare and treated mainly by radical surgery. Although the importance of perioperative imatinib has been recognized, there are few reports on its outcomes.

Method: Consecutive patients diagnosed with rectal GISTs between July 2008 and February 2021 were identified from a prospective database. Read More

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Augmentation of the Esophageal Sphincter Using LINX.

Am Surg 2022 May 20:31348221093800. Epub 2022 May 20.

Department of Surgery, Atrium Health Navicent, Macon Georgia, 12241Mercer University School of Medicine, Macon GA, USA.

Gastroesophageal reflux disease (GERD) is the retrograde flow of gastric contents into the distal esophagus and may be treated medically or surgically. Magnetic sphincter augmentation surgery using LINX has recently demonstrated comparable results to Nissen fundoplication. We aimed to evaluate preoperative patient risk factors that were associated with LINX removal rates or postoperative EGD with dilation rates (POEGDD). Read More

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Effect of hiatus hernia on reflux patterns and mucosal integrity in patients with non-erosive reflux disease.

Neurogastroenterol Motil 2022 May 20:e14412. Epub 2022 May 20.

Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Background: Hiatus hernia (HH) contributes to development of gastroesophageal reflux disease, Barrett's esophagus and esophageal adenocarcinoma. This study was aimed to investigate the influence of HH on reflux patterns and distal esophageal mucosal integrity in non-erosive reflux disease (NERD).

Methods: We retrospectively analyzed PPI-refractory NERD patients referred to three tertiary referral centers who underwent high-resolution manometry and off-PPI 24-h impedance-pH monitoring (with or without bile spectrophotometry). Read More

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Peroral endoscopic myotomy (POEM) for achalasia developing after vertical banded gastroplasty with asymptomatic gastro-gastric fistula.

VideoGIE 2022 May 14;7(5):175-177. Epub 2022 Mar 14.

Department of Gastroenterology and Hepatology, Humanitas Research Hospital IRCCS, Rozzano, Italy.

Video 1At preoperative esophagram, a typical bird's beak image is shown at the gastroesophageal junction. A gastro-gastric fistula, opening from cardia to fundus, is also shown. A scope fitted with a distal clear cap is introduced. Read More

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Endoscopic full-thickness resection of well-differentiated T2 neuroendocrine tumors in the duodenal bulb: a case series.

VideoGIE 2022 May 2;7(5):196-199. Epub 2022 Mar 2.

Moffitt Cancer Center, Tampa, Florida.

Background And Aims: Endoscopic therapies have moved to the forefront in the removal of small, well-differentiated duodenal neuroendocrine tumors (NETs). Classic procedures used to address small tumors, especially those less than 1 cm in diameter, are banding without resection, ligation endoscopic mucosal resection, or endoscopic submucosal dissection. Endoscopic full-thickness resection (EFTR) is a procedure developed recently that allows for sealing off of the tissue surrounding the tumor before full-thickness removal. Read More

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Comparison of fully coated anti-reflux metal stenting and per-oral endoscopic myotomy in patients with achalasia: a propensity score-matched retrospective study.

BMC Gastroenterol 2022 May 18;22(1):253. Epub 2022 May 18.

Department of Gastroenterology, The Seventh Medical Center of PLA General Hospital, Nanmencang 5#, Dongcheng District, Beijing, 100700, China.

Background: Achalasia is a rare primary esophageal motility disorder disease. It is reported that the long-term effect of fully coated anti-reflux metal stent (FCARMS) implantation is satisfactory. Operated by a skilled and experienced endoscopist, the effect of per-oral endoscopic myotomy (POEM) treatment is equivalent to that of surgical myotomy. Read More

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Comparative Study of Pyloromyotomy and H-M Pyloroplasty in Proximal Gastrectomy for Adenocarcinoma of Esophageal-Gastric Junction.

J Gastrointest Surg 2022 May 18. Epub 2022 May 18.

Department of Gastro-Intestine Surgery, Shanghai Changzheng Hospital, Naval Medical University, 415 FengYang Road, Shanghai, 200003, People's Republic of China.

Introduction: The incidence of adenocarcinoma of esophageal-gastric junction (AEJ) has been increasing in recent years. Esophagogastrostomy after proximal gastrectomy (PG-EG) is the most commonly used surgical method for this disease which causes a constant spasm of the pyloric sphincter by cutting the vagus nerve around the esophagus, so H-M pyloroplasty (Heineke-Mikulicz pyloroplasty) is often operated after PG-EG to prevent delayed gastric emptying. However, H-M pyloroplasty destroys anti-reflux structure of pylorus and leads to serious bile reflux. Read More

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Update on the Diagnosis and Treatment of Achalasia.

Dysphagia 2022 May 18. Epub 2022 May 18.

Division of Gastroenterology and Nutrition, Morsani College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd, MDC 72, Tampa, FL, 33612, USA.

Achalasia is a rare disease of the esophagus with impaired relaxation of the lower esophageal sphincter and aperistalsis. The etiology is unknown but speculations include a viral or autoimmune etiology. All specialists dealing with swallowing and esophageal diseases should recognize the classic symptoms of dysphagia for solids/liquids, regurgitation, and choking, especially at night. Read More

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The Effect of Swallowing Cues in Healthy Individuals: An Exploratory Study.

Dysphagia 2022 May 16. Epub 2022 May 16.

Swallowing Training and Education Portal, stepcommunity.com, Washington, D.C., USA.

The goal of this study was to determine whether providing verbal and visual cues about swallowing changes the timing of swallowing events, and whether this information interacts with bolus volume. 20 healthy adults swallowed 5 ml and 15 ml liquid barium mixed with orange juice under videofluoroscopy during 2 conditions: one condition absent swallowing-specific cues and one condition with verbal and visual input about the swallowing process. Outcome measures included the timing of 10 swallowing events and the number of swallows per bolus. Read More

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A Simple Exercise to Strengthen the Lower Esophageal Sphincter and Eliminate Gastroesophageal Reflux: An Autobiographical Case Report.

Authors:
Eric Karrfalt

Cureus 2022 Apr 13;14(4):e24122. Epub 2022 Apr 13.

Research, Retired, McKean, USA.

A novel exercise is described for resistance training of the lower esophageal sphincter. Resistance is provided by gravity as food is swallowed and pushed up an incline into the stomach. The incline is established by kneeling with the head bowed lower than the stomach. Read More

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