Conclusions  Patients with preoperative dysphagia and delayed esophageal transit on preoperative contrast study were significantly more likely to report moderate to severe postoperative dysphagia 1 year after antireflux surgery. This study confirms that the manometric criteria used to define esophageal dysmotility are not reliable to identify patients at risk for postfundoplication dysphagia, and that there is need for standardization of contrast swallow assessment of esophageal function. Content Type Journal ArticleDOI 10.1007/s00464-010-1302-9Authors Kazuto Tsuboi, Department of Surgery, Creighton University Medical Center, 601 North 30th Street, Suite 3700, Omaha, NE 68131, USATommy H. Lee, Department of Surgery, Creighton University Medical Center, 601 Nort...MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Abstract  Investigation into the upper GI-tract of patients suffering from systemic sclerosis [SSc] and mixed connective tissue disease [MCTD] without symptoms of GI-tract involvement early in the course of the disease to diagnose inflammatory and motility disorders. We retrospectively analysed patients with SSc and MCTD who underwent oesophago-gastro-duodenoscopy [OGD] within a year of the first diagnosis. Patients with a Rodnan skin score above 5, proton pump inhibitors and treatment regimes potentially harmful to the mucosa of the upper GI-tract were excluded. Mucosal damage of the oesophagus was classified according to the Los Angeles Classification. Oesophageal dysmotility was assessed during OGD and confirmed by video cineradiography. A total of thirteen patients with...

Authors: Smelt AH Changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Patients with hypertriglyceridemia (HTG) - often overweight and insulin resistant - are at risk for gallstone disease. The question arises whether HTG itself contributes to gallstone formation or whether gallstone disease only associate with this disorder. Triglycerides are formed in response to fluxes of non-esterified fatty acids and glucose. Hypertriglyceridemia results from either overproduction of triglycerides by the liver, impaired lipolysis or a combination of both. Hyperinsulinemia, as observed in the insulin resistant state, stimulates very low-density lipoprotein (VLDL)-triglyceride synthesis. Peroxisome proliferator-activated receptors (PPA...

Conclusion: It is suggested that the adaptation mechanism to chronic stress may involve the upregulation of oxytocin expression in the hypothalamus, which in turn attenuates CRF expression. PMID: 20689056 [PubMed - as supplied by publisher] (Source: Am J Physiol Gastroi...)

Dysphagia occurs in the majority of patients with Parkinson's disease (PD) and is known to correlate with abnormalities of oropharyngeal function. The aim of this study was to evaluate pharyngoesophageal activity in patients with early-stage PD. Newly diagnosed PD patients with a symptom duration not exceeding 3 years were included. All PD patients were questioned about symptoms of dysphagia and underwent combined multichannel intraluminal impedance manometry and multiple rapid swallow tests. Fifty-four patients (22 men and 32 women, 67.1 ± 10.3 years) were enrolled. The duration of Parkinsonian motor symptoms was 11.5 ± 8.8 months, the Hoehn and Yahr stage was 1.6 ± 0.4, and the total Unified Parkinson's Disease Rating Scale was 25.1 ± 18.6. Esophageal manometry in the liquid swallow ...

Thyroid eye disease (TED) is the most common cause of proptosis in adults, and should always be a consideration in patients with unexplained diplopia, pain, or optic nerve dysfunction. At least 80% of TED is associated with Graves disease (GD), and at least 50% of patients with GD develop clinically evident symptomatic TED. The most confusing patients for doctors of all subspecialties are the patients with eye symptoms and signs that precede serum evidence of a thyroid imbalance. Management of TED may include immunosuppressive medications, radiation, or surgery. Although the prognosis for optic nerve function is excellent, the restrictive dysmotility can result in permanent disability. Orbit and eyelid reconstruction are reserved for stable, inactive patients and are the final steps in min...MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Conclusions: Anastomotic stricture, secondary to the surgical treatment of esophageal atresia, remains a frequent complication in patients with esophageal atresia. Esophageal dilation with Savary-Gilliard bougies is a safe and effective procedure in the management of strictures. (Source: Journal of Pediatric Surgery)

Conclusion  We present herein the clinical, neuroimaging, and molecular findings of a patient with MNGIE caused by a novel homozygous TYMP gene mutation (c.112G>T which convert codon 38 from glutamate to a stop codon [p.38E>X]). Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00431-010-1237-0Authors Zeren Barış, Gazi University Hospital Pediatric Gastroenterology Ankara TurkeyTuba Eminoğlu, Gazi University Hospital Pediatric Metabolism and Nutrition Ankara TurkeyBuket Dalgıç, Gazi University Hospital Pediatric Gastroenterology Ankara TurkeyLeyla Tümer, Gazi University Hospital Pediatric Metabolism and Nutrition Ankara TurkeyAlev Hasanoğlu, Gazi University Hospital Pediatric Metabolism and Nutrition Ankara Turkey Journal European Jou...

Authors: Camilleri M PMID: 20410880 [PubMed - indexed for MEDLINE] (Source: Clinical Pharmacology and Therapeutics)

Lindberg G, Tornblom H, Iwarzon M, et al. (Department of Medicine, Division of Gastroenterology and Hepatology, Karolinska University Hospital, Huddinge, Stockholm, Sweden). Full-thickness biopsy findings in chronic intestinal pseudo-obstruction and enteric dysmotility. Gut 2009;58:1084–1090. (Source: Gastroenterology)

Conclusion: Autoantibodies against GnRH can be detected independently on treatment of GnRH analogue. Whether the generation of the antibody is directly linked to neuron degeneration and chronic gastrointestinal symptoms in patients with intestinal dysmotility, remains to be answered. (Source: BMC Gastroenterology)MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Conclusion: Autoantibodies against GnRH can be detected independently on treatment of GnRH analogue. Whether the generation of the antibody is directly linked to neuron degeneration and chronic gastrointestinal symptoms in patients with intestinal dysmotility, remains to be answered. (Source: BMC Gastroenterology)MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Gallbladder diseases, particularly gallstone-related syndromes, are common clinical problems facing practicing gastroenterologists and surgeons. Our understanding of the pathogenesis of gallbladder disease, including gallstones, acalculous cholecystitis, gallbladder dysmotility, and gallbladder cancer, continues to advance at a rapid pace. Furthermore, our ability to diagnose and treat gallbladder diseases is rapidly evolving. (Source: Gastroenterology Clinics of North America)

Gallbladder diseases, particularly gallstone-related syndromes, are common clinical problems facing practicing gastroenterologists and surgeons. Our understanding of the pathogenesis of gallbladder disease, including gallstones, acalculous cholecystitis, gallbladder dysmotility, and gallbladder cancer, continues to advance at a rapid pace. Furthermore, our ability to diagnose and treat gallbladder diseases is rapidly evolving. (Source: Gastroenterology Clinics of North America)