Update on Esophageal Disorders February 2, 2019 COURSE DESCRIPTION American, Delta, Frontier, Jet Blue, Southwest, United and U.S

Total Page:16

File Type:pdf, Size:1020Kb

Update on Esophageal Disorders February 2, 2019 COURSE DESCRIPTION American, Delta, Frontier, Jet Blue, Southwest, United and U.S SATURDAY, FEBRUARY 2 PAID Non-Profit Organization Permit # 1529 UPDATES IN ESOPHAGEAL DISEASE: Salt Lake City, UT U.S. Postage U.S. WHAT’S NEW AND WHAT’S COMING? Moderator and Timekeeper: Kathy Peterson 3RD ANNUAL ROCKY MOUNTAIN WEST 8:00–8:30 am Eosinophilic Esophagitis .......................Menard-Katcher UPDATE ON 8:30–9:00 am Gastroesophageal Reflux Disease. .Gawron ESOPHAGEAL DISORDERS 9:00–9:30 am Achalasia/Esophageal Motility Disorders .............. Yadlapati 9:30–10:00 am Barrett’s Esophagus ...................................Byrne 10:00–10:30 am Discussion CLINICAL HIGHLIGHTS IN ESOPHAGEAL DISEASE Moderator and Timekeeper: John Fang, University of Utah Pediatric Eosinophilic Esophagogastric Disorders: 10:30–11:00 am Diagnosis and Treatment ......................Menard-Katcher Dietary Management for Gastroenterology— 11:00–11:30 am What’s popular and What Works! ......................Doerfler Role of a Health Psychologist in the Management of 11:30–12:00 pm Esophageal Disorders .................................. Taft 12:00–12:30 pm Management of Reflux after Bariatric Surgery ............. Ibele FEBRUARY 2, 2019 12:30–1:15 pm Catered lunch University of Utah Officer’s Club HANDS ON & BREAKOUT SESSIONS (30 MIN EACH) University Medical Center Track A: Endolumenal Functional Lumen Imaging Probe and 150 Fort Douglas Blvd, Salt lake City, UT 84113 1:30–3:00 pm Esoflip Ballon Dilation .......Yadlapati/Menard-Katcher Information: 801-585-0854 Track B: High Resolution Manometry Interpretation ......Gawron Track C: pH and pH Impedance Interpretation ....Fang/Peterson University Health Utah of Gastroenterology 30 North 1900 East, 4R118 Salt City, Lake Utah 84132 http://medicine.utah.edu/internalmedicine/gastroenterology/events/eoe.php 3RD ANNUAL ROCKY MOUNTAIN WEST LOCATION The course will be held at The Officer’s Club located at 150 South Fort Douglas Blvd., Building REGISTRATION UPDATE ON 649, Salt Lake City, Utah which is 18 miles south of the Salt Lake International Airport via a six- lane interstate highway (I-80). ESOPHAGEAL DISORDERS Online registration is now available! TRANSPORTATION https://umarket.utah.edu/um2/gi-conference/ This registration fee includes attendance at The Rocky Mountain West Salt Lake City International Airport is served by 7 airlines with 645 daily flights. Airlines include, Update on Esophageal Disorders February 2, 2019 COURSE DESCRIPTION American, Delta, Frontier, Jet Blue, Southwest, United and U.S. Airways. Car rental facilities are located on the ground floor of the short-term parking garage directly If cancellation of your registration is necessary, you may send e-mail notice to Lynsey Bell As the name suggests, this course focuses on the most recent developments in diagnosis and across from the terminal buildings. at [email protected], or call 801-585-0854. Cancellations made by December 31, 2018, will be accepted subject to a cancellation fee of $50. Confirmed registrants who do management of esophageal disorders. Specific topics will cover clinically relevant information UTA TRAX is available from the airport to downtown Salt Lake City. pertaining to gastroesophageal reflux disease (GERD), Barrett’s Esophagus, esophageal motility not attend the conference or who cancel after December 31, 2018, are responsible for the disorders, and eosinophilic esophagitis. We will also discuss in detail the appropriate use and Public Transportation is available through UTA TRAX, Frontrunner, or bus. Visit www.rideuta.com entire registration fee. Substitutions, however, may be made at any time. interpretation of high resolution manometry studies. There will also be input from our surgical for schedule and fares. If you have any questions, you can call Lynsey Bell at 801-585-0854 or send a fax to colleagues regarding innovative treatments for GERD and esophageal motility disorders. 801-581-7476. E-mail inquiries should be sent to [email protected] ACCOMMODATIONS INTENDED AUDIENCE For your accommodations, you may book your room at the University Guest House which is less Register online than a minute to walk to The Officer’s Club Conference Center where the conference will be held. Practicing Gastroenterologists, General Surgeons, Gastrointestinal Surgeons, Foregut Surgeons, https://umarket.utah.edu/um2/gi-conference/ Gastroenterology Fellows, Internal Medicine residents, Physician Assistants, Nurse Practitioners. The hotel offers a variety of accommodations, including hotel rooms and condominium style suites. For reservations please call 1-888-416-4075. Be sure to reference the Intermountain West REGISTRATION FORM: Update on Esophageal Disorders Course 2018 in order to receive the conference rate. A very EDUCATIONAL OBJECTIVES limited number of premier rooms are available at reduced cost rooms need to be booked by Send your registration information via mail, fax or online. A confirmation letter will be January 3, 2018. sent upon receipt of the completed registration form. 1. Review recent advances in diagnosing and treating esophageal disorders including GERD, EoE, Barrett’s esophagus and motility disorder. Other choices range from boutique hotels such as Hotel Monaco and The Grand America to Name Degree national names such as Marriott and Hyatt. 2. To Review presentation and treatment of esophageal manifestations of systemic disease, such Address as systemic sclerosis. Please obtain information at the reservation desk regarding deposit, cancellation, tax rate, village fee, service charges and available parking facility and fees. 3. To understand appropriate use of pH and pH-impedance testing and interpretation of results. City State Zip 4. To understand and practice interpretation of high resolution manometry for esophageal symptoms. Tel ( ) - Fax ( ) - CME STATEMENT E-Mail UNIVERSITY OF UTAH John Fang, MD Accreditation: The University Of Utah School Of Medicine is accredited by the Freston Takeda Professor of Medicine Accreditation Council for Continuing Medical Education (ACCME) to provide Physician . $200 $ COURSE DIRECTORS Division Chief continuing medical education for physicians. Mid-Level . $100 $ John Fang, MD Division of Gastroenterology and Hepatology AMA Credit: The University of Utah School of Medicine designates this live activity for Andrew Gawron, MD a maximum 6.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the Andrew Gawron, MD Nurse . $90 $ Kathryn Peterson, MD Assistant Professor of Medicine credit commensurate with the extent of their participation in the activity. Division of Gastroenterology and Hepatology ABIM MOC Part II: Successful completion of this CME activity, which includes participation in Anna Ibele, MD the evaluation component, enables the participant to earn up to 6.00 Medical Knowledge MOC Amount Enclosed $ UNIVERSITY OF COLORADO Associate Professor of Surgery points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) COURSE DIRECTORS Department of General Surgery program. Participants will earn MOC points equivalent to the amount of CME credits claimed Kathryn Peterson, MD for the activity. It is the CME activity provider’s responsibility to submit participant completion Paul Menard-Katcher, MD information to ACCME for the purpose of granting ABIM MOC credit. Rena Yadlapati, MD Associate Professor of Medicine Director of Motility Nondiscrimination and Disability Accommodation Statement: The University of Utah does not Division of Gastroenterology and Hepatology exclude, deny benefits to or otherwise discriminate against any person on the basis of race, color, national origin, sex, disability, age, veteran’s status, religion, gender identity/expression, FACULTY University of Colorado Anschutz Medical Campus genetic information, or sexual orientation in admission to or participation in its programs and Payment Method: Northwestern Medicine Calies Menard-Katcher, MD activities. Reasonable accommodations will be provided to qualified individuals with disabilities Bethany Doerfler, MS, RN Assistant Professor of Medicine upon request, with reasonable notice. Requests for accommodations or inquiries or complaints I have enclosed a check made payable to: Clinical Research Dietitian Division of Pediatric Gastroenterology & about University nondiscrimination and disability/access policies may be directed to the Director, Division of Gastroenterology, University of Utah Division of Gastroenterolgy & Hepatology Hepatology OEO/AA, Title IX/Section 504/ADA Coordinator, 201 S President’s Circle, RM 135, Salt Lake City, Attn: Lynsey Bell Tiffany Taft, PsyD Paul Menard-Katcher, MD UT 84112, 801-581-8365 (Voice/TTY), 801-585-5746 (Fax). Division of Gastroenterology Research Assistant Professor of Medicine Assistant Professor of Medicine Division of Gastroenterology & Hepatology Division of Gastroenterology & Hepatology University of Utah Rena Yadlapati, MD, MSHS TO REGISTER, GO TO: 30 North 1900 East, 4R118 SOM The University of Utah School of Medicine Assistant Professor http://medicine.utah.edu/internalmedicine/gastroenterology/events/eoe.php Salt Lake City, Utah 84132-2406 Kathryn R. Byrne, MD Division of Gastroenterology & Hepatology Assistant Clinical Professor Division of Gastroenterology and Hepatology For questions, call 801-585-0854..
Recommended publications
  • Impact of HIV on Gastroenterology/Hepatology
    Core Curriculum: Impact of HIV on Gastroenterology/Hepatology AshutoshAshutosh Barve,Barve, M.D.,M.D., Ph.D.Ph.D. Gastroenterology/HepatologyGastroenterology/Hepatology FellowFellow UniversityUniversityUniversity ofofof LouisvilleLouisville Louisville Case 4848 yearyear oldold manman presentspresents withwith aa historyhistory ofof :: dysphagiadysphagia odynophagiaodynophagia weightweight lossloss EGDEGD waswas donedone toto evaluateevaluate thethe problemproblem University of Louisville Case – EGD Report ExtensivelyExtensively scarredscarred esophagealesophageal mucosamucosa withwith mucosalmucosal bridging.bridging. DistalDistal esophagealesophageal nodulesnodules withwithUniversity superficialsuperficial ulcerationulceration of Louisville Case – Esophageal Nodule Biopsy InflammatoryInflammatory lesionlesion withwith ulceratedulcerated mucosamucosa SpecialSpecial stainsstains forfor fungifungi revealreveal nonnon-- septateseptate branchingbranching hyphaehyphae consistentconsistent withwith MUCORMUCOR University of Louisville Case TheThe patientpatient waswas HIVHIV positivepositive !!!! University of Louisville HAART (Highly Active Anti Retroviral Therapy) HIV/AIDS Before HAART After HAART University of Louisville HIV/AIDS BeforeBefore HAARTHAART AfterAfter HAARTHAART ImmuneImmune dysfunctiondysfunction ImmuneImmune reconstitutionreconstitution OpportunisticOpportunistic InfectionsInfections ManagementManagement ofof chronicchronic ¾ Prevention diseasesdiseases e.g.e.g. HepatitisHepatitis CC ¾ Management CirrhosisCirrhosis NeoplasmsNeoplasms
    [Show full text]
  • Gastroesophageal Reflux Disease (GERD)
    Guidelines for Clinical Care Quality Department Ambulatory GERD Gastroesophageal Reflux Disease (GERD) Guideline Team Team Leader Patient population: Adults Joel J Heidelbaugh, MD Objective: To implement a cost-effective and evidence-based strategy for the diagnosis and Family Medicine treatment of gastroesophageal reflux disease (GERD). Team Members Key Points: R Van Harrison, PhD Diagnosis Learning Health Sciences Mark A McQuillan, MD History. If classic symptoms of heartburn and acid regurgitation dominate a patient’s history, then General Medicine they can help establish the diagnosis of GERD with sufficiently high specificity, although sensitivity Timothy T Nostrant, MD remains low compared to 24-hour pH monitoring. The presence of atypical symptoms (Table 1), Gastroenterology although common, cannot sufficiently support the clinical diagnosis of GERD [B*]. Testing. No gold standard exists for the diagnosis of GERD [A*]. Although 24-hour pH monitoring Initial Release is accepted as the standard with a sensitivity of 85% and specificity of 95%, false positives and false March 2002 negatives still exist [II B*]. Endoscopy lacks sensitivity in determining pathologic reflux but can Most Recent Major Update identify complications (eg, strictures, erosive esophagitis, Barrett’s esophagus) [I A]. Barium May 2012 radiography has limited usefulness in the diagnosis of GERD and is not recommended [III B*]. Content Reviewed Therapeutic trial. An empiric trial of anti-secretory therapy can identify patients with GERD who March 2018 lack alarm or warning symptoms (Table 2) [I A*] and may be helpful in the evaluation of those with atypical manifestations of GERD, specifically non-cardiac chest pain [II B*]. Treatment Ambulatory Clinical Lifestyle modifications.
    [Show full text]
  • Emergency Imaging Tips and Tricks
    Emergency Imaging Tips and Tricks Dr. Sally Sukut, DVM, DACVR Assistant Professor of Medical Imaging Western College of Veterinary Medicine The Plan Part I: Pitfalls of emergency imaging Thorax Part II: Abdomen Musculoskeletal Interactive emergency imaging cases Reading Room Emergency Imaging Rule #1: “No patient dies in radiology” Stabilize patient first If patient is in pain and/or distress do what you can in that moment, then plan to get better radiographs/complete study once patient has improved Potential Pitfalls of Imaging Technical errors Perception errors Occur when searching for a lesion Satisfaction of search errors are the most common and result from incomplete evaluation Analysis errors Occur when establishing a meaning to the finding(s). Radiographic signs may be seen but not recognized as abnormal Recognition error Technical Errors Positioning errors are the most common reason for radiographs to be non- diagnostic or misinterpreted Other technical errors which can lead to misinterpretation are: No/Wrong marker Incomplete studies Wrong exposure Effects of sedation or anesthesia No/Wrong Marker Initial Intra-operative Incomplete Study Orthogonal Views are imperative! Incomplete Study Three-view Abdomen for Gastrointestinal Disease Three-View Thorax Recumbent Horizontal Beam Table Atelectasis vs. Disease Perception Error Remember to evaluate structures at the edge of the image Satisfaction of Search Error Recognition Error Ultrasound Intestinal Foreign Body Thorax CT Suite Radiography Suite Pleural Effusion Need approximately 100ml of fluid in the pleural space of med sized dog before widened interlobar fissures become visible Small volume – lateral>VD>DV Be on the watch for bi-cavitary effusion Horizontal beam radiography can be useful to identify masses/hernias or detect small volumes of fluid US can be utilized to identify fluid pockets and potentially detect masses Start with a DV Drain Fluid? Stabilize? DV vs.
    [Show full text]
  • V '04 REVIEW Masterpage
    CE Article #2 Esophagitis and Esophageal Strictures Alan Glazer, DVM, DACVIM a Patricia Walters, VMD , DACVIM , DACVECC New England Animal Medical Center West Bridgewater, Massachusetts ABSTRACT: Esophagitis and esophageal strictures are relatively uncommon but significant diseases in companion animals. Often, an esophageal disorder is suspected based on the animal’s medical history and clinical signs. Esophagitis and acquired esophageal strictures are caused by prolonged contact of caustic substances or foreign bodies with the esophageal lining, leading to mucosal injury. In cases of stricture, damage extends into the submucosal and muscular layers. Timely detection and appropriate management of esophagitis and esophageal strictures significantly improve nutritional status, dysphagia, and pain and often return the animal to a normal quality of life. This article reviews the current literature and focuses on the diagnosis and treatment of esophagitis and esophageal strictures caused by fibrosis secondary to esophageal inflammation. sophageal diseases cause a range of clinical cosa , and muscle . The mucosa is lined by squa - signs , including regurgitation, weight loss, mous epithelium and overlies the submucosa. In E and respiratory distress. The diagnosis of dogs, the muscle layer is composed entirely of esophagitis is challenging and often requires skeletal muscle ; in cats , the distal third is smooth specialized procedures such as endoscopy. If muscle. The esophagus does not have a serosal inflammation damages the submucosa and layer; instead , it is covered by adventitia (Figure 1). muscularis, a cicatrix may develop , resulting in The esophagus has upper and lower sphinc ters. obstruction of the esophageal lumen and more The upper esophageal sphincter is composed of the serious illness.
    [Show full text]
  • Gastroesophageal Reflux Disease”
    МІНІСТЕРСТВО ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ ХАРКІВСЬКИЙ НАЦІОНАЛЬНИЙ МЕДИЧНИЙ УНІВЕРСИТЕТ “Затверджено” на методичній нараді кафедри внутрішньої медицини № 3 Завідувач кафедри професор______________________ (Л.В.Журавльова) “27” серпня 2010 р. МЕТОДИЧНІ РЕКОМЕНДАЦІЇ ДЛЯ СТУДЕНТІВ з англомовною формою навчання Навчальна дисципліна Основи внутрішньої медицини Модуль № 2 Змістовний модуль № 2 Основи діагностики, лікування та профілактики основних хвороб органів травлення Тема заняття Гастроезофагеальна рефлюксна хвороба (ГЕРХ) Курс 4 Факультет Медичний Харків 2010 KHARKOV NATIONAL MEDICAL UNIVERSITY DEPARTMENT OF INTERNAL MEDICINE N3 METHODOLOGICAL RECOMMENDATIONS FOR STUDENTS “Gastroesophageal reflux disease” Kharkiv 2014 Content module №2 «Bases of diagnostics, treatment and preventive maintenance of the basic illnesses organs of digestive tract» Practical class №11 "Gastroesophageal reflux disease (GERD)" Urgency The urgency of the problem of GERD gains big prevalence. The presence of both typical and atypical clinical displays which complicates diagnostics of GERD leads to hyper diagnostics of some diseases, for example IHD and it also complicates the course of the bronchial asthma. This also causes difficult complications, such as stricturing of the gullet, bleeding from ulcers of the gullet, etc. Prevalence of GERD among adult population is up to 40 %. Wide epidemiological researches in the countries of Western Europe and the USA testify that 40 % of persons constantly (with different frequency) suffering from the heartburn have symptom the GERD. In Russia prevalence the GERD among adult population makes 40-60 %, and in 45-80 % of persons with GERD esophagitis is found. The frequency of the occurrence of the complicated esophagitis within the common population makes 5 cases out of 100000 a year. The prevalence of a gullet of Barret among persons with esophagitis approaches 8 % with fluctuations from 5 up to 30 %.
    [Show full text]
  • Diagnosis and Management of Acute Esophageal Necrosis
    REVIEW ARTICLE Annals of Gastroenterology (2019) 32, 1-12 Diagnosis and management of acute esophageal necrosis Emanuel Dias, João Santos-Antunes, Guilherme Macedo Centro Hospitalar de São João, Porto, Portugal Abstract Acute esophageal necrosis is a rare syndrome classically characterized by a striking endoscopic image of diffuse and circumferential black mucosal discoloration of distal esophagus, with an abrupt transition at the gastroesophageal junction and variable proximal extension. The typical patient is an older male with general debilitation and multiple comorbidities presenting with hematemesis or melena. The pathophysiology usually involves a combination of esophageal schemi ia, backflow injury from gastric chemical contents and impaired mucosal reparative mechanisms associated with debilitated physical states. It may arise in the setting of hemodynamic compromise, diabetic ketoacidosis, hypothermia, alcoholic intoxication, trauma, inflammatory diseases, esophageal local infection, solid organ transplantation, postoperative status, drugs or acute gastric outlet obstruction, usually in the background of a chronic debilitating process, where the concurrent presence of multiple risk factors, including diabetes mellitus, hypertension, malnutrition, malignancy or alcohol abuse, places a patient at higher risk. The characteristic endoscopic appearance establishes the diagnosis. Biopsy is supportive but not required. Management is mainly supportive and consists of correcting coexisting conditions, fluid therapy, bowel rest, intravenous
    [Show full text]
  • GERD, Hiatal Hernia, Achalasia
    Benign esophageal disease Sha-Ron Jackson-Johnson,MD Clinical Instructor of Surgery University of Cincinnati GERD - pathophysiology • Failure of LES to prevent reflux • 3 Components to the LES – Resting LES pressure (normal > 6mmHg) – Resting LES length (normal >2 cm) – Intra-abdominal LES length (normal >1cm) 1 or 2 components = 75% chance of GERD 3 components = 93% GERD 60 yo man, complains of heartburn • Typical/Atypical symptoms of GERD • Lifestyle changes/Medical Management • Indication for further workup – Failure of medical management – Immediate recurrence after withdrawal of therapy • Diagnostic workup – EGD Manifestations of GERD • Esophageal – Normal – Esophagitis – Ulceration – Stricture – Barrett’s Normal GE junction • Extra-esophageal – Asthma – Cough – Aspiration – Hoarseness Stricture, hiatal hernia Esophagitis GERD • Treatment – Medical • 90% esophagitis heals with medical management • 80% recur within 1 year of withdrawal – Surgical • Indications for surgery – Failure of medical management – Primary treatment for reflux disease – Complications of GERD » Stricture, Barrett’s, ulceration, aspiration, vocal cord edema • Contraindications for surgery – Morbid obesity - controversial GERD • Preoperative workup – EGD (mandatory) – Esophagram (mandatory) helps identify strictures/esophageal shortening – Manometry (mandatory) detects esophageal motility disorders; examines lower esophageal sphincter – 24h pH probe (mandatory if no other objective signs), remains Gold Standard for diagnosis of GERD. Laparoscopic Anti-reflux
    [Show full text]
  • Characterization of Digestive Disorders of Patients with Chronic Chagas Disease in Cochabamba, Bolivia
    Received: 18 October 2018 Characterization of digestive Revised: 29 January 2019 Accepted: disorders of patients with 31 January 2019 Cite as: Jimy-Jose Pinto, chronic Chagas disease in Maria-Jesus Pinazo, Jaime Saravia, Ingrid Gainsborg, Cochabamba, Bolivia Helmut-Ramon Magne, Miriam Cuatrecasas, Nuria Cortes-Serra, Daniel-Franz Lozano, Jimy-Jose Pinto a, Maria-Jesus Pinazo b,∗, Jaime Saravia d, Ingrid Gainsborg d, Joaquim Gascon, Faustino Torrico. Helmut-Ramon Magne a, Miriam Cuatrecasas c,Nuria Cortes-Serra b, Characterization of digestive a b a disorders of patients with Daniel-Franz Lozano , Joaquim Gascon , Faustino Torrico chronic Chagas disease in a Fundacion CEADES, Cochabamba, Bolivia Cochabamba, Bolivia. Heliyon 5 (2019) e01206. b Instituto de Salud Global de Barcelona (ISGlobal), Hospital Clínic i Provincial/IDIBAPS, Universitat de doi: 10.1016/j.heliyon.2019. Barcelona, Barcelona 08036, Spain e01206 c Pathology Department, Hospital Clínic of Barcelona, University of Barcelona/Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD)/Tumor Bank-Biobank Hospital Clinic-IDIBAPS, Barcelona, Spain d Bolivian Institute Japanese Gastroenterological Sucre, Bolivia ∗ Corresponding author. E-mail address: [email protected] (M.-J. Pinazo). Abstract Background: Chagas disease (CD) is endemic in Latin America and particularly common in Bolivia, but there is little information on the characteristics of chronic digestive involvement. Objectives: To determine the prevalence and characterize digestive manifestations in chronic CD patients in Cochabamba, Bolivia. Methods: Eighty-five T. cruzi-seropositive individuals with or without digestive symptoms (G1 group), and fifteen T. cruzi-seronegative patients with similar digestive symptoms to those seen in CD (G2 group) were included in the study.
    [Show full text]
  • Gastrointestinal Manifestations of Systemic Sclerosis Isabel M
    Cur gy: ren lo t o R t e a s e m McFarlane et al., Rheumatology (Sunnyvale) 2018, a u r c e h h 8:1 R Rheumatology: Current Research DOI: 10.4172/2161-1149.1000235 ISSN: 2161-1149 Review Article Open Access Gastrointestinal Manifestations of Systemic Sclerosis Isabel M. McFarlane*, Manjeet S. Bhamra, Alexandra Kreps, Sadat Iqbal, Firas Al-Ani, Carla Saladini-Aponte, Christon Grant, Soberjot Singh, Khalid Awwal, Kristaq Koci DO, Yair Saperstein, Fray M. Arroyo-Mercado, Derek B. Laskar and Purna Atluri Division of Rheumatology and Gastroenterology, Department of Medicine and Pathology, State University of New York, Hospitals Kings County Hospital Brooklyn, USA *Corresponding author: Isabel M. McFarlane, Clinical Assistant Professor of Medicine Associate Program Director Residency Program, Department of Medicine, Division of Rheumatology SUNY Downstate, Brooklyn, USA, Tel: 718-221-6515; Email: [email protected] Received date: January 26, 2018; Accepted date: March 27, 2018; Published date: March 30, 2018 Copyright: ©2018 McFarlane IM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibroproliferative alterations of the microvasculature leading to fibrosis and loss of function of the skin and internal organs. Gastrointestinal manifestations of SSc are the most commonly encountered complications of the disease affecting nearly 90% of the SSc population. Among these complications, the esophagus and the anorectum are the most commonly affected. However, this devastating disorder does not spare any part of the gastrointestinal tract (GIT), and includes the oral cavity, esophagus, stomach, small and large bowels as well as the liver and pancreas.
    [Show full text]
  • ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing
    CLINICAL GUIDELINES 1 ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing C. Prakash Gyawali, MD, MRCP, FACG1, Dustin A. Carlson, MD2, Joan W. Chen, MD3, Amit Patel, MD4, 08/13/2020 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3wX04VDhDA66cbRHJxA+ABseHFJQZnXXLTmUjAQh8F5o= by https://journals.lww.com/ajg from Downloaded Robert J. Wong, MD, MS, FACG (GRADE Methodologist)5 and Rena H. Yadlapati, MD, MSHS6 Downloaded Esophageal symptoms are common and may indicate the presence of gastroesophageal reflux disease (GERD), structural from processes, motor dysfunction, behavioral conditions, or functional disorders. Esophageal physiologic tests are often https://journals.lww.com/ajg performed when initial endoscopic evaluation is unrevealing, especially when symptoms persist despite empiric management. Commonly used esophageal physiologic tests include esophageal manometry, ambulatory reflux monitoring, and barium esophagram. Functional lumen imaging probe (FLIP) has recently been approved for the evaluation of esophageal pressure and dimensions using volumetric distension of a catheter-mounted balloon and as an by adjunctive test for the evaluation of symptoms suggestive of motor dysfunction. Targeted utilization of esophageal BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3wX04VDhDA66cbRHJxA+ABseHFJQZnXXLTmUjAQh8F5o= physiologic tests can lead to definitive diagnosis of esophageal disorders but can also help rule out organic disorders while making a diagnosis of functional esophageal disorders.
    [Show full text]
  • Esophageal Leiomyoma As Unexpected Finding During Laparoscopic Hiatal Hernia Repair
    Case Report Adv Res Gastroentero Hepatol Volume 7 Issue 4 - November 2017 Copyright © All rights are reserved by Ivanov K DOI: 10.19080/ARGH.2017.07.555718 Esophageal Leiomyoma as Unexpected Finding during Laparoscopic Hiatal Hernia Repair Ivanov K1*, Ignatov V1, Shterev S1, Zlatarov A1, Tonev A1, Petrov D1, Naydenova B2 and Kolev N1 1Department of General and Operative Surgery, Medical University of Varna, Bulgaria 2Department of Anesthesiology, Medical University of Varna, Bulgaria Submission: September 09, 2017; Published: November 16, 2017 *Corresponding author: Ivanov K, Department of General and Operative Surgery, Medical University of Varna, 55 Main Drinov Street, Bulgaria, Email: Abstract Leiomyoma is the most common benign esophageal tumour. Although hiatal hernia is another common esophageal disease its association with leiomyoma is very rare. A case of leiomyoma in the lower third of the esophagus missed during preoperative diagnosis and revealed intraoperatively during simultaneous laparoscopic surgery for hiatal hernia and chronic calculus cholecystitis was reported. Introduction 72nd hour. The postoperative course is uneventful and the patient is Leiomyoma is the most common benign esophageal tumour. discharged on the 5th postoperative day. Although hiatal hernia is another common esophageal disease its association with leiomyoma is very rare [1-4]. We report a case of simultaneous laparoscopic surgery for hiatal hernia and chronic calculus cholecystitis during which intramural leiomyoma has been detected in the lower third of the esophagus. Esophagogastric resection and cholecystectomy were performed. Case Report We report a case of 70-year-old woman which presents with complains of pain in the upper right quadrant and epigastrium, heartburn, nausea and constipation.
    [Show full text]
  • Gastroesophageal Disease and Nausea Does Fundoplication Help Or Hurt?
    PAPER Gastroesophageal Disease and Nausea Does Fundoplication Help or Hurt? Thomas T. Hui, MD; Steven M. Fass, MD; Dan I. Giurgiu, MD; Atsushi Iida, MD; Sumito Takagi, MD; Edward H. Phillips, MD Hypothesis: Nausea associated with gastroesophageal Results: Nausea was the most common atypical symp- reflux disease is cured by laparoscopic Nissen fundopli- tom of gastroesophageal reflux disease, occurring in 33 cation (LNF). patients (33%). There were no differences in esopha- geal manometry or 24-hour pH results between groups. Design: Prospective cohort study of unselected pa- There was a female preponderance in group A (55% vs tients who underwent LNF from January 1, 1995, through 33%; P = .003). Patients in group A had a higher preva- March 31, 1999. Patients were followed up by a physi- lence of preoperative dysphagia (P = .02). Patients with cian for 6 to 36 months. persistent postoperative nausea had a higher prevalence of cough (P = .003) and dysphagia (P = .009). The LNF Setting: A large community teaching hospital. was more effective in reducing heartburn (95% reduc- tion) and regurgitation (95% reduction) than cough Patients: One hundred consecutive patients with gas- and dysphagia (60% reduction). There was a 79% re- troesophageal reflux disease who underwent LNF; all pa- duction in the number of patients with nausea (33 to 7; tients were followed up. Patients were grouped accord- P,.001). ing to the presence (group A, n = 33) or absence (group B, n = 67) of preoperative nausea. Interventions were LNF, Conclusion: Laparoscopic Nissen fundoplication is ef- esophageal manometry, 24-hour pH monitoring, and fective in eliminating nausea associated with gastro- nuclear gastric emptying studies.
    [Show full text]