Gastroesophageal Junction and Pylorus Distensibility Before and After Sleeve Gastrectomy-pilot Study with EndoFlip.

Sleeve gastrectomy (SG) is the most frequently performed bariatric surgical intervention worldwide. Gastroesophageal reflux disease (GERD) is frequently observed after SG and is a relevant clinical problem. This prospective study investigated the gastroesophageal junction (GEJ) and pyloric sphincter by impedance planimetry (EndoFlip) and their association with GERD at a tertiary university hospital center.

[Cough from the perspective of a gastroenterologist].

Cough from the perspective of a gastroenterologist Chronic cough can have numerous origins. The work-up of these conditions should always include a multidisciplinary approach to exclude other causes first (cardial, pulmonary, structural changes of pharynx and larynx, allergies, malignancy) before thinking of an upper GI pathology. Cough as an extra-esophageal manifestation of gastroesophageal reflux disease (GERD) is the most common gastroenterological condition.

Chicago Classification update (v4.0): Technical review of high-resolution manometry metrics for EGJ barrier function.

Esophagogastric junction (EGJ) barrier function is of fundamental importance in the pathophysiology of gastroesophageal reflux disease. Impaired EGJ barrier function leads to excessive distal esophageal acid exposure or, in severe cases, esophagitis. Hence, proposed high-resolution manometry (HRM) metrics assessing EGJ integrity are clinically important and were a focus of the Chicago Classification (CC) working group for inclusion in CC v4.

Radiologic, endoscopic, and functional patterns in patients with symptomatic gastroesophageal reflux disease after Roux-en-Y gastric bypass.

Background: Roux-en-Y gastric bypass (RYGB) is considered the gold standard in treatment of morbid obesity and gastroesophageal reflux disease (GERD). Resolution of GERD symptoms is reported to be approximately 85% to 90%.

Objective: To evaluate patients with persistent GERD symptoms after RYGB and to identify contributing factors.

Endoscopic stent suture fixation for prevention of esophageal stent migration during prolonged dilatation for achalasia treatment.

The aim of this study is to compare endoscopic stent suture fixation with endoscopic clip attachment or the use of partially covered stents (PCS) regarding their capability to prevent stent migration during prolonged dilatation in achalasia. Large-diameter self-expanding metal stents (30 mm × 80 mm) were placed across the gastroesophageal junction in 11 patients with achalasia. Stent removal was scheduled after 4 to 7 days.

Waist to hip ratio is a better predictor of esophageal acid exposure than body mass index.

Background: Obesity and gastroesophageal reflux disease (GERD) are major health problems showing an inconstant relationship in the literature. Therefore, anthropometric parameters which are predictive and can simply be assessed at first patient presentation may lead to a better patient selection for ambulatory reflux monitoring. We aimed to examine the association of body mass index (BMI) and waist to hip ratio (WHR) with gastroesophageal reflux activity during 24 hour-pH-impedance monitoring.

Comparison of videofluoroscopy and impedance planimetry for the evaluation of oesophageal stenosis: a retrospective study.

Objectives: To compare videofluoroscopy that included a tablet test with impedance planimetry (EndoFLIP) for the evaluation of oesophageal stenosis in patients with dysphagia.

Methods: In 56 patients, videofluoroscopic examinations following the transit of a 14-mm tablet were retrospectively reviewed and correlated with impedance planimetry findings, a catheter-based method using impedance planimetry to display the oesophageal diameter estimates. Additional findings assessed were the occurrence of symptoms during tablet passage and evaluation of oesophageal motility.

Modern GERD treatment: feasibility of minimally invasive esophageal sphincter augmentation.

Background: Gastroesophageal reflux disease (GERD) is a common chronic disease requiring adequate treatment since it represents one major cause of development of Barrett's esophagus and eventually carcinoma. Novel laparoscopic magnetic sphincter augmentation for GERD was evaluated prospectively.

Patients And Methods: A total of 23 patients with GERD underwent minimally invasive implantation of LINX™ Reflux Management System.

Upper esophageal sphincter dysfunction: diverticula-globus pharyngeus.

The following discussion of upper esophageal sphincter dysfunction includes commentaries on the role of the cricopharyngeus muscle in reflux disease; the etiology and treatment of Zenker diverticulum; the use of videofluoroscopy in patients with dysphagia, suspicion of aspiration, or globus; the role of pH-impedance monitoring in globus evaluation; and treatment for reflux-associated globus.

Review on novel concepts of columnar lined esophagus.

Background: Columnar lined esophagus (CLE) is a marker for gastroesophageal reflux and associates with an increased cancer risk among those with Barrett's esophagus. Recent studies fostered the development of integrated CLE concepts.

Methods: Using PubMed, we conducted a review of studies on novel histopathological concepts of nondysplastic CLE.

Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects - a retro-pro study.

Background: Information about gastro-oesophageal reflux disease (GERD) in patients with Diabetes mellitus type 2 (T2D) is scarce, although the incidence of both disorders is increasing.

Methods: This "retro-pro" study compared 65 T2D patients to a control group of 130 age- and sex-matched non-diabetics. GERD was confirmed by gastroscopy, manometry, pH-metry and barium swallow.

Review on the annual cancer risk of Barrett's esophagus in persons with symptoms of gastroesophageal reflux disease.

Background: Esophageal adenocarcinoma results from gastroesophageal reflux and develops along a sequence involving non-dysplastic Barrett's esophagus (NDBE), low- (LGD) and high-grade dysplasia (HGD). We aimed to examine the reported annual cancer risk for NDBE in persons with symptoms of gastroesophageal reflux disease, i.e.

Intraoperative assessment of esophagogastric junction distensibility during per oral endoscopic myotomy (POEM) for esophageal motility disorders.

Background: Per oral endoscopic myotomy (POEM) is a novel treatment for esophageal motility disorders such as achalasia. To date, the extent of the myotomy has been determined based on the subjective assessment of the endoscopist. We hypothesized that the real-time measurement of esophagogastric junction (EGJ) distensibility using a novel functional lumen-imaging probe would enable objective evaluation of POEM.

Hiatal hernia, Barrett's esophagus, and long-term symptom control after laparoscopic fundoplication for gastroesophageal reflux.

Background: The aim of this study was to determine the long-term symptom control after laparoscopic fundoplication for gastroesophageal reflux disease (GERD), and possible prognostic factors.

Methods: A cohort of 271 patients, operated on at a university hospital from 1996 through 2002, was eligible for evaluation after a median interval of 102 months (range = 12-158). The time between surgery and recurrence of reflux symptoms (i.

The cardia: esophageal or gastric? Critical reviewing the anatomy and histopathology of the esophagogastric junction.

Background: Discrepancy exists regarding the anatomical allocation of the cardia: esophageal or gastric. With this review we aimed to clarify this issue.

Methods: Using PUB MED, Scopus and Google we analyzed the recent literature (1889-2012) regarding the "esophageal" vs.

Testing for gastroesophageal reflux in the 21st century.

The following on testing for gastroesophageal reflux in the 21st century contains commentaries on wireless pH monitoring; extension of pH recording duration to 48 or 96 h; extraesophageal GERD syndromes, diagnosis paradigms, and related investigating tools; off- or on-PPI reflux monitoring in the preoperative setting; and the potential influence of PPIs on reflux parameters.

Barrett's esophagus: clinical features, obesity, and imaging.

The following includes commentaries on clinical features and imaging of Barrett's esophagus (BE); the clinical factors that influence the development of BE; the influence of body fat distribution and central obesity; the role of adipocytokines and proinflammatory markers in carcinogenesis; the role of body mass index (BMI) in healing of Barrett's epithelium; the role of surgery in prevention of carcinogenesis in BE; the importance of double-contrast esophagography and cross-sectional images of the esophagus; and the value of positron emission tomography/computed tomography.

Is there a role for dynamic swallowing MRI in the assessment of gastroesophageal reflux disease and oesophageal motility disorders?

Objectives: To evaluate the diagnostic value of dynamic MRI swallowing in patients with symptoms of Gastroesophageal Reflux Disease (GERD).

Methods: Thirty-seven patients (17 m/20f) with typical signs of GERD underwent MR swallowing in the supine position at 1.5 T with a phased-array body coil.