Dor Vs Toupet Fundoplication After Laparoscopic Heller Myotomy: Long-Term Randomized Controlled Trial Evaluated by High-Resolution Manometry.

Background: Laparoscopic Heller myotomy (LHM) with partial fundoplication is an effective treatment for achalasia. However, the type of fundoplication is still a subject of debate.

Aim: The aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores.

New insights into the pathophysiology of achalasia and implications for future treatment.

Idiopathic achalasia is an archetype esophageal motor disorder, causing significant impairment of eating ability and reducing quality of life. The pathophysiological underpinnings of this condition are loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter (LES). The clinical manifestations include dysphagia for both solids and liquids, regurgitation of esophageal contents, retrosternal chest pain, cough, aspiration, weight loss and heartburn.

Novel surgical concept in antireflux surgery: long-term outcomes comparing 3 different laparoscopic approaches.

Background: The Nissen fundoplication procedure is the most widely used type of antireflux surgery. The results are not always as good as expected, and several modifications to the original technique have been proposed. Long-term effectiveness studies comparing different techniques of antireflux surgery are limited.

Use and overuse of proton pump inhibitors in cirrhotic patients.

Background: There are several indications for the use of proton pump inhibitors (PPIs) but little evidence to support their use in patients with chronic liver disease. Moreover, the pattern of clinical use is unknown. The aim of the present study was to analyze the use of PPIs in patients with chronic liver disease in an ambulatory setting.

[Hereditary nonpolyposis colorectal cancer (Lynch syndrome). Clinical case].

Colorectal cancer is an important neoplasm in general population, about 90% of the cases are sporadical, but near of 5% are due to hereditary non polyposis colorectal cancer. Early detection is imperative due to genetic linkage and association to other neoplasms diagnosed an early age. This case report is about a young man diagnosed with colorectal cancer that presented multiple recurrences and had at least two affected generations.

Gastroesophageal reflux in healthy subjects induced by two different species of chilli (Capsicum annum).

Background: Although the ingestion of chilli has been associated with gastroesophageal reflux (GER) symptoms, there are no studies that have explored the effect of a chronic ingestion of different kinds of chilli with a variable content of capsaicin as a cause of GER.

Methods: The effect of chilli on esophageal 24-hour pH monitoring was studied in 12 healthy subjects without GER symptoms before and after of ingestion one of two kinds of chilli. Patients were randomized to ingest 3 g daily of cascabel chilli (Capsicum annum coraciforme containing 880 ppm of capsaicin) or ancho chilli (Capsicum annum grossum containing 488 ppm of capsaicin).

[Fecal incontinence in the elderly].

Unlabelled: Fecal incontinence (FI) is a devastating condition that affects quality of life. Age and gender are related with the prevalence of FI. In adults, prevalence varies from 2% to 7%.

Current and future treatment of chest pain of presumed esophageal origin.

Patients with chest pain of presumed esophageal origin should be reassured and should undergo an esophageal manometry study. In patients with spastic esophageal disorders, a trial with calcium channel blockers or low-dose antidepressants used as visceral analgesics is the best approach. Inpatients with non GERD-related, nonspastic esophageal motility disorder, low-dose antidepressants seem reasonable.

Radio-frequency energy delivery to the anal canal for the treatment of fecal incontinence.

Purpose: In this prospective study we investigated the feasibility, safety, and efficacy of radio-frequency energy delivery deep to the mucosa of the anal canal for the treatment of fecal incontinence.

Methods: We studied ten patients with fecal incontinence of varying causes. All patients underwent anoscopy, anorectal manometry, endorectal ultrasound, and pudendal nerve terminal motor latency testing at baseline and six months.