Progressive dysbiosis of human orodigestive microbiota along the sequence of gastroesophageal reflux, Barrett's esophagus and esophageal adenocarcinoma.

The incidence of esophageal adenocarcinoma (EA) has drastically increased in the United States since 1970s for unclear reasons. We hypothesized that the widespread usage of antibiotics has increased the procarcinogenic potential of the orodigestive microbiota along the sequence of gastroesophageal reflux (GR), Barrett's esophagus (BE) and EA phenotypes. This case control study included normal controls (NC) and three disease phenotypes GR, BE and EA.

Dysphagia in the elderly.

Dysphagia, or difficulty swallowing, is a common problem in the elderly. Based on the initial clinical history and physical examination, the dysphagia is assessed as either primarily oropharyngeal or esophageal in origin. Most oropharyngeal dysphagia is of neurologic origin, and management is coordinated with a clinical swallow specialist in conjunction with an ear, nose, and throat (ENT) physician if warning signs imply malignancy.

Potentially reversible pseudoachalasia after laparoscopic adjustable gastric banding.

Background: Although esophageal dilation after laparoscopic adjustable gastric banding (LAGB) has been reported, the effect of banding on esophageal peristalsis, including the development of aperistalsis and its potential reversibility, have received only little attention.

Goals: Our aim was to report our experience with 6 patients who developed manometric evidence of esophageal aperistalsis after LAGB.

Study: We retrospectively reviewed the clinical, manometric, and radiologic data of 6 patients referred between September 2005 and June 2007 to our Center for Esophageal Disease for evaluation of dysphagia or heartburn that developed after LAGB, and in whom manometric studies showed aperistalsis.

Patients with throat symptoms on Acid suppressive therapy: do they have reflux?

Purpose: The aim of this study was to characterize the reflux events in patients with laryngeal symptoms unresponsive to proton pump inhibitor (PPI) therapy.

Background: Gastroesophageal reflux disease (GERD) is commonly implicated as the cause of laryngeal symptoms.

Methods: We retrospectively reviewed the pH/impedance records of 21 patients evaluated for persistent throat symptoms despite PPI therapy.

Lap-band impact on the function of the esophagus.

Background: The laparoscopic adjustable gastric band (LAGB) has been widely used to treat morbid obesity. There is conflicting data on its long-term effect on esophageal function. Our aim was to assess the long-term impact of the LAGB on esophageal motility and pH-metry in patients who had LAGB who had normal and abnormal esophageal function at baseline.