Atypical presentations of gastroesophageal reflux disease.

Gastroesophageal reflux disease typically manifests as heartburn and regurgitation, but it may also present with atypical or extraesophageal symptoms, including asthma, chronic cough, laryngitis, hoarseness, chronic sore throat, dental erosions, and noncardiac chest pain. Diagnosing atypical manifestations of gastroesophageal reflux disease is often a challenge because heartburn and regurgitation may be absent, making it difficult to prove a cause-and-effect relationship. Upper endoscopy and 24-hour pH monitoring are insensitive and not useful for many patients as initial diagnostic modalities for evaluation of atypical symptoms.

Esophageal Dilation / Dilators.

Esophageal dilation is the treatment of choice for most patients with esophageal dysphagia (functional and mechanical). Multiple forms of esophageal dilators are available. Mechanical dilators (guidewire/nonguidewire assisted) are the major forms of dilators used.

Management of gastroesophageal reflux disease.

The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. In patients with reflux esophagitis, treatment is directed at acid suppression through the use of lifestyle modifications (e.g.

Intrasphincteric botulinum toxin versus pneumatic balloon dilation for treatment of primary achalasia.

Goals: Despite a high success rate, pneumatic dilatation for achalasia is accompanied by a significant risk of esophageal perforation. Injection of botulinum toxin (botox) into the lower esophageal sphincter (LES) can lead to improvement in symptoms with reduced risk of complications. Direct comparisons of the two techniques are needed to define their role in clinical management.

The Stretta procedure for the treatment of GERD: 6 and 12 month follow-up of the U.S. open label trial.

Background: This multicenter prospective study investigated the longer-term (12 month) safety and efficacy of radiofrequency energy delivery for the treatment of GERD.

Methods: A prospective study was conducted of 118 patients with chronic heartburn and/or regurgitation who required antisecretory medication daily and had demonstrated pathologic esophageal acid exposure, a sliding hiatal hernia ( View Article and Find Full Text PDF

Endoscopic Treatment for Gastroesophageal Reflux Disease.

Gastroesophageal reflux disease is a common illness that requires continuous and potentially long-term therapy. Current therapies include long-term acid-reducing medications (most commonly proton pump inhibitors), laparoscopic and open antireflux surgery, and most recently, endoscopic therapies. For the majority of patients with symptomatic GERD, long-term acid-reduction medications are standard therapy.