No abstract

The only independent predictor of FGP development in our study was duration of PPI therapy greater than 48 months. Increased dosage of therapy did not significantly impact the development of FGP.

Eosinophilic esophagitis (EoE) is increasingly being diagnosed in adults presenting with dysphagia, food impactions, and chest pain. Studies to date provide conflicting data on the association of EoE and esophageal dysmotility. The objective of this study was to evaluate the prevalence of esophageal dysmotility in a cohort of patients with biopsies consistent with EoE at a military treatment facility. This is a prospective evaluation of consecutively identified patients at our institution diagnosed with EoE from March 1, 2005 to June 1, 2007. Thirty-two patients with biopsies consistent with EoE completed a symptom survey and 30 underwent esophageal manometry. The majority of EoE patients (23/30, 77%) had a normal end-expiratory lower esophageal sphincter (LES) pressure (normal range 10-35), whereas six patients had a low-normal LES pressure (6-9 mm Hg) and one patient had a decreased LES pressure (<5 mm Hg). Five patients (15.6%) were diagnosed with a nonspecific esophageal motor disorder (NSEMD). Two patients had high mean esophageal amplitude contractions >180 mm Hg (188 mm Hg, 209 mm Hg). No patient was diagnosed with nutcracker esophagus or diffuse esophageal spasm. Patients with and without NSEMD reported a similar degree of swallowing difficulty, heartburn, belching, chest pain, regurgitation, symptoms at night, and total symptom score. Likewise, eosinophil count on mucosal biopsy was similar between patients with and without a NSEMD. In this cohort, we found the prevalence of an NSEMD to be similar to that of a 10% prevalence found in a gastroesophageal reflux population.

This retrospective cross-sectional study explored the associations of personality characteristics with parenting problems among 25 couples, one or both members of which were identified as alcoholics by virtue of their voluntary past completion of a residential program for alcoholics. Most of them (90%) scored lower, indicating their more problematic parental attitudes and behaviors, on all four scales of the Adult-Adolescent Parenting Inventory (AAPI: inappropriate parental expectations of children, lack empathy for children's needs, value physical punishment, and parent-child role reversal) than average "normal" nonalcoholic, nonabusive adults. Such parenting problems were found to be very highly associated with clients' personality characteristics. For example, schizoid, schizotypal, histrionic, and passive aggressive characteristics (DSM-III-R-based) along with a few other personal characteristics of the couples, accounted for nearly all (90.2%, R2 = .902) of their propensity to reverse roles with their children. Findings also suggested that the identified parenting problems among alcoholic couples are amenable to programmatic intervention: the longer couples had participated in aftercare programs offered by the treatment facility the more appropriate and empathetic was their parenting.