Mucosal Response to Esophageal Motor Disorders

Pope, Charles E.

doi:10.1001/archinte.1976.03630050037008

Cited by 13 publications

(2 citation statements)

References 30 publications

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“…How many of all columnar lined lower esophagi are an acquired disease? We are, together with other authors (2,3,10,12,15) persuaded that usually if not always, it is an acquired disease. This is supported by the high correlation with inflammation due to reflux and the incompetent lower esophageal sphincter.…”

Section: Resultsmentioning

confidence: 55%

Barrett-esophagus Following Total Gastrectomy: A Contribution to it's Pathogenesis

Meyer¹,

Vollmar²,

W³

1979

Endoscopy

109

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We have undertaken esophagoscopy 1/2 to 17 1/2 years after surgery in 20 patients with a total gastrectomy and an esophago-jejunal anastomosis. In 5 cases we found a complete columnar lining of the distal esophagus (Barrett-esophagus). 2 other cases showed a multilocular columnar epithelium. One case with a Barrett-esophagus had endoscopy before surgery, and it could be proved that the columnar lining developed after surgery. We suspect that it was the same in the remaining cases. All examined patients, except one, showed an erosive esophagitis of varying severity. These observations support the current view that the columnar lined esophagus is usually an acquired one. The pathogenesis is not completely clear, but reflux of digestive juices destroying the squamous epithelium and impairing healing is the condition for columnar lining. The observations on patients with total gastrectomy prove that it must not necessarily be gastric juice. The very urgent question of the origin of columnar lining cannot be answered at present.

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Section: Resultsmentioning

confidence: 55%

Barrett-esophagus Following Total Gastrectomy: A Contribution to it's Pathogenesis

Meyer¹,

Vollmar²,

W³

1979

Endoscopy

109

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“…Three of 15 patients after Heller operation without antireflux surgery had a small hiatal hernia associated with moderate or slight reflux. the esophageal mucosa [19]. Certainly, this etiopathological mechanism can explain the rare appearance of symptoms a long time after the beginning of reflux, and the basic esophageal motor dysfunction may explain the atypical clinical picture.…”

Section: Radiologymentioning

confidence: 99%

Cardiomyotomy associated with antireflux surgery in the treatment of achalasia

1981

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The purpose of this report was to evaluate the efficacy of cardiomyotomy combined with fundoplication in the treatment of achalasia. Results obtained in 15 patients are compared with those collected in 19 asymptomatic patients treated by the classical Heller operation (12 patients), or by cardiomyotomy combined with suture of phrenoesophageal ligament to the underside of the diaphragm (7 patients). The preventive action of fundoplication on reflux esophagitis and especially the effect of surgery on esophageal emptying are particularly examined, using two rigorous isotopic tests. It is demonstrated that even asymptomatic patients have, after cardiomyotomy without antireflux maneuvers, a very high risk of esophagitis. The statistical comparison using the gastroesophageal reflux index between patients treated by Heller cardiomyotomy and normals wasp <0.001 to the classical Heller, and 0.01

0.1), and maintained the improvement of the esophageal emptying.

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Histologic evaluation of chronic gastroesophageal reflux

Benjamin

et al. 1984

Digest Dis Sci

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Controversy exists regarding the appropriate method for biopsy confirmation of esophageal reflux injury. We have compared endoscopic pinch biopsy (PB) with endoscopically directed Rubin tube suction biopsy (SB) in 40 patients with symptomatic gastroesophageal reflux disease (GERD). Utilizing a plastic tube attached alongside the endoscope, SB at specific sites in the esophagus can be easily obtained. Suction biopsy was rated superior to PB for adequacy of tissue, ability to make an interpretation, and certainty in diagnosis. These differences were most pronounced in patients with endoscopic grades 0 and 1 + esophagitis in which 59% of PBs were uninterpretable compared to 23% of SBs. The passage of the Rubin tube was easily done and could be performed repeatedly. Six of 40 patients (15%) developed substernal chest discomfort in the 24 hr following SB. We conclude that SB is the most appropriate way to evaluate histologic changes related to reflux injury and that this method is mandatory in symptomatic patients with minimal endoscopic evidence of esophagitis (0-1 +).

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Mucosal Response to Esophageal Motor Disorders

Cited by 13 publications

References 30 publications

Barrett-esophagus Following Total Gastrectomy: A Contribution to it's Pathogenesis

Barrett-esophagus Following Total Gastrectomy: A Contribution to it's Pathogenesis

Cardiomyotomy associated with antireflux surgery in the treatment of achalasia

Histologic evaluation of chronic gastroesophageal reflux

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