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Esophageal Dysphagia

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1. Esophageal Dysphagia

Esophageal Dysphagia 5 © The Author(s) 2018. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions (...) @oup.com Original Article Clinical Practice Guidelines for the Assessment of Uninvestigated Esophageal Dysphagia Louis WC. Liu,* Christopher N. Andrews, ‡ David Armstrong, § Nicholas Diamant, || Nasir Jaffer, ¶ Adriana Lazarescu, # Marilyn Li, || Rosemary Martino,** William Paterson, || Grigorios I. Leontiadis, § Frances T se § *Division of Gastroenterology, Department of Medicine, University of T oronto, T oronto, ON ‡ Division of Gastroenterology, Department of Medicine, University of Calgary

2018 Canadian Association of Gastroenterology

2. Effects of neoadjuvant chemoradiotherapy vs chemotherapy alone on the relief of dysphagia in esophageal cancer patients: secondary endpoint analysis in a randomized trial. (PubMed)

Effects of neoadjuvant chemoradiotherapy vs chemotherapy alone on the relief of dysphagia in esophageal cancer patients: secondary endpoint analysis in a randomized trial. Dysphagia is the most significant symptom in patients with esophageal cancer. There are different therapeutic interventions designed to relieve dysphagia, but few studies have addressed the effects of neoadjuvant therapy. The aim of this study is to compare the effects on dysphagia of neoadjuvant chemotherapy (nCT) versus (...) neoadjuvant chemoradiotherapy (nCRT) and further to study the association between dysphagia response and histological response. Patient reported swallowing function was a secondary endpoint in the NeoRes trial, in which patients were randomized between neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy. Patients completed dysphagia questionnaires before the start and after neoadjuvant therapy, using the European Organization for Research and Treatment of Cancer (EORTC) esophageal cancer modules QLQ

2019 Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

3. Performance status is a predictive factor of dysphagia improvement after esophageal stenting in patients with malignant esophageal strictures and fistulas. (PubMed)

Performance status is a predictive factor of dysphagia improvement after esophageal stenting in patients with malignant esophageal strictures and fistulas. Malignant strictures and fistulas of the esophagus adversely affect quality of life (QOL) and prognosis, and stenting is considered a useful therapy for improving QOL. However, the predictive factors for improving dysphagia after esophageal stenting are unclear. This retrospective cohort study aimed to evaluate patients with esophageal (...) malignant strictures and fistulas who underwent stenting and investigate the factors for dysphagia improvement after stenting.Twenty-four patients with malignant esophageal strictures and fistulas were treated with a self-expandable metallic stent over a period of 5 years and 6 months. The main outcome was improvement in the dysphagia score. We divided the patients into dysphagia improved and non-improved groups after esophageal stenting. Sex, age, cause of stenting (primary or non-primary esophageal

2019 Surgical endoscopy

4. Esophageal IgE, IgG4, and mucosal eosinophilia in individuals with dysphagia. (PubMed)

Esophageal IgE, IgG4, and mucosal eosinophilia in individuals with dysphagia. Eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus, producing failure to thrive in infants and dysphagia with food impaction in older children and adults. Although most people with EoE manifest atopic/allergic disease, the specific allergens to which immunoglobulin E (IgE) is directed, if any, have not yet been characterized.Mucosal brush biopsy (MBB) and solid tissue biopsy (STB) specimens (...) . Clarifying the role of both IgE-mediated and non-IgE-mediated inflammatory mechanisms will help identify more targeted diagnostic and treatment strategies for individuals who present with dysphagia and esophageal eosinophilia.© 2019 ARS-AAOA, LLC.

2019 International forum of allergy & rhinology

5. Treatment for upper esophageal sphincter dysfunction in a patient with poststroke dysphagia: A case report. (PubMed)

Treatment for upper esophageal sphincter dysfunction in a patient with poststroke dysphagia: A case report. Botulinum toxin injection is a widely used procedure for the treatment of the dysfunction of the upper esophageal sphincter (UES). Although the injection can be guided by ultrasound, electromyography, or computed tomography, such techniques cannot determine the exact extent of narrowed UES and ensure that the narrowed extent is fully covered by the treatment. This report describes a dual (...) guiding technique with ultrasound and the balloon catheter in a patient with poststroke dysphagia to improve these weaknesses.The patient was admitted to a rehabilitation hospital 2 weeks postcerebral infarction.Clinical presentation of the patient included severe hemiplegia and dysphagia. The fiberoptic endoscopic evaluation of swallowing (FEES) revealed penetration/aspiration when swallowing 1 ml water and 1 ml yogurt and pooling in the postcricoid region.Balloon catheter dilatation procedures

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2019 Medicine

6. Dysphagia Score as a Predictor of Adverse Events Due to Triplet Chemotherapy and Oncological Outcomes in 434 Consecutive Patients with Esophageal Cancer. (PubMed)

Dysphagia Score as a Predictor of Adverse Events Due to Triplet Chemotherapy and Oncological Outcomes in 434 Consecutive Patients with Esophageal Cancer. Dysphagia is a major symptom of esophageal cancer (EC) that significantly affects patient quality of life; however, little is known regarding its clinical impact on the treatment course in patients with EC.This retrospective study included 434 consecutive patients with EC who received docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy (...) as an initial treatment. We evaluated the relationships between the dysphagia score at diagnosis and clinicopathological factors, including DCF therapy-related adverse events, tumor response, and survival.The dysphagia scores were 0 in 208 patients (47.9%), 1 in 82 patients (18.9%), 2 in 52 patients (12.0%), 3 in 59 patients (13.6%), and 4 in 33 patients (7.6%). High (≥ 3) dysphagia scores were significantly associated with high incidences of grade 3/4 febrile neutropenia (FN) (79.3 vs. 35.7%, P < 0.001

2019 Annals of Surgical Oncology

7. A randomized double-blind placebo-controlled crossover-style trial of buspirone in functional dysphagia and ineffective esophageal motility. (PubMed)

A randomized double-blind placebo-controlled crossover-style trial of buspirone in functional dysphagia and ineffective esophageal motility. Studies suggest that Ineffective Esophageal Motility (IEM) is the manometric correlate of Functional Dysphagia (FD). Currently, there is no accepted therapy for either condition. Buspirone is a serotonin modulating medication and has been shown to augment esophageal peristaltic amplitude in healthy volunteers. We aimed to determine if buspirone improves (...) manometric parameters and symptoms in patients with overlapping IEM/FD.We performed a prospective, double-blind, placebo-controlled, crossover-style trial of 10 patients with IEM/FD. The study consisted of two 2-week treatment arms with a 2-week washout period. Outcomes measured at baseline, end of week 2, and week 6 include high resolution esophageal manometry (HREM), the Mayo Dysphagia Questionnaire-14 (MDQ-14), and the GERD-HRQL.The mean age of our 10 patients was 53 ± 9 years and 70% were female

2018 Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society

8. Esophageal transit time in patients with chagasic megaesophagus: Lack of linear correlation between dysphagia and grade of dilatation. (PubMed)

Esophageal transit time in patients with chagasic megaesophagus: Lack of linear correlation between dysphagia and grade of dilatation. The aim of this study was to determine the esophageal transit time in control individuals and in chagasic patients with or without megaesophagus.A total of 148 patients were allocated in 6 groups according to serological diagnostic of Chagas disease and the degree of esophageal dilatation: A, control healthy individuals (n = 34, 22.9%); B, indeterminate form (n (...)  hours (median = 90 seconds). A linear correlation was observed between transit time and megaesophagus grade: 8 seconds in groups A and B, 5 minutes in C, 30 minutes in D, 2 hours in E, and 9:15 hours in F. Dysphagia was not reported by 60 of 114 (52.6%) patients with positive serological tests for Chagas disease (37/91-40.7%-of patients with megaesophagus I-IV grades). The esophageal transit time increased with the grade of megaesophagus.The esophageal transit time has a direct correlation

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2018 Medicine

9. Structural airway abnormalities contribute to dysphagia in children with esophageal atresia and tracheoesophageal fistula. (PubMed)

Structural airway abnormalities contribute to dysphagia in children with esophageal atresia and tracheoesophageal fistula. Long-term dysphagia occurs in up to 50% of repaired esophageal atresia and tracheoesophageal fistula (EA/TEF) patients. The underlying factors are unclear and may include stricture, esophageal dysmotility, or associated anomalies. Our purpose was to determine whether structural airway abnormalities (SAA) are associated with dysphagia in EA/TEF.We conducted a retrospective (...) was more common in children with SAA (58.3% vs. 36.4%, p=0.028). Children with SAA were more likely to require tube feeding both at discharge (79.6% vs. 48.3%, p<0.001) and at 1 year (52.7% vs. 13.6%, p<0.001) and had lower mean FOIS (4.18 vs. 6.21, p<0.001). In the logistic regression model adjusting for gestational age, long gap EA, and esophageal stricture, the presence of SAA remained a significant risk factor for dysphagia (OR 4.17 (95% CI 1.58-11.03)).SAA are common in children with EA/TEF

2018 Journal of Pediatric Surgery

10. Distribution of Esophageal Motor Disorders in Diabetic Patients With Dysphagia.

Distribution of Esophageal Motor Disorders in Diabetic Patients With Dysphagia. Diabetes mellitus can cause various gastrointestinal symptoms. Assessment of esophageal dysmotility in diabetic patients has been scarcely studied. The aim of this study was to determine the esophageal motor characteristics of diabetic versus nondiabetic patients who present with dysphagia.High-resolution esophageal manometries (HREMs) of 83 diabetic patients and 83 age and gender-matched nondiabetic patients (...) with dysphagia from 2 medical centers were included in this study. Demographic information, medical comorbidities, and medication usage were recorded for each patient in a single registry. HREM of each patient was evaluated and the different functional parameters were recorded.Overall, 46% of diabetic patients were found to have an esophageal motor disorder. Diabetic patients with dysphagia were more likely to have failed swallows on HREM (50.6% vs. 33.7%; P=0.03) as compared with nondiabetic patients. Among

2018 Journal of clinical gastroenterology

11. Esophageal Granular Cell Tumor in a 28-year-old: A Unique Cause for Dysphagia (PubMed)

Esophageal Granular Cell Tumor in a 28-year-old: A Unique Cause for Dysphagia This is the case of a 28-year-old female who presented with a complaint of dysphagia and was diagnosed with the rare disease of esophageal granular cell tumor (GCT) after esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS). The case acknowledges the wisdom of maintaining a broad differential for a common complaint. It also serves to reiterate the clinical and pathologic criteria for the diagnosis

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2018 Cureus

12. Gender, medication use and other factors associated with esophageal motility disorders in non-obstructive dysphagia (PubMed)

Gender, medication use and other factors associated with esophageal motility disorders in non-obstructive dysphagia High-resolution esophageal manometry (HREM) is the diagnostic test of choice for evaluation of non-obstructive dysphagia. Studies regarding the predictors of esophageal dysmotility are limited. Therefore, our aim was to study the prevalence of and factors associated with esophageal motility disorders in patients with non-obstructive dysphagia.We performed a retrospective review (...) of all patients with non-obstructive dysphagia who underwent HREM in a tertiary center between 1 January 2014 and 31 December 2015. After obtaining IRB approval (16-051), clinical records were scrutinized for demographic data, symptoms, medication use, upper endoscopic findings and esophageal pH findings. HREM plots were classified per Chicago Classification version 3.0. Primary outcome was prevalence of esophageal motility disorders; secondary outcomes assessed predictive factors.In total, 155

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2018 Gastroenterology report

13. Assessment of Esophageal High-Resolution Impedance Manometry in Patients with Nonobstructive Dysphagia (PubMed)

Assessment of Esophageal High-Resolution Impedance Manometry in Patients with Nonobstructive Dysphagia High-resolution impedance manometry (HRIM) can calculate the bolus motion parameters and the ratio of complete esophageal transit besides the conventional esophageal dynamic parameters; therefore, we could better manage the patients with nonobstructive dysphagia (NOD) clinically.To analyze the HRIM parameter results of NOD patients and evaluate the characteristics of their esophageal motility (...) and transit function.In total, 58 NOD patients were assessed and the clinical diagnoses were determined. HRIM was performed, and both conventional high-resolution manometry and esophageal transit parameters were analyzed.In 58 NOD patients, 28 patients had achalasia, 3 esophagogastric junction outflow obstruction, and 20 nonspecific esophageal motility disorders, and 7 were normal. Impedance results demonstrated that all the patients with achalasia exhibited incomplete esophageal transit (ICET), three

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2018 Gastroenterology research and practice

14. Addendum to A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery (PubMed)

Addendum to A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery 30288290 2018 11 14 2050-6406 6 8 2018 Oct United European gastroenterology journal United European Gastroenterol J Addendum to A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery . 1274-1275 10.1177/2050640618798487 Omari Taher T https://orcid.org/0000-0001-5108-7378 Department of Human Physiology, College of Medicine and Public

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2018 United European gastroenterology journal

15. A case report of metastatic breast cancer initially presenting with esophageal dysphagia. (PubMed)

A case report of metastatic breast cancer initially presenting with esophageal dysphagia. Breast cancer metastasis to the esophagus is uncommon. To our knowledge, the present case is the first report of breast cancer with dysphagia as the initial symptom.A 62-year-old woman was admitted to our hospital for progressive dysphagia.Endoscopic ultrasound-guided fine needle biopsy of the esophageal lesion found poorly differentiated carcinoma, and surgical resection of the breast nodule revealed (...) invasive ductal carcinoma.The patient underwent an esophagectomy, and the immunohistochemistry of surgical specimen was identified as metastatic breast cancer. Then patient was treated with chemotherapy and hormone therapy.The patient remained symptom-free during 5 months of follow-up examinations.This case indicates that metastatic breast cancer to the esophagus should be considered as a cause of esophageal stricture in older women.

2018 Medicine

16. A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery (PubMed)

A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery The role of high-resolution esophageal impedance manometry (HRIM) for establishing risk for dysphagia after anti-reflux surgery is unclear. We conducted a prospective study of children with primary gastroesophageal reflux (GER) disease, for whom symptoms of dysphagia were determined pre-operatively and then post-operatively and we examined for features that may predict post-operative (...) dysphagia.Thirteen children (aged 6.8-15.5 years) undergoing work-up prior to 360o Nissen fundoplication were included in the study. A dysphagia score assessed symptoms at pre-operative study and post-operatively (mean 1.4 years). A HRIM procedure recorded 5-ml liquid, 5-ml viscous and 2-cm solid boluses. We assessed esophageal motility, esophago-gastric junction (EGJ) morphology, EGJ contractility and pressure-flow variables indicative of bolus distension pressures and bolus clearance pressures. A composite

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2018 United European gastroenterology journal

17. Liquid nitrogen spray cryotherapy for dysphagia palliation in patients with inoperable esophageal cancer. (PubMed)

Liquid nitrogen spray cryotherapy for dysphagia palliation in patients with inoperable esophageal cancer. Dysphagia is a debilitating symptom in patients with inoperable esophageal cancer that contributes to poor quality of life and worsening nutritional status. The 2 most commonly used palliative modalities for dysphagia are radiation therapy and esophageal stent placement. However, radiation therapy is limited by adverse events (AEs) and total dose, and stent placement has a high rate of AEs (...) , including reflux, migration, and chest pain. A relatively new modality of liquid nitrogen endoscopic spray cryotherapy has been described as salvage when other options have been exhausted and when patients are no longer receiving systemic therapy. We evaluated the safety and efficacy of cryotherapy as the primary modality for relieving dysphagia in inoperable esophageal cancer including patients receiving systemic cancer therapy.This is a retrospective, multicenter, consecutive case series of 49

2018 Gastrointestinal endoscopy

18. The effect of disc-shaped gastric resection of anastomosis site on reducing postoperative dysphagia and stricture after esophagogastric anastomosis in patients with esophageal cancer. (PubMed)

The effect of disc-shaped gastric resection of anastomosis site on reducing postoperative dysphagia and stricture after esophagogastric anastomosis in patients with esophageal cancer. Esophagectomy remains the most reliable technique for managing esophageal cancer, but anastomotic complications including postoperative leak, ischemia and stricture negatively affect outcomes of this specific surgery. The aim of this study was to evaluate the effects of a novel method of esophagogastric (...) anastomosis for reducing postoperative dysphagia and stricture formation.Eighty patients who were scheduled for esophagectomy due to esophageal cancer were randomly assigned into two groups: intervention and control (40 each). In the control group, the esophagogastric anastomosis was performed with a linear gastric incision, whilst in the intervention group a new method of disc-shaped gastric resection for anastomosis was applied. Postoperative outcomes were compared between the two groups.The incidence

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2017 Gastroenterology report

19. Validation of Instruments Used for Assessment of Dysphagia in Patients With Esophageal Cancer

Validation of Instruments Used for Assessment of Dysphagia in Patients With Esophageal Cancer Validation of Instruments Used for Assessment of Dysphagia in Patients With Esophageal Cancer - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Validation of Instruments Used for Assessment of Dysphagia in Patients With Esophageal Cancer The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03066167 Recruitment Status : Unknown Verified January 2017 by Vastra Gotaland Region. Recruitment status was: Active

2017 Clinical Trials

20. Brachytherapy for the palliation of dysphagia owing to esophageal cancer: A systematic review and meta-analysis of prospective studies. (PubMed)

Brachytherapy for the palliation of dysphagia owing to esophageal cancer: A systematic review and meta-analysis of prospective studies. The management of dysphagia owing to esophageal cancer is challenging. Brachytherapy has been proposed as an alternative option to stent placement. We performed a systematic review to examine its efficacy and safety in the resolution of dysphagia.Prospective studies recruiting at least 20 patients with malignant dysphagia and published up to April 2016 were (...) eligible. The dysphagia-free survival (DFS) and adverse event rates were pooled by means of a random effect model.Six studies for a total of 9 treatment arms (623 patients) were eligible for inclusion. After 1month since treatment, the DFS rate was 86.9% [95%CI: 76.0-93.3%]; after 3months, it was 67.2% [95%CI: 56.1-76.7%]; after 6months, it was 47.4% [95%CI: 38.5-56.5%]; after 9months, it was 37.6% [95%CI:30.0-45.9%]; and, finally, after 12months, it was 29.4% [95%CI: 21.6-38.7%]. The heterogeneity

2017 Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

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