Abstract:
:High-resolution manometry identifies three subtypes of achalasia. However, type 3 differs from classic achalasia. Although opiates affect esophageal motility, opiate use and achalasia have not been studied. Patients with a new diagnosis of achalasia at Mayo Clinic Rochester between June 1, 2012 and January 3, 2014 were identified. Clinical records were reviewed to assess symptoms, opiate use, and therapy. Fifty-six patients with achalasia were identified, 14 (25%) were on opiates. Opiate prescription was unrelated to achalasia in all cases, with chronic back and joint pain constituting the majority. Of patients on opiates, five (36%) had type 3 achalasia compared with four (10%) not on opiates (P = 0.02). No patients on opiates had type 1 achalasia. Clinical presentation did not differ with opiates, although those on opiates were more likely to report chest pain (39 vs. 14%, P = 0.05) and less likely to have esophageal dilation (62 vs. 82%, P = 0.13), none with greater than 5-cm diameter. Contractile vigor was greater with opiate use, with distal contractile integral of 7149 versus 2615.5 mmHg/cm/second (P = 0.08). Treatment response was inferior on opiates, with persistent symptoms in 22% compared with 3% without opiates (P = 0.06). Opiate use is common in type 3 achalasia, with the majority of patients on opiates. No patients on opiates were diagnosed with type 1 achalasia. Manometric findings of type 3 achalasia mimic those induced by opiates, suggesting a physiologic mechanism for opiate induced type 3 achalasia. Treatment outcome is inferior with opiates, with opiate cessation perhaps preferable. Further studies assessing opiate use and achalasia are needed.
journal_name
Dis Esophagusjournal_title
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagusauthors
Ravi K,Murray JA,Geno DM,Katzka DAdoi
10.1111/dote.12291subject
Has Abstractpub_date
2016-01-01 00:00:00pages
15-21issue
1eissn
1120-8694issn
1442-2050journal_volume
29pub_type
杂志文章abstract::In a prior study, baseline mutational load (ML) predicted progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in Barrett's esophagus (BE) with an area under the curve (AUC) of 0.95. We aimed to validate the test characteristics of this predictive biomarker panel using crude DNA lysates in a la...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doy026
更新日期:2018-11-01 00:00:00
abstract::Until now, it is uncertain if the so-called pH-only reflux episodes that consist of a pH drop without evidence of retrograde bolus movement in multichannel intraluminal impedance (MII) represent reflux episodes or artifacts. Hiatal hernia (HH) may allow reflux of small volumes to occur that can be detected by pH-metry...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2012.01379.x
更新日期:2013-07-01 00:00:00
abstract::The laparoscopic Heller-Dor operation has been the procedure of choice for the treatment of achalasia. However, because the incidence of achalasia is low, reports on the outcome of surgical treatment for achalasia are limited. In this study, the therapeutic results after laparoscopic Heller-Dor operation for achalasia...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2008.00891.x
更新日期:2009-01-01 00:00:00
abstract::The aim of this study was to evaluate the effectiveness of floppy Nissen fundoplication with intraoperative esophageal manometry. Between February 1992 and July 2004, there were 102 patients with sliding hiatal hernia undergoing transabdominal Nissen fundoplication. They were divided into three groups: 27 patients wer...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2007.00777.x
更新日期:2008-01-01 00:00:00
abstract::The increasing incidence of adenocarcinoma of the lower esophagus and cardia arising in Barrett's metaplastic epithelium continues to be of great concern because medical and surgical efforts to reverse the process have been disappointing. A potential answer to the problem is removal of the metaplastic epithelium. Mode...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type:
doi:10.1093/dote/11.1.1
更新日期:2017-11-01 00:00:00
abstract::Day-case esophageal surgery has been demonstrated to be safe in small prospective cohorts and only for laparoscopic fundoplication. The aims of this study are to assess the feasibility and safety of a large series of esophageal day-case surgeries, including laparoscopic Nissen fundoplication (LNF), Zenker diverticulec...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/dow036
更新日期:2017-04-01 00:00:00
abstract::SUMMARY. We present a case of a 20-year-old, previously healthy, male student who presented with dysphagia secondary to mechanical esophageal obstruction that resolved spontaneously. Although our patient did not have 'classic' patient characteristics, we believe that the clinical evidence supports the conclusion that ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2005.00462.x
更新日期:2005-01-01 00:00:00
abstract::Small-cell carcinoma of the esophagus is a rare and aggressive tumor with early widespread dissemination. In this retrospective study, we report clinical outcomes of limited-disease small-cell carcinoma of the esophagus from the analysis of nine patients. Between 2003 and 2006, nine consecutive patients with small-cel...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2008.00863.x
更新日期:2009-01-01 00:00:00
abstract::Surgically induced duodenal reflux results in cancer development in the rat esophagus. One proposed mechanism of carcinogenesis relies on the production of carcinogens in the presence of bacterial overgrowth. Against this background, intestinal microflora in the rat jejunum was analyzed before and after reflux-inducin...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.2000.00023.x
更新日期:2000-01-01 00:00:00
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journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12227
更新日期:2015-07-01 00:00:00
abstract::The survival advantage associated with the addition of surgical therapy in esophageal squamous cell carcinoma (ESCC) patients who demonstrate a complete clinical response to chemoradiotherapy is unclear, and many institutions have adopted an organ-preserving strategy of selective surgery in this population. We sought ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doz067
更新日期:2020-03-16 00:00:00
abstract::Several esophageal resection techniques have been reported in literature. The objective of this study is to assess postoperative and oncological outcomes of two-stage minimally invasive esophagectomy (MIE) in a prone position using thoracoscopic hand-sewn anastomosis. Consecutive patients who underwent two-stage MIE i...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/dox150
更新日期:2018-03-01 00:00:00
abstract::Despite symptom improvement offered to achalasia patients by either pneumatic dilation or surgical myotomy, 10% to 15% of those so treated will present progressive deterioration of their esophageal function and up to 5% may eventually require an esophagectomy. The natural evolution of achalasia to its end stage as wel...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/j.1442-2050.2010.01157.x
更新日期:2012-05-01 00:00:00
abstract::In a series of 378 patients with esophageal carcinoma, 43 patients with head and neck carcinoma were divided into two groups: 30 patients without symptoms whose esophageal or head and neck second primary carcinomas were incidentally detected by an endoscopic examination for the second carcinoma (group 1) and 13 patien...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.1999.00045.x
更新日期:1999-01-01 00:00:00
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journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12345
更新日期:2016-07-01 00:00:00
abstract::Interferon (IFN)-β has efficient antitumor effect both in vitro and in vivo, but its clinical implication is limited by short half-life and systemic toxicities. Gene therapy could be the choice to avoid the defects. Adenovirus vector containing human IFN-β gene was transfected into esophageal squamous cell carcinoma K...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12081
更新日期:2014-02-01 00:00:00
abstract::Biological plausibility and evidence from case series indicate that an increased body mass index could be a risk factor for Barrett's esophagus. The aim of this study was to assemble and appraise the available evidence on the association of body mass index and Barrett's esophagus in a narrative approach. A systematic ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/j.1442-2050.2009.00967.x
更新日期:2009-01-01 00:00:00
abstract::Neoadjuvant chemoradiotherapy (CRT) was expected to improve surgical curability and prognosis for advanced esophageal cancer. However, the clinical efficacy of neoadjuvant CRT followed by esophagectomy with three-field lymphadenectomy (3FL) for initially resectable esophageal squamous cell carcinoma (SCC) remains uncl...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
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更新日期:2005-01-01 00:00:00
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journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2004.00383.x
更新日期:2004-01-01 00:00:00
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journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 临床试验,杂志文章
doi:10.1111/j.1442-2050.2007.00646.x
更新日期:2007-01-01 00:00:00
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journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2001.00179.x
更新日期:2001-01-01 00:00:00
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journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doz022
更新日期:2019-08-01 00:00:00
abstract::Esophagectomy is an extensive procedure with severe postoperative effects. It can be assumed that the greater the trauma, the longer the nutritional recovery. This retrospective observational single-center cohort study compared weight development after esophagectomy with open and minimally invasive techniques. Three g...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doy075
更新日期:2019-04-01 00:00:00
abstract::Our experience with videolaparoscopic operations for hiatus hernia and achalasia, which have almost replaced classical procedures, enabled us to use the same technique for other interventions in the distal third of the thoracic esophagus. Thus, we were able to treat epiphrenic diverticulum using a minimally invasive a...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.2002.00275.x
更新日期:2002-01-01 00:00:00
abstract::Modern treatment of esophageal cancer is multimodal and highly dependent on a detailed diagnostic assessment of clinical stage, which includes nodal stage. Clinical appraisal of nodal stage is highly dependent on knowledge of normal radiological appearance, information of which is scarce. We aimed to describe lymph no...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
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更新日期:2019-12-13 00:00:00
abstract::Self-expanding metal stents (SEMS) are the treatment of choice for advanced esophageal cancers. Literature is scarce on risk factors predictors for adverse events after SEMS placement. Assess risk factors for adverse events after SEMS placement in advanced esophageal cancer and evaluate survival after SEMS placement. ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
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更新日期:2017-02-01 00:00:00
abstract::Barrett's esophagus (BE), a premalignant condition for the development of esophageal adenocarcinoma (EAC), is a consequence of chronic gastroesophageal reflux disease (GERD). Although the incidence of EAC is increasing, a similar trend for BE is not clear. We aimed to evaluate the prevalence of newly diagnosed BE over...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doaa131
更新日期:2021-01-16 00:00:00
abstract:SUMMARY:The aim of our retrospective study was to determine the incidence of benign anastomotic strictures (BAS) in patients after esophageal resection and to examine the influence of the extent of BAS on the results of bougienage therapy. From January 2001 to July 2006, 79 patients at risk of BAS development were incl...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2008.00819.x
更新日期:2008-01-01 00:00:00
abstract::We examined the value of impedance monitoring in measuring bolus volume compared with videoesophagram. Eighty consecutive subjects were studied with simultaneous impedance-manometry-videoesophagram. A catheter with both an impedance electrode pair and a pressure transducer at four sites (5, 10, 15, 20 cm above lower e...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2011.01302.x
更新日期:2012-09-01 00:00:00
abstract::Benign esophagorespiratory fistula is a relatively rare condition in adults that poses a technical challenge to manage. This case series describes our experience in the treatment of benign esophagorespiratory fistula in 12 adults. A retrospective review of case records of 12 patients with benign esophagorespiratory fi...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2012.01347.x
更新日期:2013-02-01 00:00:00