Uncomplicate regurgitation in otherwise healthy infants is not a disease. It consists of milk flow from mouth during or after feeding. Common causes include overfeeding, air swallowed during feeding, crying or coughing; physical exam is normal and weight gain is adequate. History and physical exam are diagnostic, and conservative therapy is recommended. Pathologic gastroesophageal reflux or gas...

44 INTRODUCTION T he most common cause of gastroesophageal reflux disease (GERD) is lower esophageal sphincter (LES) dysfunction. The LES is a 3–4 cm high-pressure zone of muscular activity in the distal esophagus. The LES is anatomically and histologically distinct from the esophageal body. Manometric and radiographic studies can be used to identify the LES. Intraluminal manometry can detect t...

Introduction: Boerhaave syndrome (BS) is a spontaneous perforation of the esophagus which depends on increased intra-esophageal pressure, while the upper sphincter is closed during excessive vomiting. Case: A 75-year-old man was referred to hospital with sudden chest pain after vomiting. A computed chest tomography demonstrated mediastinal emphysema, thickening of the wall at the esophago-gastr...

Achalasia cardia, a primary esophageal motility disorder of unknown etiology involving lower twothird of esophagus and lower esophageal sphincter (LES), can be specifically diagnosed by gold standard method, manometry, which shows abnormal LES relaxation and absent or vigorous peristalsis. In our study, 125 patients were admitted with dysphagia, regurgitation of food, vomiting, chest pain, retr...

The high incidence of dysphagia in patients with symptomatic gastroesophageal reflux (GER) but no evidence of peptic stricture suggests esophageal motor dysfunction. Conventional methods for detecting dysfunction (radiologic and manometric examinations) often fail to detect abnormality in these patients. Radionuclide transit (RT), a new method for detecting esophageal motor dysfunction, was use...

BACKGROUND Three ghrelin gene-derived peptides, acyl ghrelin, des-acyl ghrelin and obestatin, are implicated in the regulation of feeding, adipogenesis and glucose metabolism, as well as gut motility. The effects of ghrelin gene-derived peptides on lower esophageal sphincter motility, however, were unknown. METHODS We investigated the influence of acyl ghrelin, des-acyl ghrelin and obestatin ...

CONTEXT Achalasia is a primary esophageal motor disorder secondary to the degeneration of ganglion cells of the inhibitory intramural myenteric plexus. It affects both sexes similarly and has two peaks of incidence, one in the 3rd to 4th decades of life and the other after 60 years of age. The effect of age on esophageal motility of patients with achalasia is not well known. Studies have shown ...

BACKGROUND & AIMS Sildenafil shows an intense and prolonged inhibitory effect on the smooth muscle cells of the human corpus cavernosum by blocking phosphodiesterase type 5 that destroys nitric oxide-stimulated cyclic guanosine monophosphate. We investigated if sildenafil possesses a similar effect on the esophageal musculature of patients with achalasia, where there is an impairment of nitric ...

Botulinum toxin injection is an accepted treatment modality for esophageal achalasia in western countries. This pilot study aimed to clarify the effectiveness of botulinum toxin injection for esophageal achalasia in Japanese patients. We enrolled 10 patients diagnosed with esophageal achalasia between 2008 and 2014. A total of 100 U botulinum toxin A was divided into eight aliquots and injected...