The efficacy of balloon dilation in achalasia is the result of stretching of the lower esophageal sphincter, not muscular disruption

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
F Borhan-ManeshA R Taghavi

Abstract

Pneumatic dilation (PD) of the lower esophageal sphincter (LES) in achalasia is a major palliative treatment. It is generally believed, although never substantiated, that therapeutic efficacy of ballooning in achalasia is the result of the disruption and tearing of the muscular layers of the LES. To clarify this issue, we investigated the frequency of muscular disruption at the LES, 24 hours after PD, by employing the endoscopic ultrasound (EUS), in a group of 43 consented patients with achalasia. Between July 2009 and March2012, 51 consecutive adult patients with tentative diagnosis of achalasia, some with recurrence of symptoms after an earlier treatment with balloon dilation, were evaluated and underwent PD, using Rigiflex balloon without major adverse effect. Out of the 51 evaluated, 43 eligible and consenting patients who underwent EUS, 24 hours after PD, using Olympus GF-UE 160 echoendoscope and an Aloka Prosound probe at 7.5 MHZ, are the subjects of this study. The EUS in 43 eligible patients revealed an intact LES in 36 (83.7%), small area of muscular disruption in 5 (11.6%) and small hematoma in 2 patients (4.6%). Our data convincingly demonstrate that the clinical effectiveness of balloon dilation in achalasia is not ...Continue Reading

References

Nov 1, 1983·Gut·G Vantrappen, J Janssens
Nov 1, 1983·Gut·I W FellowsM Atkinson
May 1, 1996·Gastroenterology·P J PasrichaA N Kalloo
Aug 26, 1998·JAMA : the Journal of the American Medical Association·A E Spiess, P J Kahrilas
Jun 3, 2005·The American Journal of Gastroenterology·Woosuk Park, Michael F Vaezi
Jul 21, 2005·Scandinavian Journal of Gastroenterology·Ines GockelTheodor Junginger
Aug 22, 2006·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·N Pehlivanov, P J Pasricha
Nov 9, 2006·JAMA : the Journal of the American Medical Association·Steven R Lopushinsky, David R Urbach
Dec 19, 2006·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ines GockelVolker F Eckardt
Aug 4, 2010·Journal of Neurogastroenterology and Motility·Joel E Richter
May 13, 2011·The New England Journal of Medicine·Stuart Jon Spechler
Jul 24, 2013·The American Journal of Gastroenterology·Michael F VaeziMarcelo F Vela

❮ Previous
Next ❯

Citations

Sep 2, 2016·The American Journal of Gastroenterology·Joel E RichterAmbuj Kumar
Jan 31, 2019·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Froukje B van HoeijArjan J Bredenoord
Nov 13, 2019·BMC Gastroenterology·Abid T JavedDonald O Castell

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsy
sedation

Software Mentioned

SPSS

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology
Katsuhiko IwakiriChoitsu Sakamoto
Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
Kareem HarishVarghese Thomas
© 2021 Meta ULC. All rights reserved