By M. Vaezi

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Extra resources for Esophageal Diseases: An Atlas of Investigation and Management

Sample text

Like ischemic chest pain, it may be relieved by nitroglycerin. Esophageal chest pain is classically non-exertional, and can be spontaneous, post-prandial, or occur at night. Symptoms may last for minutes to hours. It is often associated with other esophageal symptoms, such as heartburn, regurgitation, and dysphagia. If thought to be non-cardiac, this chest pain is often secondary to an abnormal visceral nociception, an esophageal motor disorder, or GERD. Respiratory Multiple respiratory symptoms, such as asthma, bronchitis, and cough, have been associated with GERD.

It is not uncommon to have recurrent symptoms requiring repeat dilation. Acid suppressive therapy may be used considering the possible association with GERD. 27 An endoscopic view of a Schatzki’s ring, depicting a significant narrowing of the esophageal lumen (A: esophageal view (arrows); B: retroflex gastric view). Endoscopists may use air insufflation to identify these rings better during the examination. 25). This ring is composed of hypertrophic bands of circular muscle, covered with normal squamous epithelium.

8 Multi-channel intraluminal impedance-pH normal values (number of reflux events) Total Acid Weak acid Non-acid Acid re-reflux Distal Total Upright Recumbent 73 67 7 55 52 5 26 24 4 1 1 0 4 4 1 Proximal Total Upright Recumbent 31 29 3 28 25 2 12 11 1 1 1 0 2 2 0 (Shay et al. (2000). 50 MII-pH tracing of acid, non-acid, and gas reflux. Gastroesophageal reflux is shown by retrograde pattern of the impedance recording. The proximal extent of the refluxate can also be determined by the most proximal impedance-measuring segment that detects the refluxate.

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