Biomedical subjects

Kenneth R DeVault

Publications and source records attributed to Kenneth R DeVault.

22 records · Page 2Linked to original sources

PubMed2003

Extraesophageal symptoms of GERD.

Gastroesophageal reflux disease (GERD) can be the primary cause of, or an aggravating contributor to, a wide variety of conditions affecting extraesophageal structures. As a result, GERD can lead to a number of pulmonary symptoms and diseases, otolaryngologic findings and symptoms, and other extraesophageal manifestations, including dental erosions. Clinicians must be aware of the possibility of these extraesophageal reflux-related conditions, even in the absence of classic esophageal symptoms of GERD. While antireflux therapy is often helpful, response to treatment is less predictable than it is for typical GERD.

Adult↗

PubMed2002

Presbyesophagus: a reappraisal.

The gastrointestinal tract undergoes change with aging, and the esophagus is not exempt from those changes. Failure of peristalsis in the older esophagus was labeled "presbyesophagus" over 35 years ago. Modern manometric techniques and classification systems have challenged this concept, yet there are clearly age-related changes in the esophagus. The lower esophageal sphincter changes little. Esophageal peristalsis (body) is more likely to fail in older patients, but some of this failure may be caused by damage from gastroesophageal reflux disease. The pharynx and upper esophageal sphincter also undergo age-related changes in health and disease. The ability to sense events in the esophagus fails with aging, which may cause patients with severe mucosal disease to present with less severe symptoms. Failure of the esophagus thus does not appear to be an inevitable consequence of aging, but the esophagues does undergo change with aging, and these changes should be considered in evaluation of older patients with esophageal complaints.

Aging↗

PubMed2002

Esophageal sarcoidosis: an unusual diagnosis.

We report a 48-year-old patient who developed secondary achalasia because of esophageal sarcoidosis. Sarcoidosis can involve many gastrointestinal tract organs and can affect the esophagus in different ways. We describe how achalasia was diagnosed and treated in our patient and provide a review of the presentations of esophageal sarcoidosis.

Diagnosis, Differential↗

PubMedDate not supplied

Outcome of laparoscopic antireflux surgery in patients with nonerosive reflux disease.

As many as 50% of patients with gastroesophageal reflux disease (GERD) have no endoscopic evidence of esophagitis (EGD negative). Laparoscopic antireflux surgery (LARS) provides effective symptomatic and endoscopic healing in patients with erosive GERD (EGD positive). The surgical outcome of patients undergoing LARS for EGD-negative GERD has not received wide attention. The objective of this study was to compare surgical outcomes between EGD-negative and EGD-positive patients. During the period from June 1996 to September 1998, all patients undergoing LARS for persistent GERD symptoms despite medical therapy, who were EGD-negative, were invited to respond to a questionnaire regarding their clinical status before and after LARS. To perform a comparative analysis, the same questions were posed to a randomly selected equal number of EGD-positive patients who underwent surgery during the same study period. LARS was performed in 255 patients during the study period; 59 patients (23%) had EGD-negative GERD, and 148 (58%) were EGD-positive. Forty-eight patients (19%) did not meet the entry criteria and were excluded from analysis. LARS provided effective symptomatic relief in patients with EGD-negative and EGD-positive GERD. There were no significant differences in patient satisfaction or symptom improvement between the two groups (P = 0.82). The surgical outcome of EGD-negative patients is similar to the outcome for patients with erosive esophagitis. LARS is a valuable treatment option for patients with persistent GERD symptoms regardless of the endoscopic appearance of the esophageal mucosa.

Adult↗