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Related Concept Videos

Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
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Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
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Endoscopic Procedures V: ERCP01:26

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Gastric Motility01:16

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Gastric motility is the coordinated contraction and relaxation of stomach muscles that convert ingested food into chyme, a semi-liquid substance ready for further digestion in the intestines. The process begins with the vagus nerve inducing the relaxation of the smooth muscles in the fundus and body of the stomach, allowing these regions to expand and accommodate up to approximately 1.5 liters of food and liquid.
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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:

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Robotic Myotomy and Partial Fundoplication for Achalasia
11:19

Robotic Myotomy and Partial Fundoplication for Achalasia

Published on: August 11, 2023

Patient-centered measures for achalasia.

Julie L Harnish1, Gail E Darling, Nicholas E Diamant

  • 1Division of Clinical Decision Making, Toronto General Hospital Research Institute, 200 Elizabeth Street, 13-EN-232B, M5G 2C4, Toronto, Ontario, Canada. jharnish@uhnres.utoronto.ca

Surgical Endoscopy
|November 21, 2007
PubMed
Summary

Quality of life in achalasia patients is significantly impaired, with disease-specific measures correlating better with each other than with generic health assessments. Combining both is recommended for comprehensive outcome evaluation.

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Area of Science:

  • Gastroenterology
  • Clinical Outcomes Research
  • Health-Related Quality of Life

Background:

  • Achalasia diagnosis and treatment outcomes require robust health-related quality of life (HRQoL) assessment.
  • Various instruments exist for measuring HRQoL in achalasia patients.

Purpose of the Study:

  • To evaluate and compare different patient-centered measures for assessing achalasia severity and HRQoL.
  • To determine the correlation between disease-specific and generic HRQoL measures in achalasia patients undergoing treatment.

Main Methods:

  • Administered four patient-centered measures: achalasia severity questionnaire, symptom checklist, GIQLI, and SF-36.
  • Collected data from 25 subjects in a randomized controlled trial comparing pneumatic dilatation and laparoscopic Heller myotomy.
  • Estimated correlations between the different HRQoL measures.

Main Results:

  • Baseline scores indicated a substantial burden of impairment across all measures.
  • Achalasia-specific measures (severity questionnaire and symptom checklist) showed high correlation (r=0.65, p=0.004).
  • Achalasia-specific measures correlated moderately with generic physical component scores (PCS) of SF-36 (r=-0.42, p=0.039) but not mental component scores (MCS).

Conclusions:

  • Patients undergoing achalasia treatment exhibit significant impairment in both generic and disease-specific HRQoL.
  • Disease-specific measures correlate well with each other but less so with generic measures, particularly mental health.
  • A combination of disease-specific and generic health measures is recommended for a comprehensive assessment of achalasia patient outcomes.