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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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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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Barrett Esophagus-II: Clinical Manifestations and Management01:21

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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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Barrett Esophagus-I: Introduction01:21

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Esophageal Strictures-II: Clinical Features and Management01:26

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Upper GI Series: Barium Swallow01:24

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The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
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Related Experiment Video

Updated: Jul 2, 2025

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
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Why so Many Patients With Dysphagia Have Normal Esophageal Function Testing.

Ravinder K Mittal1, Ali Zifan1

  • 1Division of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, California.

Gastro Hep Advances
|February 29, 2024
PubMed
Summary

Esophageal peristalsis involves relaxation and contraction. In dysphagia patients, narrow lumens and reduced esophageal distensibility impede bolus flow, causing discomfort.

Keywords:
Distension Contration PlotDysphagiaEsophageal PeristalsisFunctional Dysphagia

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Area of Science:

  • Gastroenterology
  • Esophageal Motility Disorders
  • Physiology

Background:

  • Esophageal peristalsis is a coordinated relaxation and contraction process essential for bolus transport.
  • Normal peristalsis is influenced by bolus properties and posture, indicating distension-contraction interactions.
  • Dysphagia is often associated with esophageal motility disorders, but the underlying mechanisms require further elucidation.

Purpose of the Study:

  • To investigate the relationship between esophageal luminal distension and peristaltic contractions in dysphagia patients.
  • To identify unique distension-contraction patterns in various esophageal motility disorders.
  • To explore the role of dynamic obstruction and reduced esophageal distensibility in dysphagia.

Main Methods:

  • Analysis of distension-contraction plots in patients with dysphagia, including achalasia, high-amplitude contractions, esophagogastric junction outflow obstruction, and functional dysphagia.
  • Assessment of luminal occlusion, esophageal lumen diameter, and bolus transit during peristalsis.
  • Objective evaluation of flow timing and esophageal wall distensibility.

Main Results:

  • Patients with type 3 achalasia and nonobstructive dysphagia exhibited luminal occlusion distal to the bolus.
  • Patients with high-amplitude contractions, EGJOTO, and functional dysphagia showed a narrowed esophageal lumen during peristalsis.
  • Findings suggest relative dynamic obstruction and reduced esophageal distensibility in these conditions.

Conclusions:

  • Dysphagia in these patients may stem from forceful contractions encountering resistance due to a narrowed lumen and reduced distensibility.
  • Current classification of esophageal motility disorders, based solely on contraction, is complemented by assessing distension and distensibility.
  • Understanding esophageal segment distensibility during peristalsis can guide novel therapeutic strategies for dysphagia.