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Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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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.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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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.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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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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Esophageal Perforation-II: Clinical Manifestations and Management01:28

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

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Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Robotic Myotomy and Partial Fundoplication for Achalasia
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Outcomes in Patients Undergoing Transoral Incisionless Fundoplication With Ineffective Esophageal Motility.

Dhruvanshu Patel1, Zarian Prenatt1, Emilie S Kim1

  • 1Department of Gastroenterology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA, slhn.org.

Gastroenterology Research and Practice
|January 1, 2026
PubMed
Summary

Transoral incisionless fundoplication (TIF) offers significant quality of life improvements for GERD patients with ineffective esophageal motility (IEM). Most patients reduced PPI use after TIF, demonstrating its effectiveness in this challenging population.

Keywords:
gastroesophageal reflux diseaseineffective esophageal motilityproton pump inhibitorstransoral incisionless fundoplication

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Esophageal Motility Disorders

Background:

  • Transoral incisionless fundoplication (TIF) is an established endoscopic treatment for GERD in patients with normal esophageal motility.
  • The efficacy and safety of TIF in patients with ineffective esophageal motility (IEM) are not well-established.
  • This study investigates the outcomes of TIF in patients diagnosed with IEM and refractory GERD.

Purpose of the Study:

  • To evaluate the effectiveness of TIF in improving quality of life for patients with GERD and IEM.
  • To assess changes in proton pump inhibitor (PPI) usage post-TIF in this patient cohort.
  • To determine the risk of dysphagia associated with TIF in patients with IEM.

Main Methods:

  • A retrospective analysis of 164 patients with refractory GERD, including 29 with IEM.
  • Assessment of quality of life using the GERD-HRQL questionnaire.
  • Monitoring of PPI usage before and after TIF.

Main Results:

  • Significant improvements were observed in overall GERD-HRQL scores, as well as heartburn and regurgitation symptoms (p < 0.001).
  • A statistically significant reduction in PPI use was noted post-TIF (p < 0.001).
  • No significant increase in the risk of dysphagia was detected (p < 0.2).

Conclusions:

  • TIF provides durable improvements in quality of life for patients suffering from GERD and IEM.
  • The procedure does not significantly increase the risk of dysphagia.
  • While some patients may require short-term re-initiation of antisecretory medications, TIF effectively reduces long-term PPI dependence for many.