Oesophageal Sphincters: Upper Oesophageal Sphincter and Lower Oesophageal Sphincter

2020 ◽  
pp. 7-9
Author(s):  
Hwee Ming Cheng ◽  
Kin Kheong Mah ◽  
Kumar Seluakumaran
Keyword(s):  
Lower Oesophageal Sphincter ◽  
Upper Oesophageal Sphincter

Tetra-probe, 24-hour pH monitoring for laryngopharyngeal reflux: a technique for simultaneous study of hypopharynx, oesophagus and stomach

2009 ◽  
Vol 123 (S31) ◽  
pp. 117-122 ◽  
Author(s):  
K Sato ◽  
H Umeno ◽  
S Chitose ◽  
T Nakashima
Keyword(s):  
Gastric Acid ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Lower Oesophageal Sphincter ◽  
The Third ◽  
Monitoring Technique ◽  
Laryngopharyngeal Reflux Disease ◽  
Upper Oesophageal Sphincter ◽  
Simultaneous Study ◽  
Functional Examination

AbstractObjective:This study aimed to introduce the technique of tetra-probe, 24-hour pH monitoring for laryngopharyngeal reflux disease.Methods:Tetra-probe, 24-hour pH monitoring was performed for 30 suspected cases of laryngopharyngeal reflux. The proximal probe was placed in the hypopharynx, just above the upper oesophageal sphincter, the second probe was placed in the middle oesophagus, the third probe was placed a few centimetres above the lower oesophageal sphincter, and the distal probe was placed in the stomach.Results:As the pH at the four sensor sites could be monitored simultaneously, gastric acid levels and gastroesophageal and laryngopharyngeal reflux could be examined. This pH monitoring technique enabled the pH relationship between the four sensor locations to be well documented, enabling gastric acid levels and patterns of reflux to be assessed. This procedure was also able to be used as a functional examination to evaluate anti-reflux medication efficacy.Conclusions:Tetra-probe, 24-hour pH monitoring is a reliable functional examination for laryngopharyngeal reflux.

scholarly journals A Bitter Pill to Swallow: Pseudoachalasia Secondary to Oesophageal Deviation Resulting from Mediastinal Shift and Left Atrial Enlargement after Left Lower Lobectomy

2020 ◽  
Vol 14 (3) ◽  
pp. 652-657
Author(s):  
Magali M.V.P. Surmont ◽  
Maridi Aerts ◽  
Rastislav Kunda ◽  
Sébastien Kindt
Keyword(s):  
Left Atrial ◽  
Mass Effect ◽  
Lower Oesophageal Sphincter ◽  
Left Atrial Enlargement ◽  
High Resolution Manometry ◽  
Lower Lobectomy ◽  
First Case ◽  
Idiopathic Achalasia ◽  
Mediastinal Shift ◽  
Atrial Enlargement

Pseudoachalasia, also known as secondary achalasia, is a rare clinical condition mimicking idiopathic achalasia but unrelated to primary loss of nitrergic innervation. It has mostly been attributed to malignancy infiltrating the oesophageal wall, but several other benign underlying pathologies have been reported. Because of similar manometric appearance, high-resolution manometry (HRM) of the oesophagus alone cannot distinguish between idiopathic achalasia and pseudoachalasia. Misdiagnosis can result in ineffective treatment by dilatation or even more invasive therapy. This is the first case-report of pseudoachalasia secondary to oesophageal deviation resulting from mediastinal shift and left atrial enlargement following prior left lower lobectomy. HRM, the gold standard for the diagnosis of achalasia, confirmed the incomplete relaxation of the lower oesophageal sphincter (LES) in absence of normal oesophageal peristalsis. However, additional workup with CAT scan and cardiac ultrasound identified an anatomical shift by the extrinsic mass effect resulting from the atrial enlargement, but without contrast retention at the LES.

scholarly journals Laparoscopic hand-sewn cardioplasty: an alternative procedure for end-stage achalasia

2021 ◽  
Author(s):  
Fátima Senra ◽  
Lalin Navaratne ◽  
Asunción Acosta-Mérida ◽  
Stuart Gould ◽  
Alberto Martínez-Isla
Keyword(s):  
Assessment Tool ◽  
Case Series ◽  
Invasive Procedure ◽  
Lower Oesophageal Sphincter ◽  
Poor Quality ◽  
Motor Disorder ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
End Stage ◽  
Rescue Procedure

Abstract Background Primary achalasia is a rare oesophageal motor disorder characterized by the absence of swallow-induced relaxation of the lower oesophageal sphincter and diminished or absent oesophageal body peristalsis. Around 5% of these patients will develop end-stage achalasia, where oesophagectomy may be advocated. We present the laparoscopic hand-sewn cardioplasty as an alternative ‘oesophagus-preserving’ procedure in patients with end-stage achalasia. Methods We present a retrospective review of four patients who underwent laparoscopic hand-sewn cardioplasty. Data collected included pre-operative demographic information and investigations; and post-operative outcomes. Patients were scored pre- and post-operatively using Reflux Symptom Index, Eating Assessment Tool-10 and Voice Handicap Index-10 questionnaires. Results Four patients underwent laparoscopic hand-sewn cardioplasty during the study period. In one patient, it was performed as a rescue procedure during attempted myotomy following multiple perforations of friable mucosa. In the other three patients, laparoscopic hand-sewn cardioplasty was performed for end-stage achalasia. None of the patients had post-operative complications and all patients were discharged on the second post-operative day. All patients experienced improvement in swallowing symptoms (EAT-10; p = 0.03) but developed post-operative gastroesophageal reflux. Conclusion To our knowledge, this is the first published case series of laparoscopic hand-sewn cardioplasty for end-stage achalasia. It appears to be a safe and effective procedure for the treatment of end-stage achalasia, offering an alternative minimally invasive procedure to oesophagectomy. Laparoscopic hand-sewn cardioplasty can also be used as a ‘rescue’ procedure during myotomy in patients who have poor-quality mucosa which perforates intra-operatively or is at high risk of perforation/leaking post-operatively.

scholarly journals Effect of cigarette smoking on the lower oesophageal sphincter.

Gut ◽  
1977 ◽  
Vol 18 (10) ◽  
pp. 833-835 ◽  
Author(s):  
D K Chattopadhyay ◽  
M G Greaney ◽  
T T Irvin
Keyword(s):  
Cigarette Smoking ◽  
Lower Oesophageal Sphincter

scholarly journals Cholecystokinin and transient lower oesophageal sphincter relaxation.

Gut ◽  
1995 ◽  
Vol 37 (2) ◽  
pp. 298-298 ◽  
Author(s):  
J Fioramonti ◽  
J Bueno ◽  
J Boulant ◽  
M Dapoigny ◽  
G Bommelaer
Keyword(s):  
Lower Oesophageal Sphincter

Flunitrazepam Increases and Diazepam Decreases the Lower Oesophageal Sphincter Tone When Administered Intravenously

1983 ◽  
Vol 27 (3) ◽  
pp. 140
Author(s):  
J. RUBIN ◽  
J. G. BROCK-UTNE ◽  
G. E. DIMOPOULOS ◽  
J. W. DOWNING ◽  
M. G. MOSHAL
Keyword(s):  
Lower Oesophageal Sphincter ◽  
Sphincter Tone

Effect of Lower Oesophageal Sphincter on Oesophageal Varices

1981 ◽  
Vol 16 (7) ◽  
pp. 957-960 ◽  
Author(s):  
J. Miskowiak ◽  
F. Burcharth ◽  
L. I. Jensen
Keyword(s):  
Lower Oesophageal Sphincter ◽  
Oesophageal Varices

scholarly journals 24-Hour Measurement of Gastric pH in Rural South Africa

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Alastair M. Sammon ◽  
Eugene J. Ndebia ◽  
Ekambaram Umapathy ◽  
Jehu E. Iputo
Keyword(s):  
South Africa ◽  
Ambulatory Monitoring ◽  
Duodenogastric Reflux ◽  
Lower Oesophageal Sphincter ◽  
Gastric Ph ◽  
Night Time ◽  
High Incidence ◽  
The Mean ◽  
H Pylori ◽  
High Level

Background. Previous studies have established norms of 24-hour gastric pH profiles for western countries. This study was designed to establish the pattern for a rural African population with a high incidence of oesophageal cancer.Methods. After lower oesophageal manometry a probe was placed 10 cm distal to the lower oesophageal sphincter. We carried out 24-hour ambulatory monitoring of gastric pH on 59 healthy subjects. This was satisfactorily completed on 26 female and 18 male (age 21–64, median 35) subjects in the Transkei region of South Africa.Results. The mean 24 hour gastric pH was 2.84 and the mean night-time pH was 3.7. 40 volunteers recorded a night-time pH reaching over 4. 33 volunteers recorded a night-time pH over 7. Night-time alkalinisation was present for 136.4 minutes (25th centile 22.8, 75th centile 208.1) at pH4 or over, and 79.3 (2.5, 122.7) minutes at pH7 or over. Episodes of rapid alkaline rise were 17 (10, 47). 21.1% of these occurred while supine. 35 of 36 tested subjects were positive forH. pyloriIgG.Conclusion. Gastric alkalinisation is common in Transkei, at a higher pH than that reported in other studies, and is sustained longer. Nighttime alkalinisation is frequent. This suggests a high level of duodenogastric reflux.

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