scholarly journals Cervical inlet patch: new insights into diagnosis and endoscopic therapy

2017 ◽  
Vol 9 (3) ◽  
pp. 214-220 ◽  
Author(s):  
Radu Rusu ◽  
Sauid Ishaq ◽  
Terry Wong ◽  
Jason M Dunn

The cervical inlet patch is an island of heterotopic gastric mucosa, most commonly found in the proximal oesophagus. Its importance as a cause of throat symptoms has been recognised, particularly chronic globus sensation. This has led to a change in the Rome IV criteria for globus management, with emphasis on ruling out the condition. Proton pump inhibitors are often ineffective in resolving symptoms. Endoscopic studies on the use of ablative techniques, most recently radiofrequency ablation (RFA), have shown promise in reversing the CIP to mormal squamous mucosa, with subsequent symtpomatic resolution.The aim of this review is to update on the investigation and management of the CIP.

2017 ◽  
Vol 30 (2) ◽  
pp. 212-218 ◽  
Author(s):  
Ivan Kristo ◽  
Erwin Rieder ◽  
Matthias Paireder ◽  
Katrin Schwameis ◽  
Gerd Jomrich ◽  
...  

Author(s):  
V.V. Parkhomenko ◽  
І.М. Skrypnyk ◽  
І.І. Starchenko ◽  
O.F. Gopko

The non-steroidal anti-inflammatory drugs (NSAIDs) in general clinical practice can provoke the development of NSAID-induced gastropathy, which can be complicated by bleeding. The aim of this article was to evaluate the effect of eupatilin on histological changes of the gastric mucosa in patients with NSAID-induced gastropathy and concomitant ischemic heart disease depending on the association with Helicobacter pylori. The study included 125 patients with NSAID-gastropathy and concomitant stable ischemic heart disease I-II functional class. Patients were divided into two groups: I (n=82) included individuals with NSAID-gastropathy, which was not associated with H. pylori, while II (n=43) included individuals with H. pylori-induced gastropathy. Depending on the prescribed treatment complexes, patients were subdivided as follows: I-A (n=44) included patients, who took proton pump inhibitors in standard doses and II-A group (n=23) included patients, who received antihelicobacter therapy according to Maastricht V (2016) guidelines. Patients of groups I-B (n=38) and II-B (n=20) were additionally prescribed 60 mg of eupatilin (1 tablet) 3 times a day for 28 days. The upper endoscopy with the gastric mucosa biopsy, followed by histological examination was done at the beginning of treatment and in 45±2 days. The severity of gastric mucosa erosive and ulcerative injury was assessed endoscopically using a modified Lanzascore scale; morphological changes were evaluated by a semi-quantitative method on a visual-analogue scale. H. pylori is an independent and significant factor determining the severity of endoscopic and morphological changes in NSAID-gastropathy patients with concomitant ischemic heart disease. Acid-suppressive and antihelicobacter therapy can reduce the intensity of the structural injury of the gastric mucosa, but the identified changes substantiate the feasibility of long-term proton pump inhibitors prescribed to the patients with NSAID-gastropathy. Prescribing eupatilin against the background of basic therapy can significantly reduce the severity of erosive-ulcerative gastric mucosa injury assessed by Lanzascore scale while histomorphological parameters by reducing the activity of neutrophilic inflammation, protective effect on mucosal barrier resistance and microcirculatory condition.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yue Yin ◽  
Hongyu Li ◽  
Ji Feng ◽  
Kexin Zheng ◽  
Eric Yoshida ◽  
...  

BMJ ◽  
2019 ◽  
pp. l536 ◽  
Author(s):  
Adrian J Stanley ◽  
Loren Laine

Abstract Upper gastrointestinal bleeding (UGIB) is a common medical emergency, with a reported mortality of 2-10%. Patients identified as being at very low risk of either needing an intervention or death can be managed as outpatients. For all other patients, intravenous fluids as needed for resuscitation and red cell transfusion at a hemoglobin threshold of 70-80 g/L are recommended. After resuscitation is initiated, proton pump inhibitors (PPIs) and the prokinetic agent erythromycin may be administered, with antibiotics and vasoactive drugs recommended in patients who have cirrhosis. Endoscopy should be undertaken within 24 hours, with earlier endoscopy considered after resuscitation in patients at high risk, such as those with hemodynamic instability. Endoscopic treatment is used for variceal bleeding (for example, ligation for esophageal varices and tissue glue for gastric varices) and for high risk non-variceal bleeding (for example, injection, thermal probes, or clips for lesions with active bleeding or non-bleeding visible vessel). Patients who require endoscopic therapy for ulcer bleeding should receive high dose proton pump inhibitors after endoscopy, whereas those who have variceal bleeding should continue taking antibiotics and vasoactive drugs. Recurrent ulcer bleeding is treated with repeat endoscopic therapy, with subsequent bleeding managed by interventional radiology or surgery. Recurrent variceal bleeding is generally treated with transjugular intrahepatic portosystemic shunt. In patients who require antithrombotic agents, outcomes appear to be better when these drugs are reintroduced early.


2004 ◽  
Vol 126 (4) ◽  
pp. 1207-1209
Author(s):  
Sreenivasa S. Jonnalagadda ◽  
Aaron Shiels ◽  
Ray E. Clouse

1999 ◽  
Vol 94 (10) ◽  
pp. 3047-3050 ◽  
Author(s):  
Andrés Sánchez-Pernaute ◽  
Florentino Hernando ◽  
Luis Díez-Valladares ◽  
Oscar González ◽  
Elia Pérez Aguirre ◽  
...  

2001 ◽  
Vol 120 (5) ◽  
pp. A156-A156
Author(s):  
I PUSCAS ◽  
L GILAU ◽  
M COLTAU ◽  
A MAGHIAR ◽  
G DOMUTA ◽  
...  

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