Esophageal Motility Disorders
Sphincter of Oddi
Esophageal Spasm, Diffuse
Esophageal Sphincter, Lower
Esophageal Sphincter, Upper
Esophageal pH Monitoring
Common Bile Duct Diseases
Diagnostic Techniques, Digestive System
Myoelectric Complex, Migrating
Sphincter of Oddi Dysfunction
Technetium Tc 99m Disofenin
Fissure in Ano
Ampulla of Vater
Technetium Tc 99m Lidofenin
Preservation of postural control of transient lower oesophageal sphincter relaxations in patients with reflux oesophagitis. (1/1553)INTRODUCTION: In normal subjects, transient lower oesophageal sphincter relaxations (TLOSRs) and gas reflux during belching are suppressed in the supine position. Supine reflux, however, is a feature of reflux disease. AIMS: To investigate whether postural suppression of TLOSRs and gas reflux is impaired in patients with reflux disease. PATIENTS: Ten patients with erosive oesophagitis. METHODS: Oesophageal manometry was performed during gastric distension with 750 ml carbon dioxide. Measurements were made for 10 minutes before and after distension in both sitting and supine positions. RESULTS: In the sitting position gastric distension substantially increased the rate of gas reflux (median (interquartile range)), as evidenced by increases in oesophageal common cavities from 1 (0-1)/10 min to 7 (5-10)/10 min and TLOSRs from 1 (1-1.5)/10 min to 6 (2.5-8)/10 min. However, this effect was suppressed in the supine position in all but one patient (TLOSRs 0 (0)/10 min to 1 (0-4.5)/10 min, common cavities 0 (0)/10 min to 0.5 (0-2)/10 min). CONCLUSIONS: Postural suppression of TLOSRs and gas reflux is generally preserved in reflux disease. (+info)
The effect of hiatus hernia on gastro-oesophageal junction pressure. (2/1553)BACKGROUND: Hiatus hernia and lower oesophageal sphincter hypotension are often viewed as opposing hypotheses for gastro-oesophageal junction incompetence. AIMS: To examine the interaction between hiatus hernia and lower oesophageal sphincter hypotension. METHODS: In seven normal subjects and seven patients with hiatus hernia, the squamocolumnar junction and intragastric margin of the gastro-oesophageal junction were marked with endoscopically placed clips. Axial and radial characteristics of the gastro-oesophageal junction high pressure zone were mapped relative to the hiatus and clips during concurrent fluoroscopy and manometry. Responses to inspiration and abdominal compression were also analysed. RESULTS: In normal individuals the squamocolumnar junction was 0.5 cm below the hiatus and the gastro-oesophageal junction high pressure zone extended 1.1 cm distal to that. In those with hiatus hernia, the gastro-oesophageal junction high pressure zone had two discrete segments, one proximal to the squamocolumnar junction and one distal, attributable to the extrinsic compression within the hiatal canal. Inspiration and abdominal compression mainly augmented the distal one. Simulation of hernia reduction by algebraically summing the proximal segment pressures with the hiatal canal pressures restored normal maximal pressure, radial asymmetry, and dynamic responses of the gastro-oesophageal junction. CONCLUSIONS: Hiatus hernia reduces lower oesophageal sphincter pressure and alters its dynamic responsiveness by spatially separating pressure components derived from the intrinsic lower oesophageal sphincter and the extrinsic compression of the oesophagus within the hiatal canal. (+info)
Erythromycin enhances early postoperative contractility of the denervated whole stomach as an esophageal substitute. (3/1553)OBJECTIVE: To determine whether early postoperative administration of erythromycin accelerates the spontaneous motor recovery process after elevation of the denervated whole stomach up to the neck. SUMMARY BACKGROUND DATA: Spontaneous motor recovery after gastric denervation is a slow process that progressively takes place over years. METHODS: Erythromycin was administered as follows: continuous intravenous (i.v.) perfusion until postoperative day 10 in ten whole stomach (WS) patients at a dose of either 1 g (n = 5) or 2 g (n = 5) per day; oral intake at a dose of 1 g/day during 1.5 to 8 months after surgery in 11 WS patients, followed in 7 of them by discontinuation of the drug during 2 to 4 weeks. Gastric motility was assessed with intraluminal perfused catheters in these 21 patients, in 23 WS patients not receiving erythromycin, and in 11 healthy volunteers. A motility index was established by dividing the sum of the areas under the curves of >9 mmHg contractions by the time of recording. RESULTS: The motility index after IV or oral administration of erythromycin at and after surgery was significantly higher than that without erythromycin (i.v., 1 g: p = 0.0090; i.v., 2 g: p = 0.0090; oral, 1 g: p = 0.0017). It was similar to that in healthy volunteers (i.v., 1 g: p = 0.2818; oral, 1 g: p = 0.7179) and to that in WS patients with >3 years of follow-up who never received erythromycin (i.v., 1 g: p = 0.2206; oral, 1 g: p = 0.8326). The motility index after discontinuation of the drug was similar or superior to that recorded under medication in four patients who did not experience any modification of their alimentary comfort, whereas it dropped dramatically parallel to deterioration of the alimentary comfort in three patients. CONCLUSIONS: Early postoperative contractility of the denervated whole stomach pulled up to the neck under either i.v. or oral erythromycin is similar to that recovered spontaneously beyond 3 years of follow-up. In some patients, this booster effect persists after discontinuation of the drug. (+info)
A manometric assessment of oesophagogastrostomy. (4/1553)Intraluminal pressures were recorded in 14 patients who had undergone oesophagogastrectomy. Seven of these had a mid-thoracic and seven a high cervical oesophagogastrostomy. The incidence of postoperative reflux complications in each group was noted. No pressure gradient across the anastomosis was detected in any patient but the upper oesophageal sphincter was shown to be retained as a functioning unit in all cases. It is considered that the thoracic anastomosis provides no demonstrable barrier to reflux. In addition, a high cervical oesophagogastrostomy does not adversely affect the upper oesophageal sphincter. The wider application of this latter procedure may be associated with a decreased incidence of postoperative reflux complications. (+info)
Effect of motilin on the lower oesophageal sphincter. (5/1553)The effect of motilin on lower oesophageal sphincter (LES) pressure has been studied in unanesthetised specially trained dogs using an infusion manometric technique. Motilin produced significant rises in resting pressure and contractions of the LES after doses ranging from 0-009 mug/kg to 0-05 mug/kg. Doses greater than 0-05 mug/kg resulted in repetitive high amplitude contractions. Atropine 30 mug/kg completely abolished the effect of the lower doses of motilin. Higher doses of motilin in atropinised dogs still caused a small rise in baseline pressure and contractile activity still appeared. Hexamethonium 2 mg/kg resulted in both a diminished rise in LES pressure and the disappearance of contractions after motilin. Hexamethonium and atropine together completely abolished the LES response to motilin. We conclude that motilin increases LES pressure by acting on preganglionic cholinergic neurones to release acetylcholine which excites other cholinergic neurones supplying the circular muscle of the LES. (+info)
Validation of a novel luminal flow velocimeter with video fluoroscopy and manometry in the human esophagus. (6/1553)There is currently no ideal method for concurrently assessing intraluminal pressures and flows in humans with high temporal resolution. We have developed and assessed the performance of a novel fiber-optic laser-Doppler velocimeter, mounted in a multichannel manometric assembly. Velocimeter recordings were compared with concurrent fluoroscopy and manometry following 50 barium swallows in healthy subjects. During these swallows, the velocimeter sensor was situated in either the proximal (24 swallows) or the distal (26 swallows) esophagus. It signaled intraluminal flow following 46 of 50 swallows. A greater mean number of deflections were recorded in the distal compared with the proximal esophagus (4. 3 vs. 2.4, P = 0.001). The maximal flow velocity recorded did not differ between the proximal and distal esophagus (76.7 vs. 73.8 mm/s). No velocimeter signals commenced after fluoroscopic lumen occlusion. The velocimeter signals were closely temporally related to fluoroscopic barium flow. Upward catheter movement on swallowing sometimes appeared to cause a velocimeter signal. Manometrically "normal" swallows were no different from "abnormal" swallows in the number and velocity of deflections recorded by the velocimeter. This novel instrument measures intraluminal flow velocity and pressures concurrently, thus enabling direct study of pressure-flow relationships. Flow patterns differed between the proximal and distal esophagus. (+info)
Cholinergic blockade inhibits gastro-oesophageal reflux and transient lower oesophageal sphincter relaxation through a central mechanism. (7/1553)BACKGROUND: Atropine, an anticholinergic agent with central and peripheral actions, reduces gastro-oesophageal reflux (GOR) in normal subjects and patients with gastro-oesophageal reflux disease (GORD) by inhibiting the frequency of transient lower oesophageal sphincter relaxation (TLOSR). AIMS: To compare the effect of methscopolamine bromide (MSB), a peripherally acting anticholinergic agent, with atropine on the rate and mechanism of GOR in patients with GORD. METHODS: Oesophageal motility and pH were recorded for 120 minutes in 10 patients with GORD who were studied on three separate occasions. For the first two recording periods, either atropine (15 microg/kg bolus, 4 microg/kg/h infusion) or saline were infused intravenously. MSB (5 mg orally, four times daily) was given for three days prior to the third recording period. RESULTS: Atropine significantly reduced basal LOS pressure (12.6 (0.17) mm Hg to 7.9 (0.17) mm Hg), and the number of TLOSR (8.1 (0.56) to 2.8 (0. 55)) and reflux episodes (7.0 (0.63) to 2.0 (0.43)) (p<0.005 for all comparisons). MSB reduced basal LOS pressure (12.6 (0.17) to 8.7 (0. 15) mm Hg, p<0.005), but had no effect on the frequency of TLOSR (8. 1 (0.56) to 7.5 (0.59)) and reflux episodes (7.0 (0.63) to 4.9 (0. 60)) (p>0.05). CONCLUSION: In contrast to atropine, MSB has no effect on the rate of TLOSR or GOR in patients with GORD. Atropine induced inhibition of TLOSR and GOR is most likely mediated through a central cholinergic blockade. (+info)
Perception of and adaptation to rectal isobaric distension in patients with faecal incontinence. (8/1553)BACKGROUND: Perception of, and adaptation of the rectum to, distension probably play an important role in the maintenance of continence, but perception studies in faecal incontinence provide controversial conclusions possibly related to methodological biases. In order to better understand perception disorders, the aim of this study was to analyse anorectal adaptation to rectal isobaric distension in subjects with incontinence. PATIENTS/METHODS: Between June 95 and December 97, 97 consecutive patients (nine men and 88 women, mean (SEM) age 55 (1) years) suffering from incontinence were evaluated and compared with 15 healthy volunteers (four men and 11 women, mean age 48 (3) years). The patients were classified into three groups according to their perception status to rectal isobaric distensions (impaired, 22; normal, 61; enhanced, 14). Anal and rectal adaptations to increasing rectal pressure were analysed using a model of rectal isobaric distension. RESULTS: The four groups did not differ with respect to age, parity, or sex ratio. Magnitude of incontinence, prevalence of pelvic disorders, and sphincter defects were similar in the incontinent groups. When compared with healthy controls, anal pressure and rectal adaptation to distension were decreased in incontinent patients. When compared with incontinent patients with normal perception, patients with enhanced perception experienced similar rectal adaptation but had reduced anal pressure. In contrast, patients with impaired perception showed considerably decreased rectal adaptation but had similar anal pressure. CONCLUSION: Abnormal sensations during rectal distension are observed in one third of subjects suffering from incontinence. These abnormalities may reflect hyperreactivity or neuropathological damage of the rectal wall. (+info)
There are several types of esophageal motility disorders, including:
1. Achalasia: A condition in which the lower esophageal sphincter (LES) does not relax properly, making it difficult for food to pass into the stomach.
2. Dysmotility: Abnormal movement of the muscles in the esophagus, which can cause slow or abnormal movement of food through the esophagus.
3. Hypercontractility: Excessive contraction of the muscles in the esophagus, which can cause spasms and difficulty swallowing.
4. Hypocontractility: Weak contraction of the muscles in the esophagus, which can cause regurgitation of food.
Esophageal motility disorders can be diagnosed using a variety of tests, including barium swallows, manometry, and high-resolution esophageal manometry. Treatment options vary depending on the specific disorder and its underlying causes, but may include medications to relax the LES or improve muscle function, or surgery to repair structural abnormalities in the esophagus.
The main symptoms of achalasia are:
1. Difficulty swallowing (dysphagia)
2. Regurgitation of food shortly after eating
3. Chest pain or discomfort during or after eating
4. Weight loss and malnutrition over time
5. Coughing or choking while eating or drinking
6. Heartburn or difficulty burping
Esophageal achalasia can be diagnosed through a series of tests, including:
1. Endoscopy (insertion of a flexible tube with a camera into the esophagus to visualize the inside of the esophagus and assess muscle function)
2. High-resolution esophageal manometry (measurement of muscle contractions in the esophagus using a thin, flexible tube)
3. Imaging tests such as X-rays or CT scans to rule out other conditions that may cause similar symptoms.
There is no cure for achalasia, but several treatment options are available to manage the symptoms and improve quality of life, including:
1. Dilation (stretching) of the esophagus using a balloon or other devices to widen the esophageal opening and improve swallowing
2. Botulinum toxin injections into the esophageal muscles to relax the muscles and improve swallowing
3. Peroral endoscopic myotomy (POEM), a minimally invasive surgical procedure that involves cutting the abnormal muscle bands in the esophagus to improve swallowing.
4. Medications such as nitrates, calcium channel blockers, or anticholinergics to relax the muscles and improve swallowing.
5. Tube feeding (enteral nutrition) may be necessary if swallowing is severely impaired.
It's important to note that achalasia is a chronic condition, and treatment may take time and require ongoing management. A healthcare professional can help determine the best course of treatment for each individual case.
Diffuse esophageal spasm is a type of motility disorder that affects the muscles in the esophagus, which is the tube that carries food from the throat to the stomach. In people with DES, the muscles in the esophagus contract and relax abnormally, leading to symptoms such as:
Chest pain (odynophagia)
Difficulty swallowing (dysphagia)
Regurgitation of food
Heartburn or acid reflux
Coughing or wheezing
In rare cases, DES can lead to more severe complications such as esophageal ulcers or bleeding.
The exact cause of diffuse esophageal spasm is not known, but it may be related to abnormalities in the nervous system that controls the esophagus. It can also be triggered by certain factors such as eating, drinking, or taking certain medications.
There are several tests that can help diagnose diffuse esophageal spasm, including:
Barium swallow: A test in which a person swallows a liquid containing barium, which helps show the outline of the esophagus on an X-ray.
Upper endoscopy: A procedure in which a flexible tube with a camera and light on the end is inserted through the nose or mouth to examine the inside of the esophagus and stomach.
Esophageal manometry: A test that measures the muscle contractions and pressure in the esophagus.
There are several treatments for diffuse esophageal spasm, including:
Medications such as antacids, proton pump inhibitors, or nitrates to help reduce acid reflux and relax the muscles in the esophagus.
Dilation, which involves widening the narrowed area of the esophagus using a balloon or other device.
Surgery, such as fundoplication, which involves wrapping the upper part of the stomach around the lower part of the esophagus to strengthen the lower esophageal sphincter.
Lifestyle changes, such as eating smaller meals, avoiding spicy or fatty foods, and elevating the head of the bed to help prevent acid reflux and relax the muscles in the esophagus.
It's important for people with diffuse esophageal spasm to work closely with their healthcare provider to develop a treatment plan that is tailored to their specific needs and symptoms.
GER can be caused by a variety of factors, including:
* Weakening of the lower esophageal sphincter (LES), which allows stomach acid to flow back up into the esophagus.
* Delayed gastric emptying, which can cause food and stomach acid to remain in the stomach for longer periods of time and increase the risk of reflux.
* Obesity, which can put pressure on the stomach and cause the LES to weaken.
Symptoms of GER can include:
* Heartburn: a burning sensation in the chest that can radiate to the throat and neck.
* Regurgitation: the sensation of food coming back up into the mouth.
* Difficulty swallowing.
* Chest pain or tightness.
* Hoarseness or laryngitis.
If left untreated, GER can lead to complications such as esophagitis (inflammation of the esophagus), strictures (narrowing of the esophagus), and barrett's esophagus (precancerous changes in the esophageal lining).
Treatment options for GER include:
* Lifestyle modifications, such as losing weight, avoiding trigger foods, and elevating the head of the bed.
* Medications, such as antacids, H2 blockers, and proton pump inhibitors, to reduce acid production and relax the LES.
* Surgical procedures, such as fundoplication (a procedure that strengthens the LES) and laparoscopic adjustable gastric banding (a procedure that reduces the size of the stomach).
It is important to seek medical attention if symptoms persist or worsen over time, as GER can have serious complications if left untreated.
Some common types of deglutition disorders include:
1. Dysphagia: This is a condition where individuals have difficulty swallowing food and liquids due to weakened or impaired swallowing muscles.
2. Aphasia: This is a condition where individuals have difficulty speaking and understanding language, which can also affect their ability to swallow.
3. Apraxia of speech: This is a condition where individuals have difficulty coordinating the muscles of the mouth and tongue to produce speech, which can also affect their ability to swallow.
4. Aspiration: This is a condition where food or liquids enter the trachea instead of the esophagus, which can cause respiratory problems and other complications.
5. Dystonia: This is a condition where individuals experience involuntary muscle contractions that can affect swallowing and other movements.
Deglutition disorders can be diagnosed through a variety of tests, including videofluoroscopy, fiber-optic endoscopic evaluation of swallowing (FEES), and instrumental assessment of swallowing physiology. Treatment options for deglutition disorders depend on the underlying cause and severity of the condition, and may include speech therapy, medications, surgery, or a combination of these.
In conclusion, deglutition disorders can significantly impact an individual's quality of life, making it important to seek medical attention if swallowing difficulties are experienced. With proper diagnosis and treatment, many individuals with deglutition disorders can improve their swallowing abilities and regain their independence in eating and drinking.
1. Gastroesophageal reflux disease (GERD): A condition in which stomach acid flows back up into the esophagus, causing symptoms such as heartburn and difficulty swallowing.
2. Esophagitis: Inflammation of the esophagus, often caused by GERD or infection.
3. Barrett's esophagus: A condition in which the cells lining the esophagus undergo abnormal changes, which can increase the risk of developing esophageal cancer.
4. Esophageal rings and webs: Abnormal bands of tissue that can form in the esophagus and cause difficulty swallowing or chest pain.
5. Achalasia: A condition in which the muscles in the lower esophagus do not function properly, making it difficult to swallow.
6. Esophageal cancer: Cancer that develops in the esophagus, often as a result of chronic inflammation or Barrett's esophagus.
7. Esophageal stricture: A narrowing of the esophagus that can cause difficulty swallowing.
8. Esophageal motility disorders: Disorders that affect the muscles in the esophagus and cause difficulty swallowing or regurgitation of food.
9. Esophageal spasms: Involuntary contractions of the muscles in the esophagus, which can cause difficulty swallowing or chest pain.
Esophageal diseases can be diagnosed through a variety of tests, including endoscopy, barium swallow, and CT scan. Treatment options vary depending on the specific disease and can include medications, surgery, or lifestyle changes such as dietary modifications and weight loss.
1. Gallstones: Small, pebble-like deposits that form in the gallbladder or bile ducts and can cause blockages and inflammation.
2. Cholangitis: An infection of the bile ducts that can cause fever, chills, and abdominal pain.
3. Bile duct cancer: A type of cancer that affects the cells lining the bile ducts.
4. Stricture: A narrowing of the bile duct that can cause obstruction and block the flow of bile.
5. Cysts: Fluid-filled sacs that can form in the bile ducts and cause symptoms such as abdominal pain and jaundice.
The causes of FI can be classified into two main categories: anorectal mechanical disorders and neurological disorders. Anorectal mechanical disorders include conditions such as rectocele, rectal prolapse, and anal sphincter dysfunction. Neurological disorders include conditions such as spinal cord injuries, multiple sclerosis, and Parkinson's disease.
Symptoms of FI may include:
* Involuntary passage of stool
* Straining during defecation
* Lack of sensation during defecation
* Incomplete evacuation of stool
* Anal itching or irritation
The diagnosis of FI typically involves a comprehensive medical history, physical examination, and various tests such as anorectal manometry, endoanal ultrasonography, and balloon expulsion tests. Treatment options for FI depend on the underlying cause and severity of symptoms, but may include:
* Dietary modifications
* Biofeedback therapy
* Pelvic floor exercises (Kegel exercises)
* Anorectal surgery
* Stool softeners or laxatives
* Anal plugs or suppositories
It is important to note that FI can have a significant impact on an individual's quality of life, and it is essential to seek medical attention if symptoms persist or worsen over time. With proper diagnosis and treatment, many individuals with FI are able to experience improved symptoms and a better quality of life.
The definition of constipation varies depending on the source, but it is generally defined as having fewer than three bowel movements per week, or as experiencing difficulty passing stools for more than half of the time during a two-week period. In addition, some people may experience "functional constipation," which means that they have normal bowel habits but still experience symptoms such as bloating and discomfort.
There are several factors that can contribute to constipation, including:
* Poor diet and dehydration: A diet low in fiber and high in processed foods can lead to constipation, as can not drinking enough water.
* Lack of physical activity: Sedentary lifestyles can contribute to constipation by slowing down the digestive process.
* Medical conditions: Certain medical conditions, such as irritable bowel syndrome (IBS), thyroid disorders, and diabetes, can increase the risk of constipation.
* Medications: Some medications, such as painkillers and antidepressants, can cause constipation as a side effect.
* Hormonal changes: Changes in hormone levels during pregnancy, menopause, or other life events can lead to constipation.
Treatment for constipation depends on the underlying cause and may include dietary changes, lifestyle modifications, and medication. In severe cases, surgery may be necessary. It is important to seek medical advice if symptoms persist or worsen over time, as untreated constipation can lead to complications such as bowel obstruction, hemorrhoids, and fecal incontinence.
There are several types of PCS, including:
1. Bouveret's syndrome: This is a severe form of PCS that occurs within the first few days after cholecystectomy, characterized by intense abdominal pain, fever, and distension of the small intestine.
2. Mirizzi's syndrome: This type of PCS develops when the cystic duct remnant is obstructed, causing bile to accumulate in the gallbladder bed and leak into surrounding tissues, leading to inflammation and infection.
3. Acute pancreatitis: This condition occurs when the pancreatic duct becomes blocked or obstructed, causing pancreatic enzymes to build up and cause inflammation in the pancreas and surrounding tissues.
4. Chronic pancreatitis: This is a long-term form of PCS that can develop after cholecystectomy, characterized by persistent inflammation and damage to the pancreas, leading to abdominal pain, diarrhea, and weight loss.
5. Biliary-pancreatic dyskinesia: This is a chronic form of PCS that occurs when the sphincter of Oddi, which regulates the flow of bile and pancreatic juice into the small intestine, becomes dysfunctional, leading to abdominal pain, diarrhea, and malabsorption.
The symptoms of PCS can be severe and debilitating, affecting quality of life and requiring ongoing medical management. Treatment options for PCS include medications to manage symptoms, endoscopic therapy to clear obstructions, and in some cases, further surgical intervention.
It is essential to seek medical attention if you experience persistent or severe abdominal pain, as early diagnosis and treatment can help alleviate symptoms and prevent complications. A healthcare professional will perform a thorough physical examination and order imaging tests such as CT scans or endoscopy to confirm the diagnosis of PCS. Treatment will depend on the underlying cause of the condition, but may include medications to manage pain, inflammation, and infection, as well as lifestyle modifications to ensure proper digestion and nutrition.
The sphincter of Oddi is a ring-like muscle that controls the opening and closing of the common bile duct into the small intestine. Sphincter of Oddi dysfunction refers to problems with the functioning of this muscle, which can lead to a range of symptoms including abdominal pain, nausea, vomiting, and jaundice (yellowing of the skin and eyes).
There are several possible causes of sphincter of Oddi dysfunction, including:
1. Gallstones: Gallstones can block the common bile duct and cause inflammation and scarring of the sphincter, leading to dysfunction.
2. Inflammatory conditions: Conditions such as pancreatitis and cholangitis can cause inflammation and damage to the sphincter muscle.
3. Cancer: Bile duct cancer or pancreatic cancer can infiltrate and damage the sphincter muscle, leading to dysfunction.
4. Injury: Trauma to the abdomen or surgical damage to the bile ducts can cause dysfunction of the sphincter.
5. Neurological disorders: Certain neurological conditions such as Parkinson's disease, multiple sclerosis, and peripheral neuropathy can affect the nerves that control the sphincter muscle, leading to dysfunction.
The symptoms of sphincter of Oddi dysfunction can vary depending on the underlying cause and the severity of the dysfunction. They may include:
* Abdominal pain, often in the right upper quadrant or middle of the abdomen
* Nausea and vomiting
* Jaundice (yellowing of the skin and eyes)
* Loss of appetite
* Weight loss
* Pale or clay-colored stools
* Dark urine
If you are experiencing any of these symptoms, it is important to seek medical attention as soon as possible. A healthcare professional can perform a series of tests to diagnose the underlying cause of the dysfunction and develop an appropriate treatment plan. These tests may include:
1. Endoscopy: A thin, flexible tube with a camera and light on the end is inserted through the mouth and into the bile ducts to visualize the sphincter and surrounding tissues.
2. Imaging tests: Such as X-rays, CT scans, or MRI scans to evaluate the structure of the bile ducts and liver.
3. Blood tests: To check for signs of liver damage or pancreas inflammation.
4. ERCP (endoscopic retrograde cholangiopancreatography): A procedure in which a flexible tube with a camera and a special tool is inserted through the mouth and into the bile ducts to diagnose and treat problems.
5. Sphincterotomy: A procedure in which the surgeon makes a small incision in the sphincter muscle to relieve pressure and allow normal flow of bile.
6. Stent placement: A small tube is placed inside the bile duct to keep it open and improve flow.
7. Biliary bypass surgery: A procedure in which the surgeon reroutes the bile flow around the blocked bile duct.
8. Liver transplantation: In severe cases of bile duct injuries, a liver transplant may be necessary.
It is important to note that the treatment plan will depend on the underlying cause of the dysfunction and the severity of the condition. A healthcare professional will be able to determine the best course of treatment based on individual circumstances.
The condition can be caused by various factors, including:
1. Neurological disorders: Conditions such as Parkinson's disease, multiple sclerosis, and spinal cord injuries can damage the nerves that control intestinal movement, leading to pseudo-obstruction.
2. Medications: Certain medications, such as anticholinergics and opioids, can slow down intestinal motility and cause pseudo-obstruction.
3. Inflammatory bowel disease: Inflammatory conditions such as Crohn's disease and ulcerative colitis can damage the muscles in the intestinal wall, leading to pseudo-obstruction.
4. Surgery: Intestinal surgery can sometimes result in adhesions or scar tissue that can cause pseudo-obstruction.
5. Infections: Infections such as appendicitis and diverticulitis can inflame the intestines and disrupt their function, leading to pseudo-obstruction.
6. Cancer: Cancer of the intestine or surrounding tissues can obstruct the flow of food through the intestines and cause pseudo-obstruction.
Treatment for intestinal pseudo-obstruction typically involves supportive care, such as fluids, electrolytes, and oxygen, as well as medications to manage symptoms. In severe cases, surgery may be necessary to remove any blockages or adhesions that are causing the condition.
Symptoms of rectal prolapse may include:
* A bulge or lump near the anus
* Pain or discomfort in the rectal area
* Difficulty controlling bowel movements
* Leaking of stool or gas
* Difficulty sitting or passing stool
If left untreated, rectal prolapse can lead to complications such as:
* Increased risk of anal fissures and skin irritation
* Infection of the rectal area
* Impaired urinary continence
* Increased risk of recurrent prolapse
Treatment options for rectal prolapse depend on the severity of the condition and may include:
* Dietary changes and bowel training to improve bowel habits
* Exercise and physical therapy to strengthen the pelvic floor muscles
* Use of rectal inserts or devices to support the rectum
* Surgery to repair or remove the prolapsed rectum
It is important to seek medical attention if symptoms of rectal prolapse are present, as early treatment can help prevent complications and improve quality of life.
* Pain during bowel movements
* Bleeding during bowel movements
* Itching or burning sensation around the anus
* Discharge of pus from the anus
* Redness and swelling around the anus
Fissure in ano can be caused by straining during bowel movements, constipation, diarrhea, or any other condition that puts pressure on the anal skin. Treatment for fissure in ano includes:
* Increasing fiber intake to soften stools and reduce constipation
* Drinking plenty of water to keep the stools soft
* Avoiding straining during bowel movements
* Using stool softeners or laxatives if necessary
* Applying a topical cream or ointment to reduce pain and promote healing
* In some cases, prescription medications may be used to treat fissure in ano.
It is important to seek medical attention if you experience any symptoms of fissure in ano, as it can lead to complications such as infection or narrowing of the anus if left untreated. A healthcare professional can diagnose fissure in ano by examining the anus and performing a physical rectal examination.
In addition to medical treatment, there are some self-care measures that can help manage symptoms of fissure in ano, such as:
* Soaking in a warm bath for 10-15 minutes several times a day to reduce pain and promote healing
* Applying a cold compress or ice pack to the affected area to reduce pain and swelling
* Avoiding spicy or irritating foods and drinks
* Using stool softeners or laxatives as directed by a healthcare professional.
It is important to note that fissure in ano can be a recurring condition, so it is important to take steps to prevent recurrence, such as maintaining a high fiber diet and drinking plenty of fluids.
Hiatal hernia occurs when the stomach bulges up into the chest through an opening in the diaphragm called the hiatus. The hiatus is a normal opening that allows the esophagus to pass through the diaphragm on its way to the stomach. However, if the opening becomes enlarged or if the muscles of the diaphragm become weakened, the stomach can bulge up into the chest through this opening, leading to a hiatal hernia.
There are two main types of hiatal hernia:
1. Sliding hiatal hernia: This is the most common type of hiatal hernia and occurs when the stomach slides up into the chest through the hiatus.
2. Paraesophageal hernia: This type of hernia occurs when the stomach bulges up into the chest next to the esophagus, rather than through the hiatus.
Hiatal hernia can be diagnosed with a barium swallow or an upper GI series, which are tests that use X-rays to visualize the esophagus and stomach. Treatment for hiatal hernia usually involves lifestyle changes, such as losing weight and avoiding heavy lifting, as well as medications to reduce acid production in the stomach. In some cases, surgery may be necessary to repair the hernia and prevent complications.
There are several possible causes of chest pain, including:
1. Coronary artery disease: The most common cause of chest pain is coronary artery disease, which occurs when the coronary arteries that supply blood to the heart become narrowed or blocked. This can lead to a heart attack if the blood flow to the heart muscle is severely reduced.
2. Heart attack: A heart attack occurs when the heart muscle becomes damaged or dies due to a lack of oxygen and nutrients. This can cause severe chest pain, as well as other symptoms such as shortness of breath, lightheadedness, and fatigue.
3. Acute coronary syndrome: This is a group of conditions that occur when the blood flow to the heart muscle is suddenly blocked or reduced, leading to chest pain or discomfort. In addition to heart attack, acute coronary syndrome can include unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI).
4. Pulmonary embolism: A pulmonary embolism occurs when a blood clot forms in the lungs and blocks the flow of blood to the heart, causing chest pain and shortness of breath.
5. Pneumonia: An infection of the lungs can cause chest pain, fever, and difficulty breathing.
6. Costochondritis: This is an inflammation of the cartilage that connects the ribs to the breastbone (sternum), which can cause chest pain and tenderness.
7. Tietze's syndrome: This is a condition that occurs when the cartilage and muscles in the chest are injured, leading to chest pain and swelling.
8. Heart failure: When the heart is unable to pump enough blood to meet the body's needs, it can cause chest pain, shortness of breath, and fatigue.
9. Pericarditis: An inflammation of the membrane that surrounds the heart (pericardium) can cause chest pain, fever, and difficulty breathing.
10. Precordial catch syndrome: This is a condition that occurs when the muscles and tendons between the ribs become inflamed, causing chest pain and tenderness.
These are just a few of the many possible causes of chest pain. If you are experiencing chest pain, it is important to seek medical attention right away to determine the cause and receive proper treatment.
1. The patient experienced a spasm in their leg while running, causing them to stumble and fall.
2. The doctor diagnosed the patient with muscle spasms caused by dehydration and recommended increased fluids and stretching exercises.
3. The athlete suffered from frequent leg spasms during their training, which affected their performance and required regular massage therapy to relieve the discomfort.
Esophagitis is a type of inflammation that affects the esophagus, which is the tube that carries food from the throat to the stomach. Peptic esophagitis is a specific type of esophagitis that is caused by reflux of stomach acid and digestive enzymes into the esophagus. This condition is also known as gastroesophageal reflux disease (GERD).
The symptoms of peptic esophagitis can vary from person to person, but common symptoms include:
* Heartburn: a burning sensation in the chest that can radiate up to the throat and neck
* Difficulty swallowing: food may feel like it's getting stuck in the throat or esophagus
* Chest pain: a sharp, stabbing pain in the chest that can be worse when lying down or eating
* Regurgitation: the sensation of food coming back up into the mouth
* Coughing or wheezing: acid reflux can irritate the lungs and cause these symptoms
* Hoarseness: stomach acid can irritate the vocal cords and cause hoarseness
Peptic esophagitis is usually diagnosed through a combination of endoscopy, which involves inserting a flexible tube with a camera into the esophagus to examine the lining, and pH testing, which measures the amount of acid in the esophagus. Treatment typically involves lifestyle changes, such as avoiding trigger foods, losing weight, and elevating the head of the bed, as well as medications to reduce acid production and protect the esophageal lining. In severe cases, surgery may be necessary to repair any damage to the esophagus.
1) The patient was diagnosed with a rectal disease and was advised to make dietary changes to manage their symptoms.
2) The doctor performed a rectal examination to rule out any underlying rectal diseases that may be causing the patient's bleeding.
3) The patient underwent surgery to remove a rectal polyp and treat their rectal disease.
The term "megacolon" is derived from the Greek words "mega," meaning large, and "colon," referring to the colon. It is also sometimes referred to as "total colonic dilation."
Megacolon can be caused by a variety of factors, including:
1. Neurological disorders such as spinal cord injuries, multiple sclerosis, and Parkinson's disease.
2. Inflammatory bowel disease (IBD) such as Crohn's disease and ulcerative colitis.
3. Infections such as tuberculosis and amoebiasis.
4. Congenital conditions such as Hirschsprung's disease.
5. Cancers such as colon cancer and lymphoma.
6. Obstetric complications such as placenta previa and placental abruption.
7. Sepsis and shock.
8. Certain medications such as opioids and anticholinergic drugs.
9. Gastrointestinal obstruction or perforation.
The symptoms of megacolon can vary depending on the underlying cause, but may include:
1. Abdominal pain and distension
3. Difficulty passing gas
4. Nausea and vomiting
6. Diarrhea or watery stools
7. Blood in the stool
8. Weight loss
Treatment for megacolon typically involves addressing the underlying cause, which may involve surgery, medication, or other interventions. In some cases, a colostomy or ileostomy may be necessary to divert the flow of stool away from the diseased portion of the colon.
In summary, megacolon is a rare condition characterized by an abnormal dilation of the colon, which can lead to a range of complications and symptoms. Treatment typically involves addressing the underlying cause, and may involve surgery, medication, or other interventions.
Encopresis can be caused by a variety of factors, including:
* Constipation: When stool is hard and difficult to pass, it can lead to soiling of clothing.
* Diarrhea: Loose stools can be difficult to control and may result in soiling.
* Infection: Infections such as gastroenteritis or urinary tract infections can cause encopresis.
* Neurological disorders: Conditions such as spina bifida, cerebral palsy, or hydrocephalus can affect the nerves that control bowel movements and lead to encopresis.
* Hormonal imbalances: Hormonal changes during puberty or pregnancy can cause constipation and encopresis.
* Food allergies or intolerances: Some people may experience encopresis due to certain foods triggering an allergic response or causing digestive issues.
Symptoms of encopresis may include:
* Soiling of clothing, especially underwear
* Involuntary passage of stool
* Difficulty with bowel movements
* Abdominal pain or discomfort
* Feeling of incomplete evacuation
Treatment for encopresis typically involves addressing the underlying cause, such as constipation or infection. This may involve dietary changes, medication, or other interventions. In some cases, encopresis may be a sign of an underlying medical condition that requires further evaluation and treatment.
In addition to medical treatment, encopresis can also have a significant impact on an individual's quality of life, particularly if it is accompanied by social embarrassment or stigma. It is important for individuals with encopresis to seek support from healthcare providers and loved ones to address these issues and improve their overall well-being.
Prevention measures for encopresis may include:
* Encouraging regular bowel habits and adequate hydration
* Avoiding foods that may trigger allergic responses or digestive issues
* Engaging in regular physical activity to promote gut health
* Managing stress and anxiety through relaxation techniques or other interventions.
Overall, encopresis can be a challenging condition to manage, but with the right treatment and support, individuals can experience improved quality of life and reduced symptoms.
Esophagitis can be acute or chronic, and it can affect people of all ages. Acute esophagitis is a short-term inflammation that can be caused by a viral or bacterial infection, while chronic esophagitis can last for weeks or months and may be caused by ongoing exposure to irritants such as stomach acid or allergens.
Esophagitis can lead to complications such as narrowing of the esophagus, stricture, or ulcers, which can make it difficult to swallow and can lead to malnutrition and weight loss. In severe cases, esophagitis can also lead to life-threatening complications such as perforation or bleeding.
Esophagitis is diagnosed through a combination of endoscopy, imaging tests such as CT scans or MRI, and laboratory tests such as blood tests or biopsies. Treatment for esophagitis depends on the underlying cause, but may include antibiotics, anti-inflammatory medications, and lifestyle changes such as avoiding trigger foods or drinks. In severe cases, surgery may be necessary to repair any damage to the esophagus.
Esophagitis is a common condition that affects millions of people worldwide, and it can have a significant impact on quality of life. While there are several effective treatment options available, prevention is often the best approach, and this involves making lifestyle changes such as avoiding trigger foods or drinks, managing gastroesophageal reflux disease (GERD), and practicing good hygiene to avoid infections. With proper diagnosis and treatment, most people with esophagitis can experience significant improvement in symptoms and quality of life.
The symptoms of heartburn can vary from person to person, but typically include:
* A burning sensation in the chest and throat
* Regurgitation of food
* Difficulty swallowing
* Coughing or wheezing
* Chest pain or discomfort
Heartburn is caused by a weakening of the lower esophageal sphincter (LES), which allows stomach acid to flow back up into the esophagus. This can be triggered by a variety of factors, including:
* Eating certain types of foods (e.g. citrus fruits, tomatoes, chocolate)
* Drinking alcohol or caffeine
* Being overweight or obese
* Certain medications (e.g. NSAIDs, theophylline)
If left untreated, heartburn can lead to complications such as:
* Esophagitis (inflammation of the esophagus)
* Ulcers in the esophagus or stomach
* Scarring of the esophagus
* Barrett's esophagus (precancerous changes in the esophagus)
Treatment for heartburn typically involves lifestyle modifications, such as:
* Avoiding trigger foods and drinks
* Eating smaller, more frequent meals
* Losing weight
* Avoiding tight clothing that can exacerbate the condition
* Elevating the head of the bed
* Reducing stress through relaxation techniques (e.g. meditation, deep breathing)
In addition to lifestyle modifications, medications such as antacids, H2 blockers, and proton pump inhibitors may be prescribed to help manage heartburn symptoms. In severe cases, surgery may be necessary to repair any damage to the esophagus or stomach.
Preventing heartburn involves making lifestyle changes and avoiding triggers that can exacerbate the condition. Some strategies for preventing heartburn include:
* Avoiding trigger foods and drinks (e.g. citrus fruits, tomatoes, chocolate, caffeine, alcohol)
* Eating smaller, more frequent meals
* Losing weight if overweight or obese
* Avoiding tight clothing that can exacerbate the condition
* Elevating the head of the bed
* Reducing stress through relaxation techniques (e.g. meditation, deep breathing)
* Quitting smoking and avoiding secondhand smoke
* Avoiding certain medications (e.g. NSAIDs, theophylline) that can exacerbate heartburn symptoms.
It is important to note that while heartburn can be uncomfortable and disrupt daily life, it is generally not a serious condition. However, if symptoms persist or worsen over time, it is important to seek medical attention to rule out any underlying conditions that may need more urgent treatment.