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ObjectiveTo determine the effect of peroral endoscopic myotomy (POEM) on esophageal manometry in patients with achalasia.MethodsEsophageal manometric data of 3 patients with achalasin before and after POEM was retrospectively analyzed.ResultsThe post-POEM lower esophageal sphincter pressure (LESP) and upper esophageal sphincter residual pressure (UESRP) were significantly lower than those of before ( P ＜ 0.05 ).The average post-POEM lower esophageal sphincter residual pressure (LESRP) decreased (P ＞0.05),with significant decrease to normal level in 2 patients and almost unchanged (above normal) in the other.The esophageal aperistalsis remained after POEM in all 3 patients.The lower esophageal sphincter relaxing rate (LESRR) remained lower than normal after POEM as before.The average upper esophgeal sphincter pressure (UESP) decreased after POEM without statistical significance.ConclusionPOEM can improve the outcomes of esophageal manometry in patients with achalasia in the short term.
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0.05).The incidence of adverse events was low and similar in each group. CONCLUSIONS Rifaximin is a safe and effective alternative to ciprofloxacin in the treatment of acute infectious diarrhea in adults.
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To evaluate the influences of sclerotherapy and band ligation on esophageal motility, EVS and EVL were measured before and after treatment respectively. After sclerotherapy, lower esophageal sphincter pressure (LESP)and residual pressure were decreased while relaxa tion was increased , relaxation duration became shorter; band ligation only influenced LESP.After EVS, the amplitude of motor waves in the sites of EVS and lower esophagus body was reduced ,and peristaltic wave duration was prolonged ,velocity of propagating contractions became faster , band ligation made the peristaltic wave duration in the sites of EVS and lower esophagus body become shorter, abnormal contractions increased. After EVS, antiacid medicine should be ased to reduced pH of gastric and raised LESP, and drugs to increase esophageal motility should be used after band ligation.
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0 05). No adverse reaction was seen in all patients. Our results suggest that intravenous Pantoloc is a good proton pump inhibitor in patients with duodenal ulcer combined with upper gastrointestinal bleeding, and it is similar to Losec in effectiveness and safety.
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Objective To compare the effects of intrasphincteric injection of botulinum toxin or pneumatic dilation on the treatment of achalasia. Methods One hundred and eighteen patients with esopha-geal achalasia were randomly assigned into 2 groups. (1) Injection group; botulinum toxin 100iu was injected into the muscular layer around LES under endoscopies with each site 20iu. (2) Dilation group; Dilating the cardiac sphincter with Rigiflex dilation balloon under endoscopies. Esophageal manometry was performed before and one week after treatment. And clinical symptoms were observed. Results Before therapy the 3 kinetic parameters of both groups revealed no significant statistical difference, but after therapy in dilation group LESP decreased to (6.03?3.45) mm Hg, LESRP ( -0. 11 ?2. 34) mm Hg, LESRR increased to 92. 50% ? 13. 86% , with significant statistical difference as compared to the data before treatment. In injection group LESP decreased to (23. 16 ? 16. 17) mm Hg, LESRP and LESRR after therapy showed no statistical difference as compared to the corresponding data before therapy. The improvement of clinical symptoms in dilatation and injection groups graded as prominent effective, improved and failed were 45 ( 80. 36% ) , 11 (19.64% ) ,0 and 15(24.19% ) , 38(61.29% ) , 9( 14.52% ) respectively. Conclusion In the treatment of esophageal achalasia the short term effect of pneumatic dilatation is superior to intrasphincteric injection method, the improvement of clinical symptoms is closely related to the decrease of LESP and LESRP especially the later.
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Objective To evaluate the changes in esophageal pressure and 24h pH on the pathogenesis of esophagitis by means of a multivariate logistic regression analysis of obtained values. Methods Monovariate comparison of parameters from 24h ambulatory esophageal pH measurements and esophageal manometry between two groups of gastro-esophageal reflux disease (GERD) patients, including 45 with esophagitis, 40 without esophagitis, and 42 healthy controls. Multivariate logistic regression analysis of parameters obtained was carried out. Results All parameters of DeMeester-Johson score were significantly higher in esophagitis than those of without esophagitis. The composite scores were 113.29?26.73 and 42.66?11.25, respectively (P
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From November 1997 to August 2002, a total of 165 achalasia patients were treated with endoscopic injection of botulinum toxin A into the gastric cardia. The results showed that the lower esophageal sphincter (LES) pressure (41.76?22.00 vs 19.14?11.40 mmHg) and LES relax pressure (14.74?9.41 vs 8.51?7.85mmHg) were decreased significantly (both P
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Twenty four hour esophageal pH monitoring was performed in 79 ambulatary patients suffering from reflux symptoms, in whom 40 with esophagitis and 39 without. The aim of the study was to investigate the correlation between reflux symptoms and objective occurrence of acid reflux in the patients with and without esophagitis. The results showed that the six parameters of Johnson/DeMeester score were significantly higher for esophagitis than endoscopic negative patients. The composite score were (85.85?15 10) and (26 20?9 25), respectively( P
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To investigate fecal continence in patients with irritable bowel syndrome (IBS), studies were performed in 43 patients with IBS and 20 healthy subjects. Anorectal pressure was measured with BioLAB monitor of digestive tract and anorectal catheter with solid state manometric transducers. The results were analyzed by computation programs of American Sandhill Company. The sensation of defecation volume (DSV),sensation of defecation urgent volume (DUSV) and maximal tolerable volume (MTV) in the patients with diarrhea predominant type IBS (Dp-IBS) were significantly lower than healthy subjects (P