phenylephrine-hydrochloride and Esophagitis--Peptic

Most studies agree that post-nasal drip syndrome (PNDS), asthma, gastroesophageal reflux disease (GORD), and laryngopharyngeal reflux (LPR) are the commonest causes of chronic cough in the immunocompetent, non-smoking patient who is not taking an angiotensin-converting enzyme inhibitor. No diagnostic test has been found to define those who are said to have PNDS other than a response to a first-generation antihistamine. Examining the available evidence suggests that mechanical stimulation of the pharynx by mucus is not an adequate theory for the production of cough. Inflammatory mediators in the lower airways are raised in PNDS, cough variant asthma and GORD, and the theory that an inflammatory process is affecting 'one airway' is a plausible one. Nasal disease is more likely to result in cough from the co-existing involvement of the lower airways through an as yet undefined pathway, and eosinophil and mast cell mediation appear a likely mechanism.

Topics: Angiotensin-Converting Enzyme Inhibitors; Asthma; Bronchitis, Chronic; Chronic Disease; Cough; Eosinophilia; Esophagitis, Peptic; Gastroesophageal Reflux; Humans; Mucus; Nose; Syndrome

Transnasal esophagoscopy (TNE), a new diagnostic technology, allows comprehensive, in-office examination of the esophagus without sedation.. To report the authors' experience using TNE.. Retrospective review of 100 consecutive patients undergoing TNE.. The most frequent indications for TNE were screening examination of the esophagus in reflux, globus, and/or dysphagia patients (n = 79), biopsy of a lesion in the laryngopharynx, trachea, or esophagus (n = 8), screening examination of the esophagus in head and neck cancer patients (n = 5), tracheoscopy and bronchoscopy (n = 4), and evaluation for an esophageal foreign body (n = 2). Four procedures were aborted secondary to a tight nasal vault. Significant findings were found in 44% (42/96). The most frequent findings were esophagitis (n = 19), Barrett's (n = 6), hiatal hernia (n = 4), and carcinoma (n = 5).. TNE is safe and well tolerated by patients with topical anesthesia alone. TNE may replace radiographic imaging of the esophagus in otolaryngology patients with reflux, globus, and dysphagia.

Topics: Anesthesia, Local; Biopsy; Conscious Sedation; Deglutition Disorders; Dilatation; Epistaxis; Equipment Design; Esophageal Diseases; Esophagitis, Peptic; Esophagoscopes; Esophagoscopy; Esophagus; Foreign Bodies; Head and Neck Neoplasms; Hernia, Hiatal; Humans; Mass Screening; Nose; Office Visits; Patient Selection; Retrospective Studies; Safety; Treatment Outcome