pulmicort and Esophageal-Achalasia

The most important novel findings presented on oesophageal disease in DDW 2015 were the following: 1) GERD: a) hypervigilance seems to be a key pathogenic factor in reflux symptoms refractory to PPI; b) post-reflux swallowing-induced peristaltic waves could be an excellent diagnostic criterion for GERD; c) laryngeal pH-metry is not useful in the diagnosis of extra-oesophageal symptoms; d) the recommendation of weight loss adequately recorded in the clinical reports of patients with GERD and obesity or overweight is an excellent quality indicator and is associated with better outcomes. 2) Barrett's oesophagus: a) persistent low-grade dysplasia in more than one endoscopy and a diagnosis of "indefinite for dysplasia" are associated with a high risk of neoplastic progression; b) narrow-band imaging allows areas of dysplasia on Barrett's oesophagus to be identified with high sensitivity and specificity; c) initial endoscopy fails to identify a high percentage of advanced neoplasms in Barrett's oesophagus. Early re-endoscopy should be considered; d) endoscopists specialized in Barret's oesophagus obtain a much higher yield in the diagnosis of advanced lesions. Patients at high risk-men, older patients, smokers and those with long-segment Barrett's oesophagus-could benefit from follow-up in a referral center. 3) Achalasia: POEM seems safe and effective, independently from patient characteristics (age, comorbidity) and the technical variations used. 4) Eosinophilic esophagitis: topical budesonide and exclusion diets are reasonably effective in PPI non-responders.

Topics: Anxiety; Barrett Esophagus; Budesonide; Clinical Trials as Topic; Disease Progression; Eosinophilic Esophagitis; Esophageal Achalasia; Esophageal Diseases; Esophageal Neoplasms; Esophagoscopy; Gastroesophageal Reflux; Humans; Meta-Analysis as Topic; Pulsed Radiofrequency Treatment; Weight Loss

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Topics: Budesonide; Deglutition Disorders; Drug Therapy, Combination; Endoscopy, Gastrointestinal; Eosinophilic Esophagitis; Esophageal Achalasia; Female; Glucocorticoids; Humans; Proton Pump Inhibitors; Young Adult