New Guidelines on Diagnosis and Management of Achalasia Published by the American College of Gastroenterology

The authors state that achalasia “is an incurable disease characterized by incomplete or absent relaxation of the LES and aperistalsis of the esophageal body. The symptomatic consequence of this motility disorder is the classic presentation of dysphagia to solids and liquids associated with regurgitation of bland undigested food or saliva.” The guidelines address the importance of early diagnosis in patients displaying symptoms of achalasia. Lead author Michael F. Vaezi, MD, PhD, MSc, FACG, of Vanderbilt University Medical Center, noted that “by definition, an assessment of esophageal motor function is essential in the diagnosis of achalasia.” Chest pain during meals, difficulty swallowing, weight loss and even heartburn are associated symptoms that often lead to misdiagnosis of achalasia, mistakenly as GERD. Achalasia must be suspected in those with dysphagia to solids and liquids and in those with regurgitation unresponsive to an adequate trial of PPI therapy. The guidelines also address the use of high-resolution esophageal manometry in the diagnosis of achalasia and its variant presentations. The authors have updated the approach to treating achalasia given recent outcome studies comparing pneumatic dilation and surgical myotomy as well as recommendations on long-term patient follow up. “Surgical myotomy has shown excellent results in most patients and remains the surgery of choice, with more being done laparoscopically. The benefit of adding a fundoplication was demonstrated in a double-blind randomized trial comparing myotomy with versus without fundoplication. In this study, abnormal acid exposure on pH monitoring was found in 47 percent of patients without an antireflux procedure and 9 percent in patients that had a posterior Dor fundoplication,” Vaezi said. He adds, “A subsequent cost-utility analysis based on the results of this trial found that myotomy plus Dor fundoplication was more cost effective than myotomy alone because of the costs of treating GERD.” Patient follow up concludes the guidelines and is essential in those diagnosed with achalasia. The guidelines include short-term and long-term goals for follow up and discuss the management of treatment failures, whether endoscopy surveillance for cancer is recommended and include a treatment algorithm. Dr.

hop over to this site http://www.marketwatch.com/story/new-guidelines-on-diagnosis-and-management-of-achalasia-published-by-the-american-college-of-gastroenterology-2013-07-23

Private gastroenterologists in the UK

Private gastroenterologists in the UK Gastroenterology or gastrology is the medical specialty concerned with digestive diseases. It is popularly (and incorrectly) known as “GI” (which stands for gastrointestinal). A gastroenterologist is a physician who specialises in the diagnosis and treatment of disorders of the gastrointestinal tract, including the oesophagus, stomach, small intestine, large intestine, pancreas, liver, gallbladder, and biliary system. The signs and symptoms of gastroenterological diseases may include: constipation nausea abdominal pain Theprofessional body in the UK which isresponsible for training and regulating medical practitioners who specialise in gastroenterologyis the Royal College of Physicians . The organisation focused on the promotion of gastroenterology within the United Kingdom is the British Society of Gastroenterology You canview the profile ofone of our featured private gastroenterologists below, or you can use our online database of 18,500 private consultantsto search for a private gastroenterologist . Featured gastroenterologists Matthew Banks: Consultant Gastroenterologist, London Consultant Gastroenterologist specialising in general gastroenterology, hepatology,… Rehan Haidry: Consultant Gastroenterologist, London Dr Rehan Haidry is a Consultant Gastroenterologist and Endoscopist at London’s University College… Edward Stoner: Consultant Gastroenterologist, Chelmsford, Essex Dr Edward Stoner is a Consultant Gastroenterologist practising at Springfield Hospital in… Simon Greenfield: Consultant Gastroenterologist, Hertfordshire A highly experienced gastroenterologist practising in Hertfordshire and treating most conditions… Farooq Rahman: Consultant Gastroenterologist, London Dr Farooq Rahman undertook his basic medical training at The Royal Free Hospital School of Medicine… Simon Anderson: Consultant Gastroenterologist, London Consultant gastroenterologist specialising in therapeutic endoscopy and colonoscopy, inflammatory… Abhay Chopada: Gastroenterologists Surgeon, London Consultant Surgeon with special interest in colorectal surgery,hernia surgery, laproscopic and… Stephen Grainger: Consultant Gastroenterologist, Chelmsford, Essex Dr Stephen Grainger is a Consultant Gastroenterologist practising at Springfield Hospital in…

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