Michele A. Young

Feasibility and safety of string, wireless capsule endoscopy in the diagnosis of Barrett's esophagus

BACKGROUND Capsule endoscopy is a major technological advancement in the visualization of the small bowell. Its utility in the evaluation of the esophagus is mainly limited by its rapid and unpredictable transmission, thus limiting the number of pictures of the esophagus, in particular, the distal esophagus. METHODS Strings were attached to the wireless capsule endoscopy device to allow its controlled movement up and down the esophagus. Microbiologic cultures of the capsules surface after high-level disinfection were carried out after the procedure. At the time of recording, discomfort associated with the procedure was documented. Patient preference compared with conventional EGD was recorded. An independent endoscopist blinded to the EGD diagnoses assessed the diagnostic accuracy of pictures obtained. OBSERVATIONS Fifty patients with Barretts esophagus were enrolled: 28 with short-segment Barretts and 22 with long-segment Barretts. The procedure was safe (no strings were disrupted, and no capsule was lost), and it rendered negative microbiologic cultures after high-level disinfection. The mean recording time was 7.9 minutes; all patients with both short- and long-segment Barretts esophagus were successfully identified. The difficulty/discomfort associated with swallowing the device, throat discomfort, gagging, moving the capsule (up and down and upon retrieval of the capsule) was none or minimal in 74%, 98%, 96%, 94%, and 76%, respectively. A single capsule was used in 24 studies, and the majority of patients (92%) preferred string-capsule endoscopy to EGD. CONCLUSIONS String-capsule endoscopy was feasible, safe, and highly acceptable, and was preferred by patients and may prove to be more cost effective than screening EGD.

The short- and long-term efficacy of empirical esophageal dilation in patients with nonobstructive dysphagia: a prospective, randomized study

The short- and long-term efficacy of empirical esophageal dilation in patients with nonobstructive dysphagia: a prospective, randomized study

Sex preferences for colonoscopists and GI physicians among patients and health care professionals

BACKGROUND There are indications that many women prefer female health care providers. OBJECTIVE To determine whether (1) patients and health care professionals have sex preferences for gastroenterologists (for office visit and colonoscopy) and (2) the reasons behind these preferences. DESIGN Prospective survey. SETTING Patients from primary care clinics at a Veterans Affairs and a community hospital and health care professionals. PATIENTS A total of 1364 individuals completed the survey: 840 patients (566 men and 274 women) and 524 health care professionals (211 men and 313 women). MAIN OUTCOME MEASUREMENTS Sex preferences for colonoscopists and gastroenterologists at a clinic. RESULTS Women had a stronger sex preference (compared with no preference) for an office visit with a gastroenterologist (44.3%) and for a colonoscopist (53%) than men (23% and 27.8% respectively; P < .001). For health care professionals, there was a significant difference in sex preferences for women and men for a gastroenterologist office visit (30.4% vs 17.6%; P < .001) and for a colonoscopist (43.1% vs 26.1%; P < .001). Of all respondents with a sex preference, the most common reason was embarrassment for both office visit and colonoscopy. For all respondents with a sex preference for colonoscopy, a higher level of education was an independent predictor of patients feeling embarrassed (P = .003). LIMITATIONS Single city, patient population from only 2 institutions. CONCLUSIONS Female patients and female health care professionals have sex preferences in choosing a gastroenterologist for an office visit and colonoscopy, and the reasons for this are significantly influenced by their level of education.

Feasibility of string-capsule endoscopy in the diagnosis of esophageal mucosal disorders

Purpose: The diagnostic utility of capsule endoscopy in the esophagus is precluded by its rapid transit time. An attached string to the capsule would allow its controlled and on-purpose movement up and down the esophagus. Aims: 1) To determine if the esophageal mucosal pictures allow accurate diagnoses of mucosal conditions. 2) To assess patients discomfort and acceptability when compared to EGD. 3) To determine whether the capsule can be re-used after conventional disinfection/sterilization.

Mo1942 Medical Prevention of Barrett's Esophagus: Effects of Statins and Aspirin/NSAIDs

results made the novel observation that there is a gradient in miRNA expression along the gastrointestinal tract as a function of the proximity of the organs. Although the correlation was highest with the gastric mucosa, overall the BE miRNA profiles do not favor a specific organ in the luminal GI tract. Expression of specific miRNA appears to be organ restricted and may be an important determinant of the epithelial phenotype and needs to be further studied.

The Angelchik® anti-reflux prosthesis (AARP) for gastroesophageal reflux disease (GERD): a 10 to 23 years follow up

The Angelchik® anti-reflux prosthesis (AARP) for gastroesophageal reflux disease (GERD): a 10 to 23 years follow up

Multi-channel 24-hour pH monitoring and esophageal manometry in long (LSB)- and short-segment (SSB) Barrett's, gastroesophageal reflux (GER) and asymptomatic subjects (AS)

Multi-channel 24-hour pH monitoring and esophageal manometry in long (LSB)- and short-segment (SSB) Barretts, gastroesophageal reflux (GER) and asymptomatic subjects (AS)

Immohistochemical expression of cytokeratin 7 and 20 in long- (LSBE) and short- (SSBE) segment Barrett's esophagus

Immohistochemical expression of cytokeratin 7 and 20 in long- (LSBE) and short- (SSBE) segment Barretts esophagus

A prospective randomized double-blind placebo controlled trial of omeprazole in the treatment of symptomatic Schatzki's ring after dilation

A prospective randomized double-blind placebo controlled trial of omeprazole in the treatment of symptomatic Schatzkis ring after dilation