Incompetent lower esophageal sphincter.A 51-year-old man presented to the Scripps Center for Voice and Swallowing with chief complaints of chronic cough, pyrosis pyrosis: see heartburn. , and odynophagia. Findings on fiberoptic laryngoscopy were unremarkable. Transnasal esophagoscopy revealed grade C erosive esophagitis esophagitis /esoph·a·gi·tis/ (e-sof?ah-ji´tis) inflammation of the esophagus. chronic peptic esophagitis reflux e. (figure 1). Esophageal manometry revealed that the patient had an incompetent lower esophageal sphincter lower esophageal sphincter n. A ring of smooth muscle fibers at the junction of the esophagus and stomach. Also called cardiac sphincter. (LES), based on a resting pressure of only 3 mm Hg (figure 2); normal LES resting pressure ranges between 15 and 35 iron Hg (figure 3). [FIGURE 1-3 OMIITED] The patient was treated with a proton-pump inhibitor and lifestyle modifications for gastroesophageal reflux. Although he improved significantly with this treatment, he continued to experience breakthrough cough and pyrosis. He ultimately underwent laparoscopic Laparoscopic A minimally-invasive surgical or diagnostic procedure that uses a flexible endoscope (laparoscope) to view and operate on structures in the abdomen. Mentioned in: Obstetrical Emergencies Nissen fundoplication, and his symptoms resolved completely. From the Scipps Center for Voice and Swallowing, La Jolla, Calif. |
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