Michael F. Vaezi

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Achalasia is a primary motor disorder of the esophagus characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. This results in patients' complaints of dysphagia to solids and liquids, regurgitation, and occasional chest pain with or without weight loss. Endoscopic finding of retained saliva with puckered(More)
he American Gastroenterological Association (AGA) Institute Medical Position Panel consisted of the authors of the technical eview, a community-based gastroenterologist (Stephen W. Hiltz, MD, MBA, AGAF), an insurance provider representative (Edgar lack, MD, Medical Director, Policy Resources Technology Evaluation Center, BlueCross BlueShield Association), a(More)
. Demonstrate an understanding of the natural history and manifestations of reflux disease . Evaluate the role of diagnostic testing such as endoscopy, esophageal manometry, ambulatory pH monitoring, and impedance-pH monitoring in the management of patients with gastroesophageal reflux disease . Evaluate the options for treatment of patients with(More)
Achalasia is a primary esophageal motor disorder of unknown etiology producing complaints of dysphagia, regurgitation, and chest pain. The current treatments for achalasia involve the reduction of lower esophageal sphincter (LES) pressure resulting in improved esophageal emptying. Calcium channel blockers and nitrates, once used as initial treatment(More)
Idiopathic achalasia is an inflammatory disease of unknown etiology characterized by esophageal aperistalsis and failure of LES relaxation due to loss of inhibitory nitrinergic neurons in the esophageal myenteric plexus. Proposed causes of achalasia include gastroesophageal junction obstruction, neuronal degeneration, viral infection, genetic inheritance,(More)
BACKGROUND Symptom relief post pneumatic dilation is traditionally used to assess treatment success in achalasia patients. Recently, we showed that symptom relief and objective oesophageal emptying are concordant in about 70% of patients, while up to 30% of achalasia patients report near complete symptom relief despite poor oesophageal emptying of barium.(More)
Idiopathic achalasia is a primary esophageal motor disorder characterized by esophageal aperistalsis and abnormal lower esophageal sphincter (LES) relaxation in response to deglutition. It is a rare disease with an annual incidence of approximately 1/100,000 and a prevalence rate of 1/10,000. The disease can occur at any age, with a similar rate in men and(More)
BACKGROUND & AIMS Acid and pepsin are known to cause esophagitis. However, the role of duodenogastroesophageal reflux (DGER) in producing esophageal mucosal injury across the spectrum of gastroesophageal reflux disease (GERD) is controversial. METHODS Twenty controls (13 men; mean age, 41 years), 30 patients with GERD (15 men; mean age, 41 years), and 20(More)
The role of acid and duodenogastric reflux (DGR) in the development of esophageal mucosal injury has been extensively investigated using both animal and human models. In this report, clinical and experimental data are reviewed. The mechanisms by which gastric and duodenal contents produce esophageal mucosal injury are also discussed. Acid and pepsin are(More)
BACKGROUND Intrasphincteric injection of botulinum toxin is a new treatment option for achalasia. AIMS To compare the immediate and long term efficacy of botulinum toxin with that of pneumatic dilatation. METHODS Symptomatic patients with achalasia were randomised to botulinum toxin (22 patients, median age 57 years) or pneumatic dilatation (20(More)