Annals of esophagus最新文献

Background and objective: Alcohol use accounts for significant morbidity and mortality globally. A wide range of esophageal disorders have been associated with alcohol consumption, most concerning of which is esophageal squamous cell cancer (ESCC). Alcohol use has also been associated with exacerbation of gastroesophageal reflux disease (GERD) symptoms. Despite being one of the first organs to encounter this toxic agent, the molecular effects of alcohol on the human esophagus and the mechanisms by which alcohol exerts its effects on esophageal motility and carcinogenesis remain incompletely defined. The objective of this narrative review is to provide an overview of the effect of alcohol and its toxic metabolite acetaldehyde on cellular signaling, the microbiome, and motility in the esophagus, along with a discussion on the possible mechanisms by which alcohol use increases risk for ESCC.

Methods: A literature search was performed using PubMed, Google Scholar, and Ovid MEDLINE for the period from inception to December 1, 2024. To identify all relevant literature, the following search terms were used: "Alcohol OR ethanol" AND "esophagus OR GERD OR gastroesophageal reflux OR reflux OR cancer OR EoE OR eosinophilic esophagitis OR signaling OR epithelium OR stroma OR fibrosis OR microbiome". Studies published in English with full available text were included.

Key content and findings: This narrative review provides an overview of the effect of alcohol consumption on the human esophagus. The review highlights the dose-dependent risk of ESCC with alcohol use, with increasing risk with higher consumption; with evidence of increased risk even with the smallest amounts of alcohol consistent with the International Agency for Research on Cancer recognition of alcohol as a Group 1 carcinogen. The review also discusses the mechanisms of carcinogenesis, highlighting the role of acetaldehyde, as well as the non-malignant consequences of alcohol on the esophagus, including effects on cellular signaling, the microbiome, and gastro-esophageal reflux disease.

Conclusions: Alcohol consumption continues to exert morbidity and mortality worldwide. Increasing awareness of the multitude of established and potential effects on the human esophagus will allow for rationale supporting at the very least the moderation of alcohol consumption.

Background: Black esophagus is a relatively rare phenomenon that seems to occur in a morbid patient population, however, this entity may be more common than we currently know. Additionally, black esophagus may even be reversible in some cases. There are far fewer cases of black stomach described. The exact etiology and cause are less well known but may have similar risk factors as black esophagus. These disease pathologies are devastating to the patients they affect and can pose clinical challenges for the providers that encounter them.

Case description: This case report details our experience with a moribund patient who was found to have extensive pneumomediastinum and gastric perforation secondary to black esophagus and black stomach. This was diagnosed on endoscopy following imaging that showed extensive pneumomediastinum. Initially the intent was to temporize the disease process in an attempt to stabilize the patient however at the time of diagnosis, the degree of ischemia had led to perforation and the disease process was not reversible or recoverable. He ultimately expired after comfort directed care measures were put in place.

Conclusions: To the best of our knowledge, this case will be the first reported in current literature and will hopefully shed some light on this unusual and devastating pathology.

Objective: The goal of this review is to describe and compare current and historic endoscopic interventions for gastroesophageal reflux disease (GERD).

Background: The prevalence of GERD affects a large portion of the population. Nearly half of those treated with conservative medical therapy have refractory symptoms of reflux. Surgery is a durable solution for reflux, however, it is an invasive procedure and classical fundoplication comes with its own share of side effects and complications. In this review, we will discuss the advantages and pitfalls of available endoscopic procedures, and describe medium-term (up to several years) outcomes.

Methods: Literature search of the PubMed database, including the years 1999 to 2021 was performed with search terms to reflect the described devices in the review. Individual review of retrieved references was performed for additional sources. Thorough review of societal guidelines was also conducted in preparation of this manuscript.

Conclusions: Gastroesophageal reflux is a common problem in the United States and worldwide, and its prevalence continues to increase. Within the last two decades, there have been several new endoscopic modalities introduced for the management of this disease. Here, we present a focused review of endoscopic gastroesophageal reflux interventions, its advantages and pitfalls. Surgeons focusing on the foregut conditions should be aware of these procedures as they may provide a minimally invasive option for the selected group of patients.