By Ralph Boulton, Sanjeev Gupta, Claire Cousins, Humphrey Hodgson
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E. no propulsive contractions) are seen in the oesophageal body on swallowing (28). Special forms Megaoesophagus associated with absent peristalsis occurs in amyloid. Paraneoplastic manifestations of carcinoma of the pancreas, stomach, and bronchus may mimic achalasia, but these patients have a shorter history of dysphagia (<1 year), and disproportionate weight loss. Secondary forms are seen in diabetic or alcoholic neuropathy, pseudo-obstruction, and Chagas’ disease (parasitic infection due to Trypanosoma cruzi).
Aetiology, epidemiology, and pathophysiology Pharyngeal pouches are uncommon and affect the elderly. The diverticula arise in the midline, posteriorly between the inferior constrictor and the cricopharyngeus muscles. They enlarge as thin-walled sacs, typically deviating to the left side of the neck. The aetiology may be failure of relaxation during swallowing, due to primary cricopharyngeal dysfunction, sometimes referred to as cricopharyngeal achalasia. There is an association with hiatus hernia.
Pylori antigen detection has been described both for diagnosis of H. pylori colonization and for assessment of eradication. Disease associations with H. pylori Duodenal ulcer There is a very strong association between chronic H. pylori infection and the development of duodenal ulceration. Up to 95% of patients with duodenal ulceration have evidence of H. pylori infection. However, it is important to recall that H. pylori infection is very common in the general population. 66B Gastric ulceration H.
A Colour Handbook of Gastroenterology by Ralph Boulton, Sanjeev Gupta, Claire Cousins, Humphrey Hodgson