Primary Motility  Disorders of the  Esophagus
 The Esophageal
 Esophagogastric  Junction

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Volume: The Esophagogastric Junction
Chapter: Particular problems in medical therapy

What are the respective mucosal damages related to pepsin or trypsin esophageal exposure?
D. Hopwood (Dundee) 

What is the mechanism of accentuation of the noxious effect of bile acids by acid suppression therapy?
D. Liebermann-Meffert, H.J. Stein (Munich) 

What is the compared effect of PPIs and H2-blockers in symptom relief?
M. Robinson (Oklahoma City) 

What is the efficacy of PPIs on acute reflux esophagitis resistant to high dose H2-blockers? On symptoms? On healing?
G. Brunner, C. Athmann (Hannover) 

Can serum gastrin be used as an indicator of acid suppression in patients treated with PPIs?
R.M. Gideon, V. Paoletti, D.O. Castell (Philadelphia) 

What is the action of PPIs on neutrophil endothelial cell adhesive activity induced by H. pylori? On oxygen-derived free-radical production from neutrophils activated by H. pylori?
M. Suzuki (Tokyo) 

Can healing of esophagitis without acid suppression be envisaged by eradication of
H. pylori?

F.K.L. Chan, J.J.Y. Sung (Hong-Kong) 

What is the optimal therapy for H. pylori eradication?
T.J. Borody (Sydney) 

What are the different groups of prokinetic agents, and their respective modes of action?
J. Behar (Providence) 

What are the mechanisms responsible for the efficacy of cisapride in treatment of reflux esophagitis?
W.G. Paterson (Kingston) 
C. Scarpignato (Nantes, Parma), I. Pelosini (Parma) 

What is the role of erythromycin derivatives as part of the medical treatment of esophagitis?
M. Delvaux (Toulouse) 

When are 5HT3 receptor antagonists and CCK antagonists indicated for slow gastric emptying?
J.P. Barbier, C. Cellier (Paris) 

Compared to cisapride, what can be expected from new erythromycin derivatives in stimulation of the LES in humans?
T.L. Peeters (Leuven) 

What is the impact of pH testing on treatment selection?
H.R. Koelz (Zurich) 

Can prolonged esophageal manometry allow for detection of an improvement in motor dysfunction after healing of esophagitis?
R. Fiasse, P. Deprez (Brussels) 

Are there data comparing endoscopic and histologic healing after H2-blockade?
J.R. Malagelada, F. Mearin (Barcelona) 

Long-term therapy

What is the incidence of bacterial overgrowth during acid suppressive treatment?
J. Thorens (Lausanne) 

Is there any explanation for fundic polyps developing after long-term PPI therapy?
F. Baldi, M.L. Brancaccio, R. Cappiello (Bologna) 

Is intermittent therapy advisable in long-term medical management of GER patients?
S. Bank, M. Blumstein, R. Greenberg, L. Austin-Brigante (New York) 

Refractory esophagitis

Can a relationship be shown between persistent delayed gastric emptying and prevision of resistance to treatment and/or recurrence in patients treated for GER?
C. Scarpignato (Nantes, Parma), I. Pelosini (Parma), J.P. Galmiche (Nantes) 

What is the rate of persistent distal acid exposure observed in patients treated with high doses of PPIs?
D.O. Castell (Philadelphia) 

To what factors can inadequate control of gastric and esophageal acid exposure be related?
V. Maffettone, A. Martella, G. Izzo, F. Acierno, A. Del Genio (Naples)  

Are histological modifications of value in predicting relapse after medical treatment?
A. Bortoli, A. Prada, E. Tavani, S. Bellone (Milan) 

What are the mechanisms responsible for failure to respond to PPIs?
A. Watson (London) 

How should maintenance therapy be conducted in refractory esophagitis?
D. Couturier, V. Abitbol (Paris) 

Is low dosage of PPIs effective?
F. Pace, S. Bollani, G. Bianchi Porro (Milan) 

Lower esophageal stenoses

What is the role of the esophageal sensitivity in the development of stenosing esophagitis?
J.F. Rey (Saint Laurent du Var) 

Is the association between non steroidal anti-inflammatory agents (NSAIDs) and reflux esophagitis significant?
A. Lanas (Zaragoza), B.I. Hirschowitz (Birmingham, Alabama) 

How can the frequent absence of symptoms in SRE be explained?
F. Mearin, J.R. Malagelada (Barcelona) 

How can the caliber of a stenosis be evaluated?
H.W. Boyce (Tampa) 

Do truly undilatable stenoses exist?
H.W. Boyce (Tampa) 

Can the proportions of obtained maximal dilatation with the different types of bougies be evaluated?
F. Vicari (Nancy) 

When should a surgical decision have been made in reflux esophagitis?
J.R. Bennett (Hull) 

Publication date: May 1998 OESO©2015