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Andrews CN, Rehak R, Woo M, Walker I, Ma C, Forbes N, Rittenbach K, Hathaway J, Wilsack L, Liu A, Nasser Y, Sharkey KA. Cannabinoid hyperemesis syndrome in North America: evaluation of health burden and treatment prevalence. Aliment Pharmacol Ther 2022; 56:1532-1542. [PMID: 36307209 DOI: 10.1111/apt.17265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/16/2022] [Accepted: 10/11/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND Cannabinoid hyperemesis syndrome (CHS) is a poorly understood vomiting disorder associated with chronic cannabis use. AIMS To characterise patients experiencing CHS in North America and to obtain a population-based estimate of CHS treatment prevalence in Canada before and during the Covid-19 pandemic METHODS: Internet survey of 157 CHS sufferers in Canada and the United States. Administrative health databases for the province of Alberta (population 5 million) were accessed to measure emergency department (ED) visits for vomiting, with a concurrent diagnostic code for cannabis use. Three time periods of 1 year were assessed: prior to recreational cannabis legalisation (2017-2018), after recreational legalisation (2018-2019) and during the first year of the Covid-19 pandemic (2020-2021). RESULTS Problematic cannabis use (defined as a CUDIT-R score ≥8) was universal among the survey cohort, and 59% and 68% screening for moderate or worse anxiety or depression, respectively. The overall treatment prevalence of CHS across all ages increased from 15 ED visits per 100,000 population (95% CI, 14-17) prior to legalisation, to 21 (95% CI, 20-23) after legalisation, to 32 (95% CI, 31-35) during the beginning of the Covid-19 pandemic (p < 0.001). Treatment prevalence among chronic cannabis users was as high as 6 per 1000 in the 16-24 age group. CONCLUSION Survey data suggest patients with CHS almost universally suffer from a cannabis use disorder, which has significant treatment implications. Treatment prevalence in the ED has increased substantially over a very short time period, with the highest rates seen during the Covid-19 pandemic.
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Affiliation(s)
- Christopher N Andrews
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Renata Rehak
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Matthew Woo
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ian Walker
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christopher Ma
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nauzer Forbes
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Katherine Rittenbach
- Provincial Addiction and Mental Health Portfolio™, Alberta Health Services, Calgary, Alberta, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Joshua Hathaway
- Alberta Health Services/CRISM Prairies, CRISM-AHS Advancement of Analytics in Substance Use, Edmonton, Alberta, Canada
| | - Lynn Wilsack
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andy Liu
- Division of Digestive and Liver Diseases, Columbia University Medical Centre, New York, New York City, USA
| | - Yasmin Nasser
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Keith A Sharkey
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Andrews CN, Woo M, Buresi M, Curley M, Gupta M, Tack J, Wilsack L, Nasser Y. Prucalopride in diabetic and connective tissue disease-related gastroparesis: Randomized placebo-controlled crossover pilot trial. Neurogastroenterol Motil 2021; 33:e13958. [PMID: 32743954 DOI: 10.1111/nmo.13958] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/25/2020] [Accepted: 07/08/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Gastroparesis, defined by delayed gastric emptying in the absence of mechanical outlet obstruction, is a frequent neuropathic complication of diabetes mellitus, and effective treatments are lacking. Prucalopride is a pan-gut prokinetic with selective agonist effects on serotonin 5-HT4 receptors in the gut. This study aimed to assess the effect of prucalopride 4 mg daily on Gastroparesis Cardinal Symptom Index (GCSI), meal-related symptom score (MRSS), and gastric emptying rate in diabetic or connective tissue disease (CTD)-related gastroparesis patients. METHODS This was a double-blind crossover trial of four-week treatment periods with prucalopride or placebo divided by two weeks of washout. GSCI, MRSS, gastric emptying scintigraphy, PAGI-SYM, and PAGI-QoL were assessed at baseline and the end of each treatment period. Daily bowel movement (BM) frequency and gastrointestinal symptoms were recorded in each period. KEY RESULTS Fifteen gastroparesis patients (13 diabetic, 2 CTD) were enrolled. GCSI scores were lower than baseline but not different between treatment arms. MRSS scores over time or cumulative score were not significantly different between groups. Gastric emptying was more rapid in the prucalopride treatment period, with mean four-hour meal retention of 22 ± 6% in PRU period vs 40 ± 9% in the placebo period (P = 0.05). Weekly BM frequency was significantly higher in prucalopride than placebo periods (10.5 ± 1.8 vs 7.5 ± 0.8, P < 0.0001). Perception of weight loss was higher in patients on prucalopride. Analysis of diabetic gastroparesis (n = 13) population did not change the conclusions. CONCLUSION AND INFERENCE Prucalopride at 4 mg accelerates gastric emptying and bowel movement frequency but does not appear to ameliorate gastroparesis or meal-related symptoms in this study.
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Affiliation(s)
- Christopher N Andrews
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Matthew Woo
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michelle Buresi
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michael Curley
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Milli Gupta
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jan Tack
- Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - Lynn Wilsack
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yasmin Nasser
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Moosavi S, Woo M, Jacob DA, Pradhan S, Wilsack L, Buresi M, Gupta M, Al-Awadh Y, Li D, Andrews CN. Anticholinergic, anti-depressant and other medication use is associated with clinically relevant oesophageal manometric abnormalities. Aliment Pharmacol Ther 2020; 51:1130-1138. [PMID: 32383253 DOI: 10.1111/apt.15758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/07/2020] [Accepted: 04/07/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Medications can affect gastrointestinal tract motility. However, their effects on oesophageal motility in particular are often not as widely known or may be underestimated. AIM To review the effect of existing medication use on high-resolution oesophageal manometry (HRM) in a 'real-world' setting. METHODS Adult patients with upper gut symptoms and normal endoscopy or imaging who had HRM over a 22-month period were analysed. Achalasia and major disorders of peristalsis were excluded. All medications taken within 24 hours of the procedure were prospectively recorded and compared with HRM results, controlling for age, gender and proton pump inhibitor use. RESULTS A total of 502 patients (323 female, mean age 51) were recruited. Of these, 41.2% had normal oesophageal HRM, while 41.4% had ineffective oesophageal motility (IOM) and 7.6% had oesophagogastric junction outflow obstruction (OGJOO). Serotonin/norepinephrine reuptake inhibitors (SNRI) and opioids were associated with significantly higher resting lower oesophageal sphincter pressure. Benzodiazepines and opioids were associated with elevated integrated relaxation pressure. SNRI and inhaled beta-agonists were associated with increased distal contractile index, whereas calcium channel blockers were associated with a lower distal contractile index. Odds ratio of being on anticholinergics was higher in IOM patients vs normal (3.6, CI 1.2-10.8). Odds ratio for anticholinergics, inhaled beta-agonists, anticonvulsants, SNRIs and opioids (trend) were all > 3 for OGJOO patients vs normal. CONCLUSION Many medication classes are associated with abnormal HRM variables and diagnoses such as OGJOO and IOM; some of these associations are probably causal. These possible links should be taken into consideration during manometry interpretation.
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Affiliation(s)
- Sarvee Moosavi
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Matthew Woo
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deepti A Jacob
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Gastroenterology and Hepatology, Mayo Clinic Health Systems, Eau Claire, WI, USA
| | - Sarah Pradhan
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lynn Wilsack
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michelle Buresi
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Milli Gupta
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yacoub Al-Awadh
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Haya Al-Habeeb Gastroenterology Center, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Dorothy Li
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christopher N Andrews
- Department of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Woo M, Liu A, Wilsack L, Li D, Gupta M, Nasser Y, Buresi M, Curley M, Andrews CN. Gastroesophageal Reflux Disease Is Not Associated With Jackhammer Esophagus: A Case-control Study. J Neurogastroenterol Motil 2020; 26:224-231. [PMID: 32235029 PMCID: PMC7176498 DOI: 10.5056/jnm19096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/27/2019] [Accepted: 09/20/2019] [Indexed: 01/01/2023] Open
Abstract
Background/Aims The pathophysiology of jackhammer esophagus (JE) remains unknown but may be related to gastroesophageal reflux disease or medication use. We aim to determine if pathologic acid exposure or the use of specific classes of medications (based on the mechanism of action) is associated with JE. Methods High-resolution manometry (HRM) studies from November 2013 to March 2019 with a diagnosis of JE were identified and compared to symptomatic control patients with normal HRM. Esophageal acid exposure and medication use were compared between groups. Multivariate regression analysis was performed to look for predictors of mean distal contractile integral. Results Forty-two JE and 127 control patients were included in the study. Twenty-two (52%) JE and 82 (65%) control patients underwent both HRM and ambulatory pH monitoring. Two (9%) JE patients and 14 (17%) of controls had evidence of abnormal acid exposure (DeMeester score > 14.7); this difference was not significant (P = 0.290). Thirty-six (86%) JE and 127 (100%) control patients had complete medication lists. Significantly more JE patients were on long-acting beta agonists (LABA) (JE = 5, control = 4; P = 0.026) and calcium channel blockers (CCB) (JE = 5, control = 3; P = 0.014). Regular opioids (β = 0.298, P = 0.042), CCB (β = 0.308, P = 0.035), and inhaled anticholinergics (β = 0.361, P = 0.049) predicted mean distal contractile integral (R2 = 0.082, F = 4.8; P = 0.003). Conclusions Pathologic acid exposure does not appear to be associated with JE. JE patients had increased CCB and LABA use. The unexpected finding of increased LABA use warrants more investigation and may provide support for a cholinergic etiology of JE.
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Affiliation(s)
- Matthew Woo
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Andy Liu
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lynn Wilsack
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Dorothy Li
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Milli Gupta
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Yasmin Nasser
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Michelle Buresi
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Michael Curley
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Christopher N Andrews
- Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Liu A, Woo M, Nasser Y, Gupta M, Buresi MC, Curley M, Li DY, Wilsack L, Andrews CN. Esophagogastric junction outflow obstruction on manometry: Outcomes and lack of benefit from CT and EUS. Neurogastroenterol Motil 2019; 31:e13712. [PMID: 31523911 DOI: 10.1111/nmo.13712] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/31/2019] [Accepted: 08/18/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Esophagogastric junction outflow obstruction (EGJOO) is a manometric diagnosis based on the Chicago Classification defined by inadequate relaxation of the gastroesophageal junction (GEJ) with swallowing, but with sufficient peristalsis such that the criteria for achalasia are not met. Possible causes include anatomical and functional etiologies. Further investigations, including computed tomography (CT) of the chest and endoscopic ultrasound (EUS), to help elucidate the etiology of EGJOO have been suggested, but the utility of this approach has not been proven. METHODS All new diagnoses of EGJOO made in the calendar years 2015-2016 were included. A review was performed for each patient to assess clinical outcomes, diagnostic, and therapeutic interventions after the EGJOO diagnosis. KEY RESULTS 107 EGJOO patients were included. Their primary complaints were dysphagia (68%), chest pain (12%), reflux (8%), pre-operative assessment (6%), regurgitation (3%), and cough (3%). The mean IRP was 21.8 mm Hg. After a mean follow-up period of 463 days, the etiology of EGJOO remained undetermined in 67% of patients. 48% of patients were investigated with cross-sectional imaging (and 10% with EUS to rule out external compression or malignancy as a cause of EGJOO; none of these tests provided any further useful information). In only two cases did the EGJOO progress to achalasia. CONCLUSIONS & INFERENCES EGJOO is a manometric diagnosis with unclear clinical significance and outcome. CT and EUS of the GEJ were unhelpful at determining the cause of this entity. In this series, very few appear to progress to achalasia, none were due to malignancy, and many resolved spontaneously.
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Affiliation(s)
- Andy Liu
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Matthew Woo
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Yasmin Nasser
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Milli Gupta
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Michelle C Buresi
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Michael Curley
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Dorothy Y Li
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Lynn Wilsack
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Christopher N Andrews
- Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada
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Woo M, Liu A, Wilsack L, Buresi MC, Curley M, Gupta M, Li DY, Andrews CN. A171
GERD IS NOT ASSOCIATED WITH JACKHAMMER ESOPHAGUS. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Woo
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - A Liu
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - L Wilsack
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M c Buresi
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M Curley
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M Gupta
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - D Y Li
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - C N Andrews
- Gastroenterology, University of Calgary, Calgary, AB, Canada
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David J, Wilsack L, Buresi M, Curley M, Li DY, Andrews CN, Gupta M. A147 QUALITY OF LIFE IN PATIENTS WITH IRRITABLE BOWEL SYNDROME WITH CONSTIPATION (IBS-C) FOLLOWING 60 DAYS TREATMENT. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J David
- Alberta Health Services, Calgary, AB, Canada
| | - L Wilsack
- University of Calgary, Calgary , AB, Canada
| | - M Buresi
- University of Calgary, Calgary , AB, Canada
| | - M Curley
- University of Calgary, Calgary , AB, Canada
| | - D Y Li
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - C N Andrews
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M Gupta
- University of Calgary, Calgary , AB, Canada
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Liu A, Woo M, Wilsack L, Buresi MC, Curley M, Gupta M, Li DY, Andrews CN. A54 ASSOCIATION BETWEEN MEDICATION USE AND JACKHAMMER ESOPHAGUS: A CASE-CONTROL STUDY. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Liu
- University of Calgary, Calgary, AB, Canada
| | - M Woo
- Division of Gastroenterology, Queen’s, Kingston6, ON, Canada
| | - L Wilsack
- University of Calgary, Calgary, AB, Canada
| | - M c Buresi
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M Curley
- University of Calgary, Calgary, AB, Canada
| | - M Gupta
- Foothills Hospital, Calgary, AB, Canada
| | - D Y Li
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - C N Andrews
- Gastroenterology, University of Calgary, Calgary, AB, Canada
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Liu A, Wilsack L, Buresi MC, Curley M, Gupta M, Li DY, Andrews CN. A300 ESOPHAGOGASTRIC JUNCTION OUTFLOW OBSTRUCTION ON MANOMETRY: OUTCOMES AND LACK OF BENEFIT FROM IMAGING. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Liu
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - L Wilsack
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M c Buresi
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M Curley
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - M Gupta
- Foothills Hospital, Calgary, AB, Canada
| | - D Y Li
- Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - C N Andrews
- Gastroenterology, University of Calgary, Calgary, AB, Canada
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Pradhan S, Buresia M, Gupta M, Curley M, Wilsack L, Andrews CN. Manometric and demographic predictors of incomplete bolus transit in patients diagnosed with ineffective esophageal motility. BMC Proc 2015. [PMCID: PMC4625412 DOI: 10.1186/1753-6561-9-s7-a14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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