Endoscopic Ablation

The preliminary data now available from a large multicenter trial, which randomized patients to photodynamic therapy using porfimer sodium with PPI versus PPI alone, suggest that this therapy is ready to enter the clinical arena. This is the largest randomized trial to date on any therapy in patients with BE. With a minimum follow-up of 2 years, there has been a documented decrease in the development of AC of the esophagus in patients undergoing photody-namic therapy. Thus, a therapy less than esophageal resection, may offer the opportunity to reduce the development of AC of the esophagus by 50% while maintaining esophageal function. The immediate potential mortality of esophagectomy is avoided, but the possibility of failure to eliminate the later development of cancer in the in situ esophagus is an additional issue that the patient and physician must face. Other forms of endoscopic ablation therapy are still considered experimental. The widely applied modalities have been thermal, including argon plasma coagulation and multipolar electrocoagulation. The next chapter (see Chapter 15) is about ablation therapy in esophageal disease.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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