[ @entity3521 as a symptom of XXXX ].

@entity1 @entity354 @entity3521 @entity2210
OBJECTIVE: To determine the importance of a symptom of @entity3521 . MATERIAL AND METHODS: The results of examining 95 @entity1 aged 62-92 years with the symptoms of @entity2210 in the Netanya State Geriatric Center (Israel) in 1994-2004 were analyzed. Standard X-ray study of the upper digestive tract was complemented by provocation tests. The length of an X-ray-negative area (XNA) between barium in the esophagus and stomach and the width in the lower esophagus were measured. RESULTS: Only 2 (2%) of the 95 @entity1 were found to have normal function of the gastroesophageal junction (GEJ). Two @entity1 with a drastic esophageal narrowing due to @entity354 were excluded. The remaining (91) @entity1 were divided into 2 groups. The width of the esophagus was less than 2 cm and 2 cm or more in 64 (70%) and 27 (30%) @entity1 , respectively. In weak GEJ, there was esophageal dilatation above the XNA. When in a horizontal position, this portion of the esophagus evacuates its contents into the stomach as a result of ampullary function. It is proximally closed by contracting the functional proximal sphincter (PS). When the ampulla contracts, its pressure increases up to the threshold. This causes the XNA to be closed and the ampulla to inject its contents into the stomach. The wider was the ampulla, the shorter the XNA was. @entity3521 was detected in 20 (22%) of the 91 @entity1 with @entity354 ( @entity354 ). It was always at the level of the PS. CONCLUSION: The so-called sliding esophageal hernia is an esophageal ampulla measuring more than 2 cm in wide. The presence of the esophageal ampulla despite its size suggests that the GEJ is incompetent and @entity354 is present. @entity3521 occurs at the level of the PS due to @entity354 .
