Unusual presentation of mucosal hypersensitivity secondary to gastroesophageal reflux disease.
We report an unusual presentation of gastroesophageal reflux disease in a 14-yr-old boy with cervical dysphagia and vomiting immediately after swallowing. Reflux disease was diagnosed by the combination of eosinophils on esophageal biopsies and abnormal 24-h pH results. The cervical site of dysphagia demonstrated acid-induced hypersensitivity to esophageal distension with water or air. The patient's symptoms resolved with marked acid suppression, which was made difficult because intact capsules of omeprazole initially could not be ingested.
Baron
T H
TH
Division of Gastroenterology, University of Alabama, Birmingham.
Richter
J E
JE
Singh
S
S
Tennyson
G S
GS
Andres
J M
JM
D000293:Adolescent; D003680:Deglutition Disorders / Q000209:etiology*; D004750:Enteral Nutrition; D004804:Eosinophils / Q000473:pathology; D004942:Esophagitis, Peptic / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D009092:Mucous Membrane / Q000473:pathology; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use; D011899:Ranitidine / Q000008:administration & dosage / Q000627:therapeutic use; D014839:Vomiting / Q000209:etiology*
D011899:Ranitidine; D009853:Omeprazole