Esophageal diverticula are uncommon lesions that are usually classified according to location, layers of the wall, and underlying pathogenesis. A true traction esophageal diverticulum, which is commonly seen in the middle one-third of the thoracic esophagus, occurs secondary to mediastinal inflammatory lesions, such as those caused by tuberculosis. Esophageal tuberculosis usually develops secondary to tuberculous lymphadenitis or lung lesion; it manifests with various endoscopic findings such as single or multiple ulcers, elevated lesions with ulcers at the center, extrinsic compressions, fistulas, and rarely, anthracosis. Its shape can vary greatly depending on disease progression and treatment. Herein, we report sequential endoscopic findings of a tuberculous esophageal ulcer that turned into a depressed lesion with black-pigmentation, finally developing into a typical traction esophageal diverticulum in a patient with mediastinal lymphadenitis.

Gastric acid-related disorders are commonly encountered in clinical practice. Acetylcholine, gastrin, and histamine are physiological agonists that stimulate acid secretion from parietal cells. Histamine plays a decisive role in the transformation of parietal cells into acid-secreting forms. The H+, K+- ATPase proton pump, which represents the final step of acid secretion, translocates from cytoplasmic tubulovesicles to secretory canaliculi upon parietal cell stimulation and facilitates exchange of intracellular H+ with extracellular K+ in a 1:1 ratio. Histamine-2 receptor antagonists and proton pump inhibitors (PPIs) are widely used in clinical practice, and potassium-competitive acid blockers (P-CABs) have gained attention in recent times. P-CABs address the unmet needs of patients who receive conventional PPIs and have broadened the spectrum of drug choices; however, further research is warranted to confirm long-term safety of these drugs. Comprehensive understanding of the mechanisms of actions, characteristics, advantages and disadvantages, and the adverse effect profile is essential for appropriate prescription of gastric acid-suppressive drugs. In this review, we provide a developing history and outline the pharmacological mechanisms underlying various gastric acid-suppressive drugs used in clinical settings.

Achalasia is a rare primary esophageal motility disorder characterized by the loss of enteric neurons leading to an absence of peristalsis and impaired relaxation of the lower esophageal sphincter. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of esophageal carcinoma. Structural or functional pulmonary abnormalities occur in more than half of patients and may be due to recurrent aspiration or tracheal compression from a dilated esophagus. Delayed diagnosis or ineffective intervention may lead to progressive dilation of the esophagus and the development of a megaesophagus. Respiratory distress and cardiopulmonary arrest from tracheal or left atrial compression secondary to a megaesophagus are rare complications of achalasia. There is only limited evidence that pneumatic dilation may be used as a first-line therapy for a megaesophagus. The choice of definitive treatment will depend on many factors including achalasia type, patient wishes, performance status, and surgical expertise.

The small intestinal microbiota plays a crucial role in maintaining the health and pathogenesis of various gastrointestinal disorders. Despite extensive research on gut microbiota, studies focusing on the small intestine are limited owing to methodological challenges. This review discusses the taxonomic composition, microbial load, and diversity of normal small intestinal microbiota. Additionally, it highlights the role of small intestinal microbiota in gastrointestinal disorders, such as functional dyspepsia, small intestinal bacterial overgrowth, and nonsteroidal anti-inflammatory drug-induced enteropathy. The impact of proton pump inhibitors on small intestinal microbiota dysbiosis underscores the importance of the appropriate use of strong acid suppressants in clinical practice. Future research should focus on both the luminal and mucosal microbiota of the small intestine to explore the taxonomic changes and functional differences.

The small intestinal microbiota plays a crucial role in maintaining the health and pathogenesis of various gastrointestinal disorders. Despite extensive research on gut microbiota, studies focusing on the small intestine are limited owing to methodological challenges. This review discusses the taxonomic composition, microbial load, and diversity of normal small intestinal microbiota. Additionally, it highlights the role of small intestinal microbiota in gastrointestinal disorders, such as functional dyspepsia, small intestinal bacterial overgrowth, and nonsteroidal anti-inflammatory drug-induced enteropathy. The impact of proton pump inhibitors on small intestinal microbiota dysbiosis underscores the importance of the appropriate use of strong acid suppressants in clinical practice. Future research should focus on both the luminal and mucosal microbiota of the small intestine to explore the taxonomic changes and functional differences.

The small intestinal microbiota plays a crucial role in maintaining the health and pathogenesis of various gastrointestinal disorders. Despite extensive research on gut microbiota, studies focusing on the small intestine are limited owing to methodological challenges. This review discusses the taxonomic composition, microbial load, and diversity of normal small intestinal microbiota. Additionally, it highlights the role of small intestinal microbiota in gastrointestinal disorders, such as functional dyspepsia, small intestinal bacterial overgrowth, and nonsteroidal anti-inflammatory drug-induced enteropathy. The impact of proton pump inhibitors on small intestinal microbiota dysbiosis underscores the importance of the appropriate use of strong acid suppressants in clinical practice. Future research should focus on both the luminal and mucosal microbiota of the small intestine to explore the taxonomic changes and functional differences.

The small intestinal microbiota plays a crucial role in maintaining the health and pathogenesis of various gastrointestinal disorders. Despite extensive research on gut microbiota, studies focusing on the small intestine are limited owing to methodological challenges. This review discusses the taxonomic composition, microbial load, and diversity of normal small intestinal microbiota. Additionally, it highlights the role of small intestinal microbiota in gastrointestinal disorders, such as functional dyspepsia, small intestinal bacterial overgrowth, and nonsteroidal anti-inflammatory drug-induced enteropathy. The impact of proton pump inhibitors on small intestinal microbiota dysbiosis underscores the importance of the appropriate use of strong acid suppressants in clinical practice. Future research should focus on both the luminal and mucosal microbiota of the small intestine to explore the taxonomic changes and functional differences.

The small intestinal microbiota plays a crucial role in maintaining the health and pathogenesis of various gastrointestinal disorders. Despite extensive research on gut microbiota, studies focusing on the small intestine are limited owing to methodological challenges. This review discusses the taxonomic composition, microbial load, and diversity of normal small intestinal microbiota. Additionally, it highlights the role of small intestinal microbiota in gastrointestinal disorders, such as functional dyspepsia, small intestinal bacterial overgrowth, and nonsteroidal anti-inflammatory drug-induced enteropathy. The impact of proton pump inhibitors on small intestinal microbiota dysbiosis underscores the importance of the appropriate use of strong acid suppressants in clinical practice. Future research should focus on both the luminal and mucosal microbiota of the small intestine to explore the taxonomic changes and functional differences.

No abstract available.
Esophagus ; Sebaceous Glands

No abstract available.
Misoprostol*