This research study will include patients undergoing esophagectomy. The purpose of this study is to determine the effectiveness of using a FDA approved monitor, the FloTrac monitor, to help determine how much fluid and blood pressure medications a patient receives during surgery to maintain a stable blood pressure.
Eosinophilic esophagitis is understood to be a chronic inflammatory disease characterized by the presence of esophageal eosinophilia in the clinic context of dysphagia. This disease has been further categorized into predominantly fibrostenotic and inflammatory phenotypes. It is believed that these two subtypes may represent a continuum of change and disease progression of the esophagus; with fibrostenotic changes developing over time. We have demonstrated in another study that intrabolus pressure as obtained via high resolution esophageal manometry can reliably differentiate these two subtypes. It is our hypothesis that intrabolus pressure may not only serve as a novel tool to differentiate these subtypes, but may serve as a novel objective marker to assess overall clinical severity of this disease. After thorough review of the current literature, there have yet been no studies demonstrating a reliable diagnostic modality to accomplish this objective. A novel prognostic marker would help further our understanding of eosinophilic esophagitis and help guide more focused management.
In this study, patients undergoing a Modified Barium Swallowing Study (MBSS) will also have a high resolution pharyngeal and esophageal manometry catheter in place to measure the pressures generated by the throat (pharynx) and esophagus (food pipe) during swallowing. Certain swallowing behaviors (such as performing an "effortful swallow") will be done to see how these behaviors might affect the swallowing mechanism as a whole.
The study will compare two durations of treatment with Octreotide in patients with confirmed esophageal variceal hemorrhage who have undergone successful endoscopy and possible endoscopic therapy for control of bleeding. All procedures including the treatment are the standard of care. Octreotide infusion and endoscopic therapy for esophageal variceal bleeding with esophageal banding, hemoclipping, and/or saline and/or ethanolamine injection are not investigational.
This study is to find the best time that a follow up appointment can be scheduled to benefit the patient with liver cirrohis to return after having the bleeding vessels in the esophagus repaired by directing a scope in the esophagus and using bands to stop the bleeding.