A Simple Guide to Plummer-Vinson Syndrome, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Plummer-Vinson Syndrome, Diagnosis and Treatment and Related Diseases

Plummer-Vinson syndrome (PVS) is a rare disorder featured by the conventional triad of:
1. dysphagia,
2. iron-deficiency anemia, and
3. esophageal web.

The significance of Plummer-Vinson Syndrome is the relationship of long-term (chronic) iron deficiency anemia with dysphagia.

The incidence of Plummer-Vinson Syndrome has declined due to improvement of nutrition world wide.

The precise cause of Plummer-Vinson syndrome is not known.

While genetic predispositions and several other mechanisms have been suggested, the evidence is weak, even though iron deficiency seems to consistently have an important part to play.

This is partly related to studies that have documented an improvement in dysphagia with iron supplements, while iron deficiency is suspected of inducing mucositis leading to web production.

Since patients with Plummer Vinson syndrome may also experience malnutrition, deficiency of vitamin B has also been indicated as a cause, even though the evidence is weak and inconclusive.

Other disorders documented to be linked with Plummer Vinson Syndrome are:
1. Celiac disease,
2. Crohn disease,
3. Rheumatoid arthritis, and
4. Thyroid disease

This raises the possibility that immune dysregulation may be affected in its pathogenesis, even though this has not been proven

It is a rare disorder that can be linked to cancers of the esophagus (gullet) and pharynx (throat).

The precise pathogenesis of PVS and the production of the esophageal web are not well known.

It has been suggested that iron deficiency causes iron-dependent enzyme dysfunction, resulting in oxidative stress and DNA injuries in the epithelia of the esophageal mucosa.

Recurring injury to epithelia due to iron deficiency causes atrophy of mucosa and degradation of pharyngeal muscles, resulting in the development of esophageal webs.

The esophageal web is sited below the cricopharyngeal muscle and is asymmetrically connected to the anterior esophageal wall.

The esophageal web forms a thin mucous membrane on the wall, composed of squamous epithelia.

Upon biopsy, no inflammatory infiltrates are detected.

Iron deficiency has been reported to induce a decrease in contraction amplitude of esophageal muscle.

The part of mucosal inflammation and atrophy particularly in the post-cricoid region has been proposed as a factor for the pathogenesis of PVS.

The post-cricoid region endures maximum trauma during swallowing of the solid bolus, resulting in a higher risk of web production.

Long-standing iron deficiency anemia can manifest as:
1. Dyspnea or difficulty breathing,
2. Tachycardia,
3. Weakness,
4. Pallor, and
5. Koilonychia or spoon nails.

Dysphagia is normally painless and slowly progressing, beginning with solid foods and difficulty swallowing liquids after years of first onset.

Dysphagia shows symptoms only when the luminal diameter in the region of the esophageal web is less than 12 mm.

Hematological testing is done to establish the source of iron deficiency and the severity of anemia.

Video-fluoroscopy is normally more dependable for the demonstration of esophageal webs.

It is a dynamic X-ray evaluation that appraises swallowing while the barium bolus travels to the esophagus from the mouth.

Fiber optic endoscopy is the safest and most reliable method for esophageal examination.

Esophagoscopy, endoscopic examination of the esophagus, has the benefit of being both diagnostic and therapeutic at the same time.

Iron replacement and dilation of esophageal webs are the main treatments of Plummer-Vinson Syndrome.

TABLE OF CONTENT
Introduction
Chapter 1 Plummer-Vinson Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatme

• Language: English
• Publisher: Kenneth Kee
• Release date: Mar 31, 2021
• ISBN: 9781005399955

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Plummer-Vinson Syndrome,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Plummer-Vinson Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Plummer-Vinson Syndrome)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first