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Sample records for non-erosive reflux diseases

  1. Heartburn, gastro-oesophageal reflux disease and non-erosive ...

    African Journals Online (AJOL)

    2010-01-31

    Jan 31, 2010 ... stomach acid causes troublesome reflux-associated symptoms and/or .... Magnesium salts, however, can lead to diarrhoea, and aluminium salts can cause ... relieve symptoms for longer periods.12 Although some proton ... 15 mg and pantoprazole 20 mg.13 Higher dosage PPIs and other. PPIs are ...

  2. Impact of hiatal hernia on histological pattern of non-erosive reflux disease

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    Lyratzopoulos Nikolaos

    2005-01-01

    Full Text Available Abstract Background Hiatus hernia (HH has major pathophysiological effects favoring gastroesophageal reflux and hence contributing to esophageal mucosa injury, especially in patients with severe gastroesophageal disease. However, prospective studies investigating the impact of HH on the esophageal mucosa in non-erosive reflux disease (NERD are lacking. This study evaluated the association between the presence of (HH and the histological findings in symptomatic patients with NERD. Methods Fifty consecutive patients with gastroesophageal reflux disease (GERD were enrolled. After conventional endoscopy, Lugol solution was applied and biopsy specimens were obtained. Histological parameters including basal zone hyperplasia, papillary length and cellular infiltration were evaluated. The chi-square test with Yates' correlation was used for comparing discrete parameters between groups. However, Fisher's exact probability test was used where the expected frequencies were lower than 5. Wilcoxon's test for unpaired samples was preferred in cases of semi-quantitative parameters. Results The presence of HH along with more severe findings (0.01 P P Conclusion The presence of HH is correlated with more severe endoscopy findings, and predisposes for severe histological abnormality in cases of NERD.

  3. Response to air insufflation in patients with non-erosive gastro-oesophageal reflux disease (NERD).

    Science.gov (United States)

    Kira, F; Suzuki, T; Suyama, Y; Nishimura, S; Ogura, K

    2011-01-01

    This study compared changes in intragastric pressure (IGP) in response to a gastric distension stimulus caused by air insufflation in 25 patients with non-erosive gastro-oesophageal reflux disease (NERD) and 34 healthy volunteers (controls). In four NERD patients, IGP responses were also measured before and after oral treatment with 10 mg rabeprazole daily for 2 weeks. The rate of increase in IGP at the start of insufflation was significantly higher in NERD patients than in controls. The time to appearance of symptoms (i.e. time to threshold) was significantly shorter in NERD patients than in controls. Direct measurement of IGP showed that visceral hypersensitivity and impaired fundal relaxation are both characteristic of NERD. Administration of rabeprazole led to a marked prolonging of time to threshold, indicating that treatment could alleviate this hypersensitivity.

  4. Impact of Helicobacter pyloriinfection on histological changes in non-erosive reflux disease

    Institute of Scientific and Technical Information of China (English)

    Anthie Gatopoulou; Konstantinos Mimidis; Alexandra Giatromanolaki; Alexandros Polichronidis; Nikolaos Lirantzopoulos; Efthimios Sivridis; George Minopoulos

    2004-01-01

    AIM: The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease, either in non- erosive (NERD) or erosive esophagitis (ERD) remains uncertain. The available data on the histological changes in NERD and the effect on H pylori infection on them are elusive.The aim of this study therefore was to prospectively evaluate the histological findings and the impact of H pylori infection on a group of symptomatic patients with NERD.METHODS: Fifty consecutive patients were prospectively evaluated for symptoms compatible with GORD. In all cases,routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner.RESULTS: The overall prevalence of H pylori infection was 70%. Twenty-nine patients out of 50 (58%) were NERD patients. No statistical significance was observed between the H pylori status and NERD. The remaining 21 (42%)were diagnosed as follows: 13 (26%), 6 (12%), 2(4%) with esophagitis grade A, B and C respectively. A statistically significant correlation was observed between the H pylori+and esophagitis grade A, as well as between H pylori- and grade B. Biopsies from 2 patients were not included because of insufficient materials. Histologically, a basal zone hyperplasia was found in 47 (97.91%) patients, alterations of glycogen content in 47 (97.91%), papillae elongation in 33 (68.75%),blood vessels dilatation in 35(72.91%), chronic inflammation in 21 (43.75%), infiltration with eosinophils, neutophils and T-lymphocytes in 4 (8.33%), 6 (12.5%) and 39 (81.25%)respectively. No correlation was observed between the H pylori status and the histological parameters studied either in NERD or GERD.CONCLUSION: Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux disease. Moreover, H pylori infection may not act as an important factor in patients with NERD.

  5. Functional dyspepsia (FD) and non-erosive reflux disease (NERD): overlapping or discrete entities?

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2012-02-03

    As the incidence of both gastric cancer and peptic ulcer disease have declined, that of gastro-oesophageal reflux disease (GORD) and non-ulcer, or functional dyspepsia (FD) have reached virtually epidemic proportions. As we come to appreciate the expression of these disorders in the community, the real spectrum of each disease has become evident. FD and non-erosive reflux disease (NERD), the most prevalent manifestation of GORD, frequently overlap. Where then does GORD end and FD begin? Is it realistic, or even clinically relevant, to attempt a clear separation between these entities? These are more than issues of mere semantics; therapeutic options may be dictated by the classification of the patient as one or the other. Recent work indicates clearly that NERD is a heterogeneous disorder incorporating some patients who may well harbour subtle manifestations of oesophagitis and others who have entirely normal 24-hour pH studies. These differences may be crucial to the concept of NERD\\/FD overlap. While evidence in support of this concept is far from complete, it would appear that this overlap is most relevant to those NERD patients who do not exhibit abnormal esophageal acid exposure. These patients truly belong in the spectrum of functional gastrointestinal disorders rather than in GORD; attempts to shoe-horn these individuals into the spectrum of GORD will result in therapeutic disappointment and surgical disaster.

  6. Cell proliferation of esophageal squamous epithelium in erosive and non-erosive reflux disease

    Institute of Scientific and Technical Information of China (English)

    Carlo Calabrese; Davide Trerè; Lorenzo Montanaro; Giuseppina Liguori; Elisa Brighenti; Mauela Vici; Paolo Gionchetti; Fernando Rizzello; Massimo Campieri; Massimo Derenzini

    2011-01-01

    AIM: To elucidate cell proliferation in erosive reflux disease (ERD) and non-erosive reflux disease (NERD), we evaluated markers in squamous epithelial cells. METHODS: Thirty-four consecutive patients with gastroesophageal- reflux-disease-related symptoms (21 NERD and 13 ERD) were evaluated for the enrolment into the study. All patients underwent 24-h pH monitoring, standard endoscopy, and biopsy for histological evaluation. The expression of cyclins D and A was evaluated by real-time reverse transcription polymerase chain reaction (RT-PCR) from isolated epithelial cells. In all samples, analysis of the isolated cell population revealed the presence of epithelial cells only. RESULTS: Real-time RT-PCR showed that, in patients with ERD, the relative expression of cyclin D1 mRNA in esophageal epithelium was strongly decreased in comparison with NERD patients. The mean value of relative expression of cyclin D1 mRNA in NERD patients was 3.44 ± 1.9, whereas in ERD patients, it was 1.32 ± 0.87 (P = 0.011). Real-time RT-PCR showed that, in patients with ERD, relative expression of cyclin A mRNA in esophageal epithelium was decreased in comparison with that in NERD patients (2.31 ± 2.87 vs 0.66 ± 1.11). The mean bromodeoxyuridine labeling index in the NERD patients was 5.42% ± 1.68%, whereas in ERD patients, it was 4.3% ± 1.59%. CONCLUSION: We confirmed reduced epithelial proliferation in ERD compared with NERD patients, and that individuals who develop ERD are characterized by weaker epithelial cell proliferation.

  7. Risk factors for gastroesophageal reflux disease, reflux esophagitis and non-erosive reflux disease among Chinese patients undergoing upper gastrointestinal endoscopic examination

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To analyze the spectrum and risk factors of gastroesophageal reflux disease (GERD) based on presenting symptoms and endoscopic findings. METHODS: A cross-sectional survey in a cluster random sample was conducted from November 2004 to June 2005 using a validated Chinese version Reflux Disease Questionnaire (RDQ) and other items recording the demographic characteristics and potential risk factors for GERD. Subjects were defined as having GERD symptoms according to the RDQ score (>12). All subjects were endoscopied and the definition and severity of erosive esephagitis were evaluated by Los Angeles classification.The statistical analysis was performed with SPSS13.0 programs. RESULTS: Of 2231 recruited participants, 701 (31.40%) patients were diagnosed as having GFRD while 464 (20.80%) patients had objective findings of reflux esophagitis (RE). Of those 464 patients, only 291 (13.00%) were reported as subjects with GERD symptoms. A total of 528 (23.70%) patients were found to have GERD symptoms, including 19.50% patients with grade A or B reflux esophagitis, 0.90% with grade C and 0.40% with grade D. On multivariate analysis, old age,male, moderate working burden, divorced/widowed and strong tea drinking remained as significant independent risk factors for erosive esophagitis. Meanwhile, routine usage of greasy food and constipation were considered as significant independent risk factors for non-erosive reflux disease (NERD).CONCLUSION: GERD is one of the common GI diseases with a high occurrence rate in China and its main associated factors include sex, anthropometrical variables and sociopsychological characteristics.

  8. Efficacy of esomeprazole and flupentixol and melitracen in treatment of non-erosive gastroesophageal reflux disease with depression and anxiety

    Institute of Scientific and Technical Information of China (English)

    钟英强

    2006-01-01

    Objective To investigate the efficacy of esomeprazole (Esomeprazole) and flupentixol and melitracen (Deanxit) in treatment of non-erosive gastroesophageal reflux disease (NERD) with depression and anxiety. Methods The diagnosis of NERD was based on the results of esomeprazole scale (reflux diagnostic questionnaires, RDQ) and endoscopy, the degree and frequency of symptoms were graded and scored. Hamilton depression scale was used to evaluate depression and anxiety status. Sixty-three patients were randomly divided into group A (esomeprazole 20 mg qd),B (Deanxit 1 tab

  9. Therapeutic efficacy of digital music gastric electrical pacing for refractory functional dyspepsia concomitant with non-erosive reflux disease

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    Ya-mei RAN

    2015-04-01

    Full Text Available Objective To study the clinical efficacy of digital music gastric electrical pacing for refractory functional dyspepsia concomitant with non-erosive reflux disease, and its effects on mental health and life-quality of the patients. Methods According to the Rome Ⅲ criteria and Montreal consensus in diagnosis of gastroesophageal reflux disease, 50 patients with concomitant refractory functional dyspepsia and non-erosive reflux disease were recruited. The clinical efficacy of digital music gastric electrical pacing were evaluated using the score of clinical symptoms before treatment and 15 days after treatment, and the mental health and life-quality of patients were assessed using symptom checklist 90. Results Main symptoms, including upper abdominal pain, abdominal fullness, early satiety, belching, hiccup, nausea, heartburn, acid reflux (daytime, nocturnal acid reflux, loss of appetite and sleep, were significantly improved 15 days after treatment compared with those of pre-treatment, and there were statistically significant differences (all P<0.005. The significant response rate/response rate (efficacy rate were 59.0%/100.0%, 59.3%/96.3%, 47.0%/94.1%, 61.3%/96.8 %, 86.7%/100.0%, 80.0%/100.0%, 64.3%/92.9%, 73.7%/89.5%, 64.3%/85.7%, 90.0%/90.0%, 36.7%/93.3% respectively. After treatment for 15 days, the overall response rate of symptom relief was 94.4% in patients and the overall significant response rate was 65.7%. The symptom scores of somatization, obsessive-compulsiveness, depression, and anxiety were significantly improved, and the differences were statistically significant (all P<0.01. Conclusion The clinical efficacy of digital music gastric electrical pacing is significant for refractory functional dyspepsia concomitant with nonerosive reflux disease, and it is expected to be a new option for the treatment of this disease complex. DOI: 10.11855/j.issn.0577-7402.2015.03.08

  10. A study on the efficacy of rebamipide for patients with proton pump inhibitor-refractory non-erosive reflux disease.

    Science.gov (United States)

    Adachi, Kyoichi; Furuta, Kenji; Miwa, Hiroto; Oshima, Tadayuki; Miki, Masaharu; Komazawa, Yoshinori; Iwakiri, Katsuhiko; Furuta, Takahisa; Koike, Tomoyuki; Shimatani, Tomohiko; Kinoshita, Yoshikazu

    2012-06-01

    Reflux symptoms in patients with non-erosive reflux disease (NERD) cannot be easily controlled by treatment with proton pump inhibitors (PPI). The anti-inflammatory function of rebamipide may be effective for protecting the esophageal mucosa. This prospective randomized multicenter placebo-controlled study was performed to clarify the efficacy of rebamipide for NERD patients whose reflux symptoms were refractory to PPI treatment. One hundred forty-nine patients were enrolled on the basis of a QUEST score of over 6 and absence of endoscopically proven esophageal mucosal breaks. All the patients were initially administered 15 mg of lansoprazole for 4 weeks, and the symptoms were then assessed using QUEST and GSRS. PPI-refractory patients were randomly assigned to administration of rebamipide or placebo t.i.d. for 4 weeks. Three of the 149 patients were lost to follow-up, and 60 among the remaining 146 patients were found to be PPI-refractory. Among these PPI-refractory patients, 31 were randomly assigned to a rebamipide group and 29 to a placebo group. At the end of drug administration, the QUEST and GSRS scores did not differ between the rebamipide and placebo groups, although a significantly higher proportion of patients in the rebamipide group showed amelioration of abdominal pain and diarrhea. Administration of rebamipide cannot effectively control reflux symptoms in NERD patients whose symptoms are refractory to PPI therapy.

  11. Background factors of reflux esophagitis and non-erosive reflux disease: a cross-sectional study of 10,837 subjects in Japan.

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    Chihiro Minatsuki

    Full Text Available BACKGROUND: Despite the high prevalence of gastroesophageal reflux disease (GERD, its risk factors are still a subject of controversy. This is probably due to inadequate distinction between reflux esophagitis (RE and non-erosive reflux disease (NERD, and is also due to inadequate evaluation of adjacent stomach. Our aim is therefore to define background factors of RE and NERD independently, based on the evaluation of Helicobacter pylori infection and gastric atrophy. METHODS: We analyzed 10,837 healthy Japanese subjects (6,332 men and 4,505 women, aged 20-87 years who underwent upper gastrointestinal endoscopy. RE was diagnosed as the presence of mucosal break, and NERD was diagnosed as the presence of heartburn and/or acid regurgitation in RE-free subjects. Using GERD-free subjects as control, background factors for RE and NERD were separately analyzed using logistic regression to evaluate standardized coefficients (SC, odds ratio (OR, and p-value. RESULTS: Of the 10,837 study subjects, we diagnosed 733 (6.8% as RE and 1,722 (15.9% as NERD. For RE, male gender (SC = 0.557, OR = 1.75, HP non-infection (SC = 0.552, OR = 1.74, higher pepsinogen I/II ratio (SC = 0.496, OR = 1.64, higher BMI (SC = 0.464, OR = 1.60, alcohol drinking (SC = 0.161, OR = 1.17, older age (SC = 0.148, OR = 1.16, and smoking (SC = 0.129, OR = 1.14 are positively correlated factors. For NERD, HP infection (SC = 0.106, OR = 1.11, female gender (SC = 0.099, OR = 1.10, younger age (SC = 0.099, OR = 1.10, higher pepsinogen I/II ratio (SC = 0.099, OR = 1.10, smoking (SC = 0.080, OR = 1.08, higher BMI (SC = 0.078, OR = 1.08, and alcohol drinking (SC = 0.076, OR = 1.08 are positively correlated factors. Prevalence of RE in subjects with chronic HP infection and successful HP eradication denotes significant difference (2.3% and 8.8%; p<0.0001, whereas that of NERD shows no difference (18.2% and 20.8%; p = 0.064. CONCLUSIONS: Significantly associated factors of NERD are considerably

  12. Background Factors of Reflux Esophagitis and Non-Erosive Reflux Disease: A Cross-Sectional Study of 10,837 Subjects in Japan

    Science.gov (United States)

    Minatsuki, Chihiro; Yamamichi, Nobutake; Shimamoto, Takeshi; Kakimoto, Hikaru; Takahashi, Yu; Fujishiro, Mitsuhiro; Sakaguchi, Yoshiki; Nakayama, Chiemi; Konno-Shimizu, Maki; Matsuda, Rie; Mochizuki, Satoshi; Asada-Hirayama, Itsuko; Tsuji, Yosuke; Kodashima, Shinya; Ono, Satoshi; Niimi, Keiko; Mitsushima, Toru; Koike, Kazuhiko

    2013-01-01

    Background Despite the high prevalence of gastroesophageal reflux disease (GERD), its risk factors are still a subject of controversy. This is probably due to inadequate distinction between reflux esophagitis (RE) and non-erosive reflux disease (NERD), and is also due to inadequate evaluation of adjacent stomach. Our aim is therefore to define background factors of RE and NERD independently, based on the evaluation of Helicobacter pylori infection and gastric atrophy. Methods We analyzed 10,837 healthy Japanese subjects (6,332 men and 4,505 women, aged 20–87 years) who underwent upper gastrointestinal endoscopy. RE was diagnosed as the presence of mucosal break, and NERD was diagnosed as the presence of heartburn and/or acid regurgitation in RE-free subjects. Using GERD-free subjects as control, background factors for RE and NERD were separately analyzed using logistic regression to evaluate standardized coefficients (SC), odds ratio (OR), and p-value. Results Of the 10,837 study subjects, we diagnosed 733 (6.8%) as RE and 1,722 (15.9%) as NERD. For RE, male gender (SC = 0.557, OR = 1.75), HP non-infection (SC = 0.552, OR = 1.74), higher pepsinogen I/II ratio (SC = 0.496, OR = 1.64), higher BMI (SC = 0.464, OR = 1.60), alcohol drinking (SC = 0.161, OR = 1.17), older age (SC = 0.148, OR = 1.16), and smoking (SC = 0.129, OR = 1.14) are positively correlated factors. For NERD, HP infection (SC = 0.106, OR = 1.11), female gender (SC = 0.099, OR = 1.10), younger age (SC = 0.099, OR = 1.10), higher pepsinogen I/II ratio (SC = 0.099, OR = 1.10), smoking (SC = 0.080, OR = 1.08), higher BMI (SC = 0.078, OR = 1.08), and alcohol drinking (SC = 0.076, OR = 1.08) are positively correlated factors. Prevalence of RE in subjects with chronic HP infection and successful HP eradication denotes significant difference (2.3% and 8.8%; p<0.0001), whereas that of NERD shows

  13. 非糜烂性反流病与功能性烧心%Non-erosive reflux disease and functional heartburn

    Institute of Scientific and Technical Information of China (English)

    郑晓敏; 李敏

    2012-01-01

    Rome III criteria provide the diagnostic criteria for non-erosive reflux disease ( IN'ERD ) and functional heartburn (FH). Actually, sometimes it is difficult to distinguish between NERD and FH in clinical. NERD and FH are heterogeneous diseases with distinct pathogenesis and clinical characteristics. This review combines recent research progress and describes characteristics of 2 diseases, based on e,sophageal visceral sensitivity, esophageal motility, psychological factors, the relationship with functional diseases, symptom characteristics and therapeutic effect. Further, their mutual relations are also explored.%罗马Ⅲ标准提出了非糜烂性反流病(NERD)和功能性烧心(FH)的诊断标准,实际上,临床上有时很难区分NERD和FH.NERD和FH是两种发病机制及临床特点不同的异质性疾病,本综述结合目前研究进展,从食管内脏敏感性、食管动力、精神心理因素、与功能性疾病关系、症状特点及治疗效果方而阐述两者特点,并探讨其相互关系.

  14. Rabeprazole vs esomeprazole in non-erosive gastro-esophageal reflux disease: A randomized, double-blind study in urban Asia

    Institute of Scientific and Technical Information of China (English)

    KM Fock; EK Teo; TL Ang; TS Chua; TM Ng; YL Tan

    2005-01-01

    AIM: Gastro-esophageal reflux disease (GERD) is becoming increasingly common in Asia. Data on the efficacy of proton pump inhibitors in patients with non-erosive GERD (NERD) in Asia is lacking. This double-blind study compared the efficacy and safety of rabeprazole with esomeprazole in relief of symptoms in patients with NERD. METHODS: One hundred and thirty-four patients with reflux symptoms of NERD and normal endoscopy were randomized to receive rabeprazole 10 mg or esomeprazole 20 mg once daily for 4 wk. Symptoms were recorded in a diary and changes in severity of symptoms noted. RESULTS: At 4 wk of treatment, rabeprazole 10 mg and esomeprazole 20 mg were comparable with regards to the primary endpoint of time to achieve 24-h symptomfree interval for heartburn 8.5 d vs 9 d and regurgitation 6 d vs 7.5 d. Rabeprazole and esomeprazole were also similarly efficacious in term of patient's global evaluation with 96% of patients on rabeprazole and 87.9% of patients on esomeprazole, reporting that symptoms improved (P = NS). Satisfactory relief of day- and night-time symptoms was achieved in 98% of patients receiving rabeprazole and 81.4% of patients receiving esomeprazole. Adverse events were comparable in both groups (P = NS). CONCLUSION: Rabeprazole 10 mg has a similar efficacy and safety profile in Asians with NERD as esomeprazole 20 mg. Further study is necessary to investigate whether the small differences between the two drugs seen in this study are related to the improved pharmacodynamic properties of rabeprazole. Both drugs were well tolerated.

  15. Clinical characteristics of elderly patients with proton pump inhibitor-refractory non-erosive reflux disease from the G-PRIDE study who responded to rikkunshito

    Science.gov (United States)

    2014-01-01

    Background The incidence and severity of gastroesophageal reflux disease (GERD) in Japan tends to increase in elderly women. Rikkunshito (RKT), a traditional Japanese medicine, acts as a prokinetic agent and improves gastric emptying and gastric accommodation. Our previous prospective randomized placebo-controlled study showed that RKT combined with a standard-dose of rabeprazole (RPZ) significantly improved the acid-related dysmotility symptoms (ARD) in elderly patients with proton pump inhibitor (PPI)-refractory non-erosive reflux disease (NERD). This study aimed to evaluate clinical characteristics of elderly PPI-refractory NERD patients with ARD symptoms who responded to RKT. Methods Two hundred forty-two patients with PPI-refractory NERD were randomly assigned to 8 weeks of either RPZ (10 mg/q.d.) + RKT (7.5 g/t.i.d.) (RKT group) or RPZ + placebo (PL group). Among them, 95 were elderly (≥65 years) with ARD (RKT group: n = 52; PL group: n = 43). We analyzed the changes using the 12 subscale score of frequency scale for the symptoms of GERD (FSSG) and 15 items of the Gastrointestinal Symptom Rating Scale at 4 and 8 weeks and compared the therapeutic efficacy between the 2 groups. Results There were no marked differences in baseline demographic or clinical characteristics in the 2 groups except for rate of current smoking. The FSSG score (mean ± SD at 0, 4, and 8 weeks) in both the RKT (16.0 ± 7.0; 9.9 ± 8.4; 7.0 ± 6.4) and PL (15.1 ± 6.4; 10.9 ± 6.7, 11.1 ± 8.5) groups significantly decreased after treatment. However, the degree of improvement of total and ARD scores of FSSG after the 8-week treatment was significantly greater in the RKT group than in the PL group. Combination therapy with RKT for 8 weeks showed significant improvement in 3 subscale scores (abdominal bloating, heavy feeling in stomach and sick feeling after meals) of the ARD domain and 1 subscale score (heartburn after meals) of the reflux symptom domain

  16. No association of coffee consumption with gastric ulcer, duodenal ulcer, reflux esophagitis, and non-erosive reflux disease: a cross-sectional study of 8,013 healthy subjects in Japan.

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    Takeshi Shimamoto

    Full Text Available Probably due to caffeine-induced gastric acid secretion, negative effects of coffee upon various upper-gastrointestinal diseases have been precariously accepted, despite the inadequate epidemiological evidence. Our aim is to evaluate the effect of coffee consumption on four major acid-related diseases: gastric ulcer (GU, duodenal ulcer (DU, reflux esophagitis (RE, and non-erosive reflux disease (NERD based on the large-scale multivariate analysis. Of the 9,517 healthy adults, GU, DU, and RE were diagnosed by endoscopy, and NERD was diagnosed by the symptoms of heartburn and regurgitation without esophageal erosion. Associations between coffee consumption and the four disorders were evaluated, together with age, gender, body mass index (BMI, Helicobacter pylori (HP infection status, pepsinogen I/II ratio, smoking, and alcohol. We further performed meta-analysis using the random effects model to redefine the relationship between coffee intake and peptic ulcer disease. The eligible 8,013 study subjects comprised of 5,451 coffee drinkers and 2,562 non-coffee drinkers. By univariate analysis, age, BMI, pepsinogen I/II ratio, smoking, and alcohol showed significant associations with coffee consumption. By multiple logistic regression analysis, positively correlated factors with significance were HP infection, current smoking, BMI, and pepsinogen I/II ratio for GU; HP infection, pepsinogen I/II ratio, and current smoking for DU; HP non-infection, male, BMI, pepsinogen I/II ratio, smoking, age, and alcohol for RE; younger age, smoking, and female for NERD. The meta-analyses could detect any association of coffee consumption with neither GU nor DU. In conclusion, there are no significant relationship between coffee consumption and the four major acid-related upper gastrointestinal disorders.

  17. It is possible to classify non-erosive reflux disease (NERD) patients into endoscopically normal groups and minimal change groups by subjective symptoms and responsiveness to rabeprazole -- a report from a study with Japanese patients.

    Science.gov (United States)

    Kusano, Motoyasu; Shirai, Naohito; Yamaguchi, Kanako; Hongo, Michio; Chiba, Tsutomu; Kinoshita, Yoshikazu

    2008-12-01

    The hypothesis that non-erosive reflux disease (NERD) patients comprise various subgroups is gaining popularity. This study was conducted to investigate the possibility of categorizing NERD patients according to symptom types and response to acid-suppressive drug rabeprazole (RPZ) 10 mg/day. NERD patients were classified as grade N (endoscopically normal), M (minimal change), or erosive GERD, and answered a 51-item, yes-or-no questionnaire pre and post-treatment. Compared to erosive GERD, clear differences existed in pretreatment prevalence of symptoms and responsiveness to RPZ in grades N and M; the results suggested stomachaches (especially at night) were significant symptoms in grade N and dysmotility-like symptoms like bloated stomach were significant in grade M while gastroesophageal reflux symptoms were significant in erosive GERD. Clinical significance of classifying NERD was indicated from different symptoms and responsiveness to PPI.

  18. The added value of impedance-pH monitoring to Rome III criteria in distinguishing functional heartburn from non-erosive reflux disease.

    Science.gov (United States)

    Savarino, Edoardo; Marabotto, Elisa; Zentilin, Patrizia; Frazzoni, Marzio; Sammito, Giorgio; Bonfanti, Daria; Sconfienza, Luca; Assandri, Lorenzo; Gemignani, Lorenzo; Malesci, Alberto; Savarino, Vincenzo

    2011-07-01

    Functional heartburn is defined by Rome III criteria as an endoscopy-negative condition with normal oesophageal acid exposure time, negative symptom association to acid reflux and unsatisfactory response to proton pump inhibitors. These criteria underestimated the role of non-acid reflux. To assess the contribution of impedance-pH with symptom association probability (SAP) analysis in identifying endoscopy-negative patients with reflux disease and separating them from functional heartburn. Consecutive endoscopy-negative patients treated with proton pump inhibitors (n=219) undergoing impedance-pH monitoring off-therapy were analysed. Distal acid exposure time, reflux episodes, SAP and symptomatic response to proton pump inhibitors were measured. Based on impedance-pH/SAP, 67 (31%) patients were pH+/SAP+, 6 (2%) pH+/SAP-, 83 (38%) hypersensitive oesophagus and 63 (29%) functional heartburn. According to pH-metry alone/response to proton pump inhibitors, 62 (28%) were pH+/SAP+, 11 (5%) pH+/SAP-, 61 (28%) hypersensitive oesophagus and 85 (39%) functional heartburn. In the normal-acid exposure population the contribution of impedance-pH/SAP compared to pH-metry alone/response to proton pump inhibitors in identifying patients with reflux disease and functional heartburn resulted to be 10%. In patients with abnormal-acid exposure, the contribution of impedance-pH/SAP increased by 3%. Comparing impedance-pH testing with pH-metry alone plus the response to proton pump inhibitor therapy demonstrated that the latter ones cause underestimation of reflux disease patients and overestimation of functional heartburn patients. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Impact of endoscopically minimal involvement on IL-8 mRnA expression in esophageal mucosa of Patients with non-erosive reflux disease

    Institute of Scientific and Technical Information of China (English)

    Yusei Kanazawa; Ikuo Murata; Shunichi Yamashita; Shigeru Kohno; Hajime Isomoto; Chun-Yang Wen; Ai-Ping Wang; Vladimir A Saenko; Akira Ohtsuru; Fuminao Takeshima; Katsuhisa Omagari; Yohei Mizuta

    2003-01-01

    AIM: Little has been known about the pathogenesis of nonerosive reflux disease (NERD). Recent studies have implicated interleukin 8 (IL-8) in the development and progression of gastroesophgeal reflux disease (GERD). The purpose of this study was to determine IL-8 RNA expression levels in NERD patients with or without subtle mucosal changes.METHODS: We studied 26 patients with NERD and 13 asymptomatic controls. Biopsy sample was taken from the esophagus 3 cm above the gastroesophageal junction and snap frozen for measurement of IL-8 mRNA levels by real-time quantitative polyrnerase chain reaction (PCR). We also examined mRNA expression of IL-8 receptors, CXCR-1 and -2 by reverse transcriptase PCR. The patients were endoscopically classified into grade M (mucosal color changes without visible mucosal break) and N (neither minimal involvement nor mucosal break) of the modified Los Angeles classification.RESULTS: The relative IL-8 mRNA expression levels were significantly higher in esophageal mucosa of NERD patients than those in esophageal mucosa of the controls. There was a significant difference in IL-8 mRNA levels between grades M and N. The CXCR-1 and -2 mRNAs were constitutively expressed in esophageal mucosa.CONCLUSION: Our results suggest that high IL-8 levels in esophageal mucosa may be involved in the pathogenesis of NERD through interaction with its receptors. NERD seems to be composed of a heterogeneous population in terms of not only endoscopically minimal involvement but also immune and inflammatory processes.

  20. Relação entre o tamanho de hérnia hiatal e tempo de exposição ácida esofágica nas doenças do refluxo erosiva e não-erosiva Relationship between the size of hiatal hernia and esophageal acid exposure time in erosive and non-erosive reflux disease

    Directory of Open Access Journals (Sweden)

    Luiz João Abrahão Jr.

    2006-03-01

    erosiva e doença do refluxo não-erosiva.BACKGROUND: In the last few years studies have demonstrated that hiatal hernias have an important role in the pathogenesis of reflux disease, promoting reflux by many different mechanisms, emphasizing that the larger the hiatal hernia, the higher the reflux intensity and erosive esophagitis prevalence. AIM: To correlate the size of hiatal hernias (small or large with reflux intensity (measured by pH monitoring parameters in patients with non-erosive and erosive reflux disease. PATIENTS AND METHODS: We reviewed pH monitoring from patients with typical reflux symptoms (heartburn previously submitted to upper endoscopy. Reflux intensity was measured by the % of total time of pH 5 cm. RESULTS: A total of 192 patients were included, being 115 in erosive reflux disease group and 77 in non-erosive reflux disease group. In erosive reflux disease patients, there were 94 (81% with small hiatal hernias and 21 (19% with large ones and in non-erosive reflux disease patients there were 66 (85% with small and 11(15% with large hiatal hernias. In erosive reflux disease group, the %TT, %UT and %ST were of 13.1 + 7.1; 13.4 + 7.4 and 12.3 + 11.5 in small hiatal hernias and 20.2 + 12.3; 17.8 + 14.1 and 20.7 + 14.1 in large hiatal hernias, respectively (P <0,05 for %TT and %TS. In non-erosive reflux disease patients, %TT, %UT and %ST were 9.6 + 4.8; 10.8 + 6.8 and 8.6 + 7.3 in small hiatal hernias and of 14.6 + 13.3; 11.2 + 7.5 and 18.1 + 21.0 in large hiatal hernias respectively (P <0,05 for %TT and %TS. CONCLUSION: Large hiatal hernias increase acid exposure time only in supine position in erosive esophagitis patients and in non-erosive patients.

  1. Reflux and Lung Disease

    Science.gov (United States)

    ... Healthy Eating Reflux and Lung Disease Reflux and Lung Disease Make an Appointment Ask a Question Find a Doctor Many people with chronic lung disease also suffer from gastroesophageal reflux (GERD). In this ...

  2. Esophageal motility abnormalities in gastroesophageal reflux disease.

    Science.gov (United States)

    Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo

    2014-05-06

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett's esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  3. Treatment of uncomplicated reflux disease

    Institute of Scientific and Technical Information of China (English)

    Joachim Labenz; Peter Malfertheiner

    2005-01-01

    Uncomplicated reflux disease comprises the non-erosive reflux disease (NERD) and erosive reflux disease (ERD).The objectives of treatment are the adequate control of symptoms with restoration of quality of life, healing of lesions and prevention of relapse. Treatment of NERD consists in the administration of proton pump inhibitors (PPI) for 2-4 wk, although patients with NERD show an overall poorer response to PPI treatment than patients with ERD owing to the fact that patients with NERD do not form a pathophysiologically homogenous group. For long-term management on-demand treatment with a PPI is probably the best option. In patients with ERD, therapy with a standard dose PPI for 4-8 wk is always recommended.Long-term treatment of ERD is applied either intermittently or as continuous maintenance treatment with an attempt to reduce the daily dosage of the PPI (step-down principle).In selected patients requiring long-term PPI treatment,antireflux surgery is an alternative option. In patients with troublesome reflux symptoms and without alarming features empirical PPI therapy is another option for initial management. Therapy should be withdrawn after initial success. In the case of relapse, the long-term care depends on a careful risk assessment and the response to PPI therapy.

  4. Refractory gastroesophageal reflux disease

    OpenAIRE

    Joaquim Prado P. Moraes-Filho

    2012-01-01

    CONTEXT: Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Its pathophysiology, diagnosis and treatment have frequently been analyzed but it is interesting to review some aspects of the GERD refractory patients to the proton pump inhibitors treatment. The treatment encompasses behavioral measures and pharmacological therapy. The majority of the patients respond well to proton pump inhibito...

  5. Gastro-oesophageal Reflux Disease: An Update

    Directory of Open Access Journals (Sweden)

    T Murphy

    2015-09-01

    Full Text Available Gastro-oesophageal reflux disease (GERD is a disorder in which reflux of stomach contents causes troublesome symptoms and/or complications and which affects health-related quality of life. It is one of the commonest disorders and appears to be increasing in incidence. The mechanisms leading to reflux are complex and multifactorial. The lower oesophageal sphincter (LES is an important part of the gastro-oesophageal barrier. Transient LES relaxations (TLESRs lead to reflux as these vagally mediated motor patterns cause relaxation of the LES and also result in oesophageal shortening and inhibition of the crural diaphragm. Heartburn and regurgitation are the characteristic symptoms of GERD. A clinical diagnosis of GERD can be made with typical symptoms. Oesophagitis is seen in a minority of patients with GERD. Lifestyle modification is widely advocated for patients with GERD. For short-term relief of symptoms of mild GERD, antacids/alginates are frequently used but they do not heal oesophagitis. Both histamine 2 receptor antagonists (H2RA and proton pump inhibitors (PPI have been shown to heal and prevent relapse of oesophagitis, although PPIs have been shown to be superior. The PPIs are the recommended first-line therapy for erosive oesophagitis and initial management of non-erosive reflux disease. Maintenance PPI therapy should be given to patients with oesophagitis, those who have recurrence of symptoms after discontinuation of medication and for those with complications of GERD.

  6. Biomarkers of Reflux Disease.

    Science.gov (United States)

    Kia, Leila; Pandolfino, John E; Kahrilas, Peter J

    2016-06-01

    Gastroesophageal reflux disease (GERD) encompasses an array of disorders unified by the reflux of gastric contents. Because there are many potential disease manifestations, esophageal and extraesophageal, there is no single biomarker of the entire disease spectrum; a set of GERD biomarkers that each quantifies specific aspects of GERD-related pathology might be needed. We review recent reports of biomarkers of GERD, specifically in relation to endoscopically negative esophageal disease and excluding conventional pH-impedance monitoring. We consider histopathologic biomarkers, baseline impedance, and serologic assays to determine that most markers are based on manifestations of impaired esophageal mucosal integrity, which is based on increased ionic and molecular permeability, and/or destruction of tight junctions. Impaired mucosal integrity quantified by baseline mucosal impedance, proteolytic fragments of junctional proteins, or histopathologic features has emerged as a promising GERD biomarker.

  7. Efficacy of low-dose lansoprazole in the treatment of non-erosive gastroesophageal reflux disease: Influence of infection by Helicobacter pylori Eficacia de lansoprazol a dosis bajas en el tratamiento de la enfermedad por reflujo gastroesofágico no erosiva: Influencia de la infección por Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    M. Castro Fernández

    2006-03-01

    Full Text Available Introduction: proton pump inhibitors (PPIs are the most effective drugs to cure peptic esophagitis and control the symptoms of gastroesophageal reflux disease (GERD. In most patients with GERD esophagitis is not detected by endoscopy, which represents GERD with a negative endoscopy or non-erosive reflux disease (NERD. The influence of infection by H. pylori in the evolution of GERD is controversial since a protective action is identified by some studies, but not all. We conducted a clinical trial to assess the efficacy of lansoprazole 15 mg/day in the initial control of NERD symptoms, and as a secondary endpoint the impact of H. pylori infection on response to treatment. Patients and methods: a pilot, single-center clinical trial was conducted -single-blind regarding the experimental medication (unknown to patients, and double-blind regarding the information concerning H. pylori infection. Sixty (60 patients with NERD were initially included, who had suffered from daytime or nocturnal heartburn for 1-2 days in each of the last two weeks. Nine patients were excluded for failing to comply with the study protocol. The 51 remaining patients, 35 women and 16 men, with a mean age of 49 years, comprised the per protocol analysis population. Patients received treatment for two weeks with a capsule of the study medication (15 mg/day of lansoprazole, with daily controls on the presence and severity of daytime and nocturnal heartburn. Treatment was considered effective when, upon completion, patients referred a maximum of one episode of mild heartburn as defined in the protocol, or answered the following question in the affirmative: "Does the medication you are receiving satisfactorily control the symptoms of your disease?". During diagnostic endoscopy we obtained biopsies of the gastric body and antrum to investigate infection by H. pylori by means of a urease test. Treatment efficacy was assessed with no patients or doctors responsible for the study

  8. The treatment effects of proton pump inhibitor combined with flupenthixol melitracen on non-erosive gastroesophageal reflux disease with anxiety and depression%质子泵抑制剂联合氟哌噻吨美利曲辛对伴焦虑抑郁的非糜烂性胃食管反流病的治疗作用

    Institute of Scientific and Technical Information of China (English)

    陈一萍; 王彩花; 李惠春; 刘微波; 郑磊磊; 俞少华

    2013-01-01

    non-erosive gastroesophageal reflux disease (NERD) with anxiety and depression.Methods Fifty six NERD patients with anxiety and depression were evenly divided into the positive treatment group and positive control group.Thirty NERD patients without anxiety and depression were set as negative control group.Both flupethixol melitracen (20 mg per day after breakfast) and PPI esomeprazole magnesium (20 mg per day,20 minutes before breakfast) were administrated in positive treatment group.Only esomeprazole magnesium was given in positive control group and negative control group and the dosage was same as that of positive treatment group.The treatment course of three groups was eight weeks.Before and after the treatment,the symptoms of patients were scored according to gastroesophageal reflux disease questionnaire (GERDQ),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and Pittsburgh sleep quality index (PSQI).Adverse effects were also observed.Variance analysis was performed for the comparison among three groups.Variance analysis or Post-hoc analysis were used for comparison between two groups.Results The differences of different score value before and after treatment of three groups were statistically significant in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (F=6.32,3.93,5.63,49.61,78.69 and 7.07,all P< 0.05).The differences of the score value before and after treatment of positive treatment group in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (4.24±2.05,3.16±1.46,1(0,3),9.32±3.21 and 8.88±2.92) were all higher than those of positive control group (2.38±2.22,1.68±1.33,0(0,2),3.72±2.95 and 3.84±1.97) and negative control group (2.32±2.18,2.48±1.34,0(0,1),2.36±1.25 and 2.36±0.79).And the differences were statistically significant (positive treatment group vs positive control group:Post-hoc analysis,P=0.002,0.022,0.003,0.002 and 0.002; positive

  9. Randomised clinical trial: sodium alginate oral suspension is non-inferior to omeprazole in the treatment of patients with non-erosive gastroesophageal disease.

    Science.gov (United States)

    Chiu, C-T; Hsu, C-M; Wang, C-C; Chang, J-J; Sung, C-M; Lin, C-J; Chen, L-W; Su, M-Y; Chen, T-H

    2013-11-01

    The burden of gastroesophageal reflux disease (GERD) is increasing in the Asia area and the majority of GERD patients have non-erosive reflux disease (NERD). To evaluate the efficacy and safety of sodium alginate suspension compared to omeprazole in adult subjects with NERD. In this 4-week, double-blind, parallel study, 195 NERD subjects were randomised to one of two treatment groups: sodium alginate suspension 20 mL three times a day and omeprazole 20 mg once daily. The primary efficacy endpoint was the percentage of patients achieving adequate heartburn or regurgitation relief at day 28 assessed by patient diary. The secondary efficacy endpoints included percentage of patients achieving adequate heartburn or regurgitation relief, change from baseline of the Reflux Disease Questionnaire total score at day 14 and 28 from baseline, and patients' overall satisfaction. In this study, 183 subjects were included in the intent-to-treat population, and 172 subjects were included in the per-protocol population. Non-inferiority of sodium alginate to omeprazole was demonstrated in the intent-to-treat population [difference, 2.7% (53.3% vs. 50.5%, P = 0.175), 95% lower confidence interval -11.9%, above the preset margin of -19%]. All of the secondary efficacy endpoints were comparable between two groups. The incidence of adverse event was relatively low and there was no difference between the two groups (5.4% vs. 5.5% for sodium alginate vs. omeprazole). No severe adverse event was noted in this study. The study showed that sodium alginate was as effective as omeprazole for symptomatic relief in patients with non-erosive reflux disease (Clinicaltrials.gov NCT01338077). © 2013 John Wiley & Sons Ltd.

  10. Characteristics of cortical mapping in response to acid exposure in non-erosive reflux disease and erosive esophagitis using functional magnetic resonance imaging%应用fMRI研究非糜烂性反流病和糜烂性食管炎患者酸灌注时脑激活模式的差异

    Institute of Scientific and Technical Information of China (English)

    杨敏; 李兆申; 陈东风; 徐晓蓉; 许国铭; 邹多武; 房殿春

    2008-01-01

    目的 探索食管内脏高敏感性形成的脑机制.方法 2005年9月至2007年6月随机选择31例非糜烂性反流病(NERD)患者、13例糜烂性食管炎(EE)患者和12名正常对照者参与实验,并将NERD患者分为感知过敏组(NERD-H)21例和感知正常组(NERD-N)10例.利用血氧水平依赖脑功能磁共振成像(BOLD-fMRI)技术对比研究食管酸灌注时NERD-H组、NERD-N组、EE患者及正常对照者大脑功能活动区域定位、MR-BOLD信号激活及消退模式的差异.结果 NERD-H组酸灌注时激活的脑区包括单侧或双侧第二躯体感觉皮质(S Ⅱ)、初级躯体感觉皮质(S Ⅰ)、前额叶皮质(右侧为主)、框额皮质、岛叶皮质、楔前叶、杏仁体、腹侧纹状体、运动区/辅助运动区及小脑半球,且以双侧大脑激活为主.NERD-H组上述感兴趣区(ROI)区的fMRI峰值影像强度和最大磁共振(MR)信号增加幅度明显高于NERD-N组和正常对照组(均P<0.01),前扣带回激活信号值(562±104)明显低于正常组(587±126,P<0.05),但显著高于EE组(535±91,P<0.05).酸灌注刺激后,NERD-H组初始影像潜伏期、峰值影像潜伏期(1.7 min±0.9 min、4.5 min±1.3 min)均明显短于NERD-N组(4.0 min±1.1 min、6.8 min±1.6 min,均P<0.01)和正常对照组(5.4 min±1.7 min、7.2 min±1.5 min,均P<0.01).NERD-H组双侧SⅡ、右前额皮质信号消退失活幅度(26.5%±5.4%、20.3%±3.0%)均明显高于NERD-N组(8.2%±2.2%、16.4%±3.6%,均P<0.05)和EE组(11.9%±4.8%、11.7%±3.1%,均P<0.01),而正常对照组前扣带回的MR信号消退失活幅度(16.9%±2.5%)明显高于NERD-H组、EE组(11.8%±2.8%、6.4%±1.0%,均P<0.05).结论 在食管内脏高敏感状态下,中枢神经系统处理整合、处理食管痛敏传入信息功能异常.%Objective To investigate the brain mechanisms for esophageal visceral hypersensitivity. Methods Thirty-one non-erosive reflux disease(NERD)patients, 21 in the group of NERD with esophageal

  11. Gastroesophageal reflux disease in children.

    Science.gov (United States)

    Barnhart, Douglas C

    2016-08-01

    Despite the frequency with which antireflux procedures are performed, decisions about gastroesophageal reflux disease treatment remain challenging. Several factors contribute to the difficulties in managing gastroesophageal reflux. First, the distinction between physiologic and pathologic gastroesophageal reflux (gastroesophageal reflux disease-GERD) is not always clear. Second, measures of the extent of gastroesophageal reflux often poorly correlate to symptoms or other complications attributed to reflux in infants and children. A third challenge is that the outcome of antireflux procedures, predominately fundoplications, are relatively poorly characterized. All of these factors contribute to difficulty in knowing when to recommend antireflux surgery. One of the manifestations of the uncertainties surrounding GERD is the high degree of variability in the utilization of pediatric antireflux procedures throughout the United States. Pediatric surgeons are frequently consulted for GERD and fundoplication, uncertainties notwithstanding. Although retrospective series and anecdotal observations support fundoplication in some patients, there are many important questions for which sufficient high-quality data to provide a clear answer is lacking. In spite of this, surgeons need to provide guidance to patients and families while awaiting the development of improved evidence to aid in these recommendations. The purpose of this article is to define what is known and what is uncertain, with an emphasis on the most recent evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Gastroesophageal reflux disease - children

    Science.gov (United States)

    ... sugar or foods that are very spicy Avoiding chocolate, peppermint, or drinks with caffeine Avoiding acidic drinks ... with your child's provider before limiting fats. The benefit of reducing fats in children is not as ... 8, 2015. www.niddk.nih.gov/health-information/health-topics/digestive-diseases/ger-and-gerd- ...

  13. Esophageal motility abnormalities in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Irene; Martinucci; Nicola; de; Bortoli; Maria; Giacchino; Giorgia; Bodini; Elisa; Marabotto; Santino; Marchi; Vincenzo; Savarino; Edoardo; Savarino

    2014-01-01

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophagealmotility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from nonerosive reflux disease to erosive reflux disease and Barrett’s esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  14. 认知行为疗法在治疗非糜烂性反流病合并疑病症患者的疗效观察%Cognitive behavioral therapy in the treatment of patients with non-erosive reflux disease combined with hypochondriasis:a clinical application analysis

    Institute of Scientific and Technical Information of China (English)

    覃益; 韦照永; 潘丽莹

    2013-01-01

    目的观察认知行为疗法在治疗非糜烂性反流病合并疑病症患者的临床疗效。方法将42例非糜烂性反流病合并疑病症患者随机分为治疗组21例和对照组21例,对照组采用雷贝拉唑10 mg,po, bid、多潘立酮10 mg,po,tid治疗(常规治疗),治疗组在对照组治疗的基础上,实施认知行为疗法治疗,两组疗程均为8周,比较两组治疗后症状缓解、RDQ问卷评分、症状自评量表(SCL-90)评分及明尼苏达多项人格测验(MMPI)改善情况。结果经治疗8周后,对照组中显效28.6%,总有效率47.6%;治疗组中显效61.9%,总有效率85.7%,两组总有效率差异有显著性(P0.05). However, after 8-week treatment, there were sig-nificant differences between the two groups on RDQ scores, SCL-90 score, and T points of MMPI such as hypochondria, depression, hysteria, psychopathic deviate, paranoia and psychasthenia (P<0.05). Conclusion CBT could significantly improve the gastroesophageal reflux symptoms of patients with NERD combined with hypochondriasis, and at the same time could significantly improve the mood disorder of patients.

  15. Esophageal epithelial surface in patients with gastroesophageal reflux disease: An electron microscopic study

    Institute of Scientific and Technical Information of China (English)

    Takane Azumi; Nobuo Ashizawa; Yoshikazu Kinoshita; Kyoichi Adachi; Kenji Furuta; Shuji Nakata; Shunji Ohara; Kenji Koshino; Masaharu Miki; Terumi Morita; Takashi Tanimura,

    2008-01-01

    AIM: To investigate the intercellular spaces between the most superficially located esophageal epithelial cells in patients with gastroesophageal reflux disease (GERD).METHODS: Eighteen patients with erosive esophagitis,10 patients with non-erosive reflux disease (NERD),and 18 normal asymptomatic volunteers were enrolled.Biopsy specimens were obtained from the lower esophageal mucosa without ulcer or erosion.Scanning electron microscopy was employed to investigate the tightness of the superficial cellular attachment.RESULTS: The intercellular space between the most superficially located epithelial cells in patients with erosive esophagitis or NERD was not different from that in asymptomatic healthy individuals.CONCLUSION: Widened luminal intercellular spaces of esophageal superficial epithelium are not responsible for the induction of reflux symptoms in patients with GERD.

  16. Management of gastroesophageal reflux disease.

    Science.gov (United States)

    Tutuian, Radu; Castell, Donald O

    2003-11-01

    Gastroesophageal reflux disease (GERD) is a chronic condition requiring long-term treatment. Simple lifestyle modifications are the first methods employed by patients and, because of their low cost and simplicity, should be continued even when more potent therapies are initiated. Potent acid-suppressive therapy is currently the most important and successful medical therapy. Whereas healing of the esophageal mucosa is achieved with a single dose of any proton pump inhibitor (PPI) in more than 80% of cases, symptoms are more difficult to control. Patients with persistent symptoms on therapy should be tested (preferably with combined multichannel intraluminal impedance and pH) for association of symptoms with acid, nonacid, or no GER. Long-term follow-up studies indicate that PPIs are efficacious, tolerable, and safe medication. So far, promotility agents have shown limited efficacy, and their side-effect profile outweighs their benefits. Antireflux surgery in carefully selected patients (ie, young, typical GERD symptoms, abnormal pH study, and good response to PPI) is as effective as PPI therapy and should be offered to these patients as an alternative to medication. Still, patients should be informed about the risks of antireflux surgery (ie, risk of postoperative dysphagia; decreased ability to belch, possibly leading to bloating; increased flatulence). Endoscopic antireflux procedures are recommended only in selected patients and given the relative short experience with these techniques, patients treated with endoscopic procedures should be enrolled in a rigorous follow-up program.

  17. Is obesity associated with gastropharyngeal reflux disease?

    Institute of Scientific and Technical Information of China (English)

    Cheol Woong Choi; Gwang Ha Kim; Chul Soo Song; Soo Geun Wang; Byung Joo Lee; Hoseok I; Dae Hwan Kang; Geun Am Song

    2008-01-01

    AIM: To examine the association between obesity and gastropharyngeal reflux disease (GPRD) as well as gastroesophageal reflux disease (GERD)METHODS: We conducted a cross-sectional study of consecutive patients undergoing ambulatory 24-h dual-probe pH monitoring from July 2003 to December 2006.The association between body mass index (BMI) and parameters about gastroesophageal or gastropharyngeal reflux was examined in univariate and multivariate analyses.RESULTS: A total of 769 patients (307 men and 462 women; mean age 50.7 years) were finally enrolled. Most variables showing gastroesophageal reflux was higher in the obese patients than the patients with normal BMI.There was no difference in all the variables showing gastropharyngeal reflux according to the BMI. After adjustment for age, sex, alcohol intake and smoking,obese patients demonstrated an about 2-fold increase in risk of GERD compared with patients with normal BMI (OR, 1.9; 95 CI, 1.3-2.9), but overweight patients did not demonstrate increased risk of GERD (OR, 1.2; 95 CI,0.8-1.7). Both obese patients and overweight patients did not demonstrated increased risk of GPRD compared with patients with normal BM[ (OR, 1.1; 95 CI, 0.8-1.7;and OR, 0.9; 95 CI, 0.6-1.3, respectively).CONCLUSION: Obesity is not associated with GPRD reflux while it is associated with GERD.

  18. The effect of decaffeination of coffee on gastro-oesophageal reflux in patients with reflux disease.

    Science.gov (United States)

    Pehl, C; Pfeiffer, A; Wendl, B; Kaess, H

    1997-06-01

    Patients with reflux disease often complain of heartburn after ingestion of coffee. Induction of gastro-oesophageal reflux has been demonstrated by pH-metry following the intake of coffee in healthy volunteers. The reflux was reduced when the coffee had undergone a decaffeination process. The aim of this study was to investigate the effect of decaffeination of coffee on reflux in patients with reflux disease. Seventeen reflux patients underwent two osesophageal 3-h pH measurements. The patients received, in a double-blind study design in a randomized order, 300 mL of either regular or decaffeinated coffee together with a standardized breakfast. The fraction time oesophageal pH decaffeinated coffee. The amount of gastro-oesophageal reflux induced by the intake of regular coffee in patients with reflux disease can be reduce by the decaffeination of coffee.

  19. Severity of gastroesophageal reflux disease influences daytime somnolence:A clinical study of:t34 patients underwent upper panendoscopy

    Institute of Scientific and Technical Information of China (English)

    Pál Demeter; Katalin Várdi Visy; N(o)ra Gyulai; R(o)bert Sike; Tamás G T(o)th; János Novák; Pál Magyar

    2004-01-01

    AIM: To asses the relationship between severity of gastroesophageal refluxe disease and Epworth sleepiness scale as an indicator of daytime somnolence.METHODS: One hundred and thirty-four patients underwent an upper panendoscopy as indicated by the typical reflux symptoms and were also investigated with regard to somnolence. Sleepiness was evaluated by Epworth Sleepiness Scale, which was compared to the severity of endoscopic findings (Savary-Miller/modified by Siewert). Patients with psychiatric disorders or being on sedato-hypnotics as well as shift workers were excluded from the study. The relationship between the severity of the reflux disease and daytime somnolence was analyzed with the help of multivariate regression analysis.RESULTS: A positive tendency was found between the severity of the reflux disease and the corresponding Epworth Sleepiness Scale. In the case of the more severe type -Savary-Miller Ⅲ - at least a mild hypersomnia was found.For this group daytime somnolence was significantly higher than in the case of the non-erosive type of Gastroesophageal Reflux Disease representing the mildest stage of reflux disease.CONCLUSION: The severity of Gastroesophageal Reflux Disease influences daytime somnolence.

  20. Reflux perception and the esophageal mucosal barrier in gastroesophageal reflux disease

    NARCIS (Netherlands)

    P.W. Weijenborg

    2016-01-01

    Gastroesophageal reflux disease (GERD) is one of the most common disorders of the gastrointestinal tract. Heartburn, regurgitation and chest pain are the key symptoms. Patients with reflux symptoms often have more than average reflux of acidic contents in the esophagus. However, frequently there is

  1. [Alginates in therapy for gastroesophageal reflux disease].

    Science.gov (United States)

    Avdeev, V G

    2015-01-01

    This article presents evidence of the prevalence of gastroesophageal reflux disease (GERD) and highlights its main treatment options. Among its medications, particular emphasis is laid on alginates and their main mechanisms of action are described. There is information on the efficacy of alginates, including the alginate-antacid Gaviscon Double Action, in treating GERD. Recommendations for how to administer these drugs are given.

  2. Reflux esophagitis and gastroesophageal reflux disease: a cross-sectional study of gastroesophageal reflux disease patients by age group

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    Flora Filho Rowilson

    1999-01-01

    Full Text Available The purpose of this study was to explore the relationship between the intensity of acid reflux and severity of esophageal tissue damage in a cross-sectional study of patients with gastroesophageal reflux disease (GERD. Seventy-eight patients with were selected in accordance with the strict 24-hour ambulatory esophageal pHmetry (24h-pHM criteria and distributed into three age groups: Group A: 14 - 24 years of age. Group B: 25 - 54; and Group C: 55 - 64. The 24h-pHM was carried out in accordance with DeMeester standardization, and the Savary-Miller classification for the diagnosis of reflux esophagitis was used. The groups were similar in 24h-pHM parameters (p > 0.05, having above normal values. For the study group as a whole, there was no correlation between age group and intensity of acid reflux, and there was no correlation between intensity of acid reflux and severity of esophageal tissue damage. However, when the same patients were sub-grouped in accordance with the depth of their epithelial injury and then distributed into age groups, there was a significant difference in esophagitis without epithelial discontinuity. Younger patients had less epithelial damage than older patients. Additionally, although there was a significant progression from the least severe to the moderate stages of epithelial damage among the age groups, there was no apparent difference among the age groups in the distribution between the moderate stages and most severe stages. The findings support the conclusion that the protective response of individuals to acid reflux varies widely. Continued aggression by acid reflux appears to lead to the exhaustion of individual mechanisms of epithelial protection in some patients, but not others, regardless of age or duration of the disease. Therefore, the diagnosis and follow-up of GERD should include both measurements of the quantity of refluxed acid and an assessment of the damage to the esophageal epithelium.

  3. Saliva transit in patients with gastroesophageal reflux disease.

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    Cassiani, R A; Mota, G A; Aprile, L R O; Dantas, R O

    2015-10-01

    Saliva is an important factor in the neutralization of the acidity of the refluxed material that comes from the stomach to the esophagus. The impairment of saliva transit from oral cavity to distal esophagus may be one of the causes of esophagitis and symptoms in gastroesophageal reflux disease (GERD). With the scintigraphic method, the transit of 2 mL of artificial saliva was measured in 30 patients with GERD and 26 controls. The patients with GERD had symptoms of heartburn and acid regurgitation, a 24-hour pH monitoring with more than 4.2% of the time with pH below four, 26 with erosive esophagitis, and four with non-erosive reflux disease. Fourteen had mild dysphagia for solid foods. Twenty-one patients had normal esophageal manometry, and nine had ineffective esophageal motility. They were 15 men and 15 women, aged 21-61 years, mean 39 years. The control group had 14 men and 12 women, aged 19-61 years, mean 35 years. The subjects swallowed in the sitting and supine position 2 mL of artificial saliva labeled with 18 MBq of (99m) Technetium phytate. The time of saliva transit was measured from oral cavity to esophageal-gastric transition, from proximal esophagus to esophageal-gastric transition, and the transit through proximal, middle, and distal esophageal body. There was no difference between patients and controls in the time for saliva to go from oral cavity to esophageal-gastric transition, and from proximal esophagus to esophageal-gastric transition, in the sitting and supine positions. In distal esophagus in the sitting position, the saliva transit duration was shorter in patients with GERD (3.0 ± 0.8 seconds) than in controls (7.6 ± 1.7 seconds, P = 0.03). In conclusion, the saliva transit from oral cavity to the esophageal-gastric transition in patients with GERD has the same duration than in controls. Saliva transit through the distal esophageal body is faster in patients with GERD than controls. © 2014 International Society for Diseases of the

  4. Gastroesophageal Reflux Disease and Sleep Quality in a Chinese Population

    Directory of Open Access Journals (Sweden)

    Mei-Jyh Chen

    2009-01-01

    Conclusion: The present study highlights the adverse effect of gastroesophageal reflux on sleep, even in the absence of reflux symptoms. This finding has therapeutic implications in patients with silent erosive disease, and future trials are warranted.

  5. Diagnosis and treatment of gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Raul; Badillo; Dawn; Francis

    2014-01-01

    Gastroesophageal reflux disease(GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical,atypi-cal and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms,these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations,further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms. GERD complications include erosive esophagitis,peptic stricture,Barrett’s esophagus,esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modification,medical therapy and surgical therapy. Life-style modifications including weight loss and/or head of bed elevation have been shown to improve esophageal pH and/or GERD symptoms. Medical therapy involves acid suppression which can be achieved with antacids,histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy,others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The purpose of this review is to discuss the current approach to the diagnosis and treatment of gas-troesophageal reflux disease.

  6. Gastroesophageal Reflux Disease in Children with Interstitial Lung Disease.

    Science.gov (United States)

    Dziekiewicz, M A; Karolewska-Bochenek, K; Dembiński, Ł; Gawronska, A; Krenke, K; Lange, J; Banasiuk, M; Kuchar, E; Kulus, M; Albrecht, P; Banaszkiewicz, A

    2016-01-01

    Gastroesophageal reflux disease is common in adult patients with interstitial lung disease. However, no data currently exist regarding the prevalence and characteristics of the disease in pediatric patients with interstitial lung disease. The aim of the present study was to prospectively assess the incidence of gastroesophageal reflux disease and characterize its features in children with interstitial lung disease. Gastroesophageal reflux disease was established based on 24 h pH-impedance monitoring (MII-pH). Gastroesophageal reflux episodes (GERs) were classified according to widely recognized criteria as acid, weakly acid, weakly alkaline, or proximal. Eighteen consecutive patients (15 boys, aged 0.2-11.6 years) were enrolled in the study. Gastroesophageal reflux disease was diagnosed in a half (9/18) of children. A thousand GERs were detected by MII-pH (median 53.5; IQR 39.0-75.5). Of these, 585 (58.5 %) episodes were acidic, 407 (40.7 %) were weakly acidic, and eight (0.8 %) were weakly alkaline. There were 637 (63.7 %) proximal GERs. The patients in whom gastroesophageal reflux disease was diagnosed had a significantly higher number of proximal and total GERs. We conclude that the prevalence of gastroesophageal reflux disease in children with interstitial lung disease is high; thus, the disease should be considered regardless of presenting clinical symptoms. A high frequency of non-acid and proximal GERs makes the MII-pH method a preferable choice for the detection of reflux episodes in this patient population.

  7. Gastroesophageal reflux disease and asthma in children.

    Science.gov (United States)

    Khoshoo, Vikram; Haydel, Robert; Saturno, Emilio

    2006-06-01

    Gastroesophageal reflux disease (GERD) occurs in about two thirds of children with asthma. It may simply represent a concomitant unrelated finding or it may be responsible for provoking or worsening asthma. GERD could also be a byproduct of asthma itself. In any case, aggressive treatment of GERD seems to improve asthma outcomes. GERD should be suspected in asthma patients who do not have any known risk factors or those who are becoming difficult to treat.

  8. Validation and Diagnostic Usefulness of Gastroesophageal Reflux Disease Questionnaire in a Primary Care Level in Mexico

    Science.gov (United States)

    Zavala-Gonzáles, Miguel Angel; Azamar-Jacome, Amyra Ali; Meixueiro-Daza, Arturo; de la Medina, Antonio Ramos; Reyes-Huerta J, Job; Roesch-Dietlen, Federico; Remes-Troche, José María

    2014-01-01

    Background/Aims Different non-invasive diagnostics strategies have been used to assess patients with gastroesophageal reflux. Gastroesophageal reflux disease (GERD) questionnaire (GerdQ) is a 6-item, easy to use questionnaire that was developed primarily as a diagnostic tool for GERD in primary care. Our aim was to validate and assess diagnostic utility of GerdQ questionnaire in Mexican patients in the primary care setting. Methods The study was performed in 3 phases: (1) a questionnaire translation and comprehension study (n = 20), (2) are a reproducibility and validation study (50 patients and 50 controls) and (3) a study to assess the clinical utility in 252 subjects with GERD symptoms. Diagnostic accuracy was calculated using endoscopy and/or pH-metry as the gold standard. Results Internal consistency measured by the Cronbach’s α coefficient was 0.81 for patients and 0.90 for healthy controls, with a mixed coefficient of 0.93. Reproducibility for GerdQ was very good and its discriminating validity was 88%. Most of the patients with erosive reflux and non-erosive reflux with abnormal pH-metry had scores > 8, meanwhile most of the patients with functional heartburn and hypersensitive esophagus had < 8. Sensitivity, specificity and positive predictive value of GerdQ com -pared to the gold standard were 72%, 72% and 87%, respectively. Conclusions In Mexico, the GerdQ questionnaire Spanish validated version is useful for GERD diagnosis in the primary care setting. PMID:25273118

  9. Esophageal sphincter device for gastroesophageal reflux disease.

    Science.gov (United States)

    Ganz, Robert A; Peters, Jeffrey H; Horgan, Santiago; Bemelman, Willem A; Dunst, Christy M; Edmundowicz, Steven A; Lipham, John C; Luketich, James D; Melvin, W Scott; Oelschlager, Brant K; Schlack-Haerer, Steven C; Smith, C Daniel; Smith, Christopher C; Dunn, Dan; Taiganides, Paul A

    2013-02-21

    Patients with gastroesophageal reflux disease who have a partial response to proton-pump inhibitors often seek alternative therapy. We evaluated the safety and effectiveness of a new magnetic device to augment the lower esophageal sphincter. We prospectively assessed 100 patients with gastroesophageal reflux disease before and after sphincter augmentation. The study did not include a concurrent control group. The primary outcome measure was normalization of esophageal acid exposure or a 50% or greater reduction in exposure at 1 year. Secondary outcomes were 50% or greater improvement in quality of life related to gastroesophageal reflux disease and a 50% or greater reduction in the use of proton-pump inhibitors at 1 year. For each outcome, the prespecified definition of successful treatment was achievement of the outcome in at least 60% of the patients. The 3-year results of a 5-year study are reported. The primary outcome was achieved in 64% of patients (95% confidence interval [CI], 54 to 73). For the secondary outcomes, a reduction of 50% or more in the use of proton-pump inhibitors occurred in 93% of patients, and there was improvement of 50% or more in quality-of-life scores in 92%, as compared with scores for patients assessed at baseline while they were not taking proton-pump inhibitors. The most frequent adverse event was dysphagia (in 68% of patients postoperatively, in 11% at 1 year, and in 4% at 3 years). Serious adverse events occurred in six patients, and in six patients the device was removed. In this single-group evaluation of 100 patients before and after sphincter augmentation with a magnetic device, exposure to esophageal acid decreased, reflux symptoms improved, and use of proton-pump inhibitors decreased. Follow-up studies are needed to assess long-term safety. (Funded by Torax Medical; ClinicalTrials.gov number, NCT00776997.).

  10. Changing epidemiology of gastroesophageal reflux disease in the Asian-Pacific region: an overview.

    Science.gov (United States)

    Goh, K L

    2004-09-01

    Gastroesophageal reflux disease (GERD) is a common disease in the West, which now appears to be also increasing in prevalence in the Asian Pacific region. The reasons for this changing epidemiology are two-fold: an increased awareness among doctors and patients, and/or a true increase in the prevalence of the disease. Prevalence rates of reflux esophagitis (RE) of up to 16% and prevalence of GERD symptoms of up to 9% have been reported in the Asian population. However, the frequency of strictures and Barrett's esophagus remain very low. Non-erosive reflux disease (NERD) appears to be the most common form of GERD among Asian patients accounting for 50-70% of cases with GERD. Among Asian patients differences can also be discerned among different ethnic groups. For example, in Malaysia where a multiracial society exists, RE is significantly more common among Indians compared to Chinese and Malays whereas NERD is more frequently seen in the Indian and Malays compared to the Chinese. The reasons for these differences are not known but may indicate both genetic factors and environmental factors peculiar to the particular racial group. GERD has also been increasing in the region demonstrating a time-lag phenomenon compared to the West. Differing predisposition to GERD among different ethnic groups would mean that such an increase would be more prominent among certain racial groups.

  11. Relationship between acid pocket and acid reflux in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    姚东英

    2014-01-01

    Objective To explore the relationship between acid pocket and acid reflux in gastroesophageal reflux disease(GERD).Methods From March 2011 to January 2012,29 patients with GERD were enrolled and nine healthy individuals were set as control.All objects of this study accepted esophageal manometry test,acid pocket test,test of the occurrence time of acid pocket and ambulatory

  12. Effect of coffee on gastro-oesophageal reflux in patients with reflux disease and healthy controls

    NARCIS (Netherlands)

    Boekema, PJ; Samsom, M; Smout, AJP

    1999-01-01

    Background Many patients with gastro-oesophageal reflux disease (GORD) report that coffee aggravates their symptoms and doctors tend to discourage its use in GORD. Objective To assess the effect of coffee ingestion on gastro-oesophageaI acid reflux. Design A randomized, controlled, crossover study.

  13. Dietary guideline adherence for gastroesophageal reflux disease

    Science.gov (United States)

    2014-01-01

    Background Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high. Recently described side effects of long-term acid suppression have increased the interest in nonpharmacologic methods for alleviating GERD symptoms. We aimed to examine whether GERD patients follow recommended dietary guidelines, and if adherence is associated with the severity and frequency of reflux symptoms. Methods We conducted a population-based cross-sectional study within the Kaiser Permanente Northern California population, comparing 317 GERD patients to 182 asymptomatic population controls. All analyses adjusted for smoking and education. Results GERD patients, even those with moderate to severe symptoms or frequent symptoms, were as likely to consume tomato products and large portion meals as GERD-free controls and were even more likely to consume soft drinks and tea [odds ratio (OR) = 2.01 95% confidence interval (CI) 1.12-3.61; OR = 2.63 95% CI 1.24-5.59, respectively] and eat fried foods and high fat diet. The only reflux-triggering foods GERD patients were less likely to consume were citrus and alcohol [OR = 0.59; 95% CI: 0.35-0.97 for citrus; OR = 0.41 95% CI 0.19-0.87 for 1 + drink/day of alcohol]. The associations were similar when we excluded users of proton pump inhibitors. Conclusions GERD patients consume many putative GERD causing foods as frequently or even more frequently than asymptomatic patients despite reporting symptoms. These findings suggest that, if dietary modification is effective in reducing GERD, substantial opportunities for nonpharmacologic interventions exist for many GERD patients. PMID:25125219

  14. Comorbidities are frequent in patients with gastroesophageal reflux disease in a tertiary health care hospital

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    Joaquim Prado P Moraes-Filho

    2009-01-01

    Full Text Available INTRODUCTION: Several aspects of gastroesophageal reflux disease (GERD have been studied, but the frequency of comorbidities is not yet fully understood. OBJECTIVES: To study the prevalence of GERD comorbidities in a tertiary care hospital. METHODS: We prospectively studied 670 consecutive adult patients from the outpatient department of our facility. A diagnosis was established using clinical, endoscopic and/or pHmetry-related findings. Each patient's medical file was reviewed with respect to the presence of other medical conditions and diagnoses. RESULTS: Of the 670 patients, 459 (68.6% were female, and the mean age was 55.94 (17-80 years. We registered 316 patients (47.1% with the erosive form of GERD and 354 patients (52.9% with the non-erosive form. A total of 1,664 instances of comorbidities were recorded in 586 patients (87.5%, with the most common being arterial hypertension (21%, hypercholesterolemia (9%, obesity (9%, type II diabetes mellitus (5% and depression (4%. Two or more comorbidities were present in 437 individuals (64.8%. The occurrence of comorbidities increased with age and was higher in patients with the non-erosive form of GERD. CONCLUSIONS: In a tertiary referral population, comorbidities were very common, and these may have worsened the already impaired health-related quality of life of these patients. Clinicians caring for GERD patients in this setting must be aware of the likelihood and nature of comorbid disorders and their impact on disease presentation and patient management.

  15. Current Pharmacological Management of Gastroesophageal Reflux Disease

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    Yao-Kuang Wang

    2013-01-01

    Full Text Available Gastroesophageal reflux disease (GERD, a common disorder with troublesome symptoms caused by reflux of gastric contents into the esophagus, has adverse impact on quality of life. A variety of medications have been used in GERD treatment, and acid suppression therapy is the mainstay of treatment for GERD. Although proton pump inhibitor is the most potent acid suppressant and provides good efficacy in esophagitis healing and symptom relief, about one-third of patients with GERD still have persistent symptoms with poor response to standard dose PPI. Antacids, alginate, histamine type-2 receptor antagonists, and prokinetic agents are usually used as add-on therapy to PPI in clinical practice. Development of novel therapeutic agents has focused on the underlying mechanisms of GERD, such as transient lower esophageal sphincter relaxation, motility disorder, mucosal protection, and esophageal hypersensitivity. Newer formulations of PPI with faster and longer duration of action and potassium-competitive acid blocker, a newer acid suppressant, have also been investigated in clinical trials. In this review, we summarize the current and developing therapeutic agents for GERD treatment.

  16. [Dyspepsia, Ulcer Disease – Helicobacter pylori, Gastroesophageal Reflux Disease].

    Science.gov (United States)

    Wirth, Hans-Peter

    2016-06-01

    Prevalence of H. pylori (HP) is declining, whereas reflux disease and the proportion of non-steroidal antiinflammatory drugs (NSAR) to HP-induced ulcers increase. Eradication heals HP-ulcer disease, interrupts cancerous progression and can improve dyspeptic symptoms. NSAR-ulcers heal under proton pump inhibitor (PPI) therapy but tend to recur after reexposition. Anticoagulants and antiplatlet agents increase the risk additionally. PPI reduces NSAR-ulcer recurrence. Reflux patients with severe inflammation and complications often need long-term therapy. Barrett’s esophagus patients are at risk of esophageal adenocarcinoma.

  17. [Gastroesophageal reflux disease and respiratory disease].

    Science.gov (United States)

    Mattioli, G; Caffarena, P E; Battistini, E; Fregonese, B; Barabino, A; Jasonni, V

    1995-01-01

    The patients treated for oesophageal atresia present a correlation between the clinical sintomatology after recanalization characterized by disfagia, dispnea, recurrent cough, chronic pneumopaties and oesophageal anomalies. Where morphological alterations accounting for the presence of gastro-oesophageal reflux (GOR) were not evident, possible functional alterations of the motility were considered. The incidence of GOR was considerably high and, expression of a congenital alteration of the lower oesophageal sphincter and of oesophageal peristalsis, becomes even more severe due to further stretching of the gastro-esophageal junction. The authors underline that the early demonstration of histological changes, even before recanalization, and the motility disorders of the oesophagus have to be well studied, while the LES is normalized, in order to prevent and treat the possible appearance of the well-known complications of GOR.

  18. Disagreement between symptom-reflux association analysis parameters in pediatric gastroesophageal reflux disease investigation

    Institute of Scientific and Technical Information of China (English)

    Samuel; C; Lüthold; Mascha; K; Rochat; Peter; Bhler

    2010-01-01

    AIM: To assess the agreement within 3 commonly used symptom-reflux association analysis (SAA) parameters investigating gastroesophageal reflux disease (GERD) in infants. METHODS: Twenty three infants with suspected GERD were included in this study. Symptom index (SI), Symptom sensitivity index (SSI) and symptom association probability (SAP) related to cough and irritability were calculated after 24 h combined pH/multiple intraluminal impedance (MII) monitoring. Through defined cutoff values, SI, SSI and SAP...

  19. High prevalence of gastroesophageal reflux disease with minimal mucosal change in asthmatic patients.

    Science.gov (United States)

    Shimizu, Yasuo; Dobashi, Kunio; Kobayashi, Setsuo; Ohki, Ichiro; Tokushima, Masahiko; Kusano, Motoyasu; Kawamura, Osamu; Shimoyama, Yasuyuki; Utsugi, Mitsuyoshi; Mori, Masatomo

    2006-08-01

    It is known that the prevalence of gastroesophageal reflux disease (GERD) in asthmatic patients is high. Although an endoscopic diagnosis of GERD based on the established Los Angeles (LA) classification requires the detection of erosive mucosal breaks, there are patients with GERD who have prominent erythema of the esophageal membrane without erosive mucosal breaks. Non-erosive mucosal change denotes the minimal change of the discoloring type of reflux esophagitis. This study was undertaken to determine the prevalence of GERD in asthmatic patients using the LA classification with the inclusion of minimal change, compared to the prevalence determined using the established LA classification without minimal change. The presence of GERD in asthmatic patients (n = 78), non-asthmatic disease control patients (n = 56), and healthy subjects (n = 150) was evaluated by endoscopic examination. The frequency of GERD in asthmatic patients based on the LA classification with minimal change was higher (54/78, 69.2%) than in asthmatic patients based on the LA classification without minimal change (37/78, 47.4%) (p disease control patients (17/56, 30.4%) and healthy subjects (27/150, 18.0%) based on the LA classification with minimum change. These data indicate that asthmatic patients have a high frequency of GERD. In addition, without the inclusion of minimum change to the diagnosis of GERD, the prevalence of GERD appears to be underestimated in asthmatic patients. Therefore, physicians should carefully observe asthmatic patients with minimal change on endoscopy.

  20. Different risk factors between reflux symptoms and mucosal injury in gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Chung-Hsien Li

    2015-06-01

    Full Text Available Gastroesophageal reflux disease (GERD is diagnosed based on typical symptoms in clinical practice. It can be divided into two groups using endoscopy: erosive and nonerosive reflux disease (NERD. This study aims to determine the risk factors of reflux symptoms and mucosal injury. This was a two-step case-control study derived from a cohort of 998 individuals having the data of reflux disease questionnaire (RDQ and endoscopic findings. Those with minor reflux symptoms were excluded. The first step compared symptomatic GERD patients with healthy controls. The 2nd step compared patients with erosive esophagitis with healthy controls. In this study, the prevalence of symptomatic GERD and erosive esophagitis were 163 (16.3% and 166 (16.6%, respectively. A total of 507 asymptomatic individuals without mucosal injury of the esophagus on endoscopy were selected as healthy controls. Compared with healthy controls, multivariate analyses showed that symptomatic GERD patients had a higher prevalence of hypertriglyceridemia [odds ratio (OR, 1.83; 95% confidence interval (CI 1.13–2.96] and obesity (OR, 1.85; 95% CI 1.08–3.02. By contrast, male sex (OR, 2.24; 95% CI 1.42–3.52, positive Campylo-like organism (CLO test (OR, 0.56; 95% CI 0.37–0.84, and hiatus hernia (OR, 14.36; 95% CI 3.05–67.6 were associated with erosive esophagitis. In conclusion, obesity and hypertriglyceridemia were associated with reflux symptoms. By contrast, male sex, negative infection of Helicobacter pylori, and hiatus hernia were associated with mucosal injury. Our results suggested that risk factors of reflux symptoms or mucosal injury might be different in GERD patients. The underlying mechanism awaits further studies to clarify.

  1. Pulmonary manifestations of gastroesophageal reflux disease

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    Gaude Gajanan

    2009-01-01

    Full Text Available Gastroesophageal reflux disease (GERD may cause, trigger or exacerbate many pulmonary diseases. The physiological link between GERD and pulmonary disease has been extensively studied in chronic cough and asthma. A primary care physician often encounters patients with extra esophageal manifestations of GERD in the absence of heartburn. Patients may present with symptoms involving the pulmonary system; noncardiac chest pain; and ear, nose and throat disorders. Local irritation in the esophagus can cause symptoms that vary from indigestion, like chest discomfort and abdominal pain, to coughing and wheezing. If the gastric acid reaches the back of the throat, it may cause a bitter taste in the mouth and/or aspiration of the gastric acid into the lungs. The acid can cause throat irritation, postnasal drip and hoarseness, as well as recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis/ pneumonia. This clinical review examines the potential pathophysiological mechanisms of pulmonary manifestations of GERD. It also reviews relevant clinical information concerning GERD-related chronic cough and asthma. Finally, a potential management strategy for GERD in pulmonary patients is discussed.

  2. Gastroesophageal Reflux Disease: Medical or Surgical Treatment?

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    Theodore Liakakos

    2009-01-01

    Full Text Available Background. Gastroesophageal reflux disease is a common condition with increasing prevalence worldwide. The disease encompasses a broad spectrum of clinical symptoms and disorders from simple heartburn without esophagitis to erosive esophagitis with severe complications, such as esophageal strictures and intestinal metaplasia. Diagnosis is based mainly on ambulatory esophageal pH testing and endoscopy. There has been a long-standing debate about the best treatment approach for this troublesome disease. Methods and Results. Medical treatment with PPIs has an excellent efficacy in reversing the symptoms of GERD, but they should be taken for life, and long-term side effects do exist. However, patients who desire a permanent cure and have severe complications or cannot tolerate long-term treatment with PPIs are candidates for surgical treatment. Laparoscopic antireflux surgery achieves a significant symptom control, increased patient satisfaction, and complete withdrawal of antireflux medications, in the majority of patients. Conclusion. Surgical treatment should be reserved mainly for young patients seeking permanent results. However, the choice of the treatment schedule should be individualized for every patient. It is up to the patient, the physician and the surgeon to decide the best treatment option for individual cases.

  3. Gastroesophageal reflux disease correlation with posterior laryngitis

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    Dimitrijević Milovan

    2009-01-01

    Full Text Available Background/Aim. Over the last years numerous studies have been performed dealing with mutual relations among gastroesophageal reflux disease (GERD and numerous diseases of the upper airways. The aim of the present study was to establish possible causal relationship between GERD and posterior laryngitis (PL. Methods. The study included 103 patients with gastrointestinal complaints. Diagnostic procedure included a medical history, gastroscopy and laryngeal directoscopy. The obtained data processed using classic methods of the descriptive statistics, as well as Pearson's chi-square test, Student's t test, rank sum test and Fisher's parametric analysis of variance. Results. Out of the total number of 103 examined patients, 33 (32% were diagnosed with PL, while GERD was diagnosed in five of the examined patients all belonging to the PL group (15% of the patients with PL. In the remaining patients, PL was caused by other factors. All the patients with GERD had PL and globus sensation while 80% of GERD patients had prominent symptom of pain. Conclusion. The results of the study are indicative of the causal relationship between GERD and PL.

  4. Pediatric GERD (Gastro-Esophageal Reflux Disease)

    Science.gov (United States)

    ... in Toggle navigation b Join Now Donate Now Disclosure Form News About Us Our Campaigns Foundation Governance ... the stomach and out of the esophagus. The continuous entry of acid or refluxed materials into areas ...

  5. Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

    Institute of Scientific and Technical Information of China (English)

    Luigi Monaco; Antonio Brillantino; Francesco Torelli; Michele Schettino; Giuseppe Izzo; Angelo Cosenza; Natale Di Martino

    2009-01-01

    AIM: To determine the prevalence and characteristics of bile reflux in gastroesophageal reflux disease (GERD) patients with persistent symptoms who are nonresponsive to medical therapy.METHODS: Sixty-five patients (40 male, 25 female;mean age, 50 ± 7.8 years) who continued to report symptoms after 8 wk of high-dose proton pump inhibitor (PPI) therapy, as well as 18 patients with Barrett's esophagus, were studied. All patients filled out symptom questionnaires and underwent endoscopy,manometry and combined pH-metry and bilimetry.RESULTS: There were 4 groups of patients: 22 (26.5%)without esophagitis, 24 (28.9%) grade A-B esophagitis,19 (22.8%) grade C-D and 18 (21.6%) Barrett's esophagus. Heartburn was present in 71 patients (85.5%) and regurgitation in 55 (66.2%), with 44 (53%)reporting simultaneous heartburn and regurgitation. The prevalence of pathologic acid reflux in the groups without esophagitis and with grades A-B and C-D esophagitis was 45.4%, 66.6% and 73.6%, respectively. The prevalence of pathologic bilirubin exposure in these 3 groups was 53.3%, 75% and 78.9%, respectively. The overall prevalence of bile reflux in non-responsive patients was 68.7%. Pathologic acid and bile reflux was observed in 22.7% and 58.1% of non-esophagitic patients and esophagitic patients, respectively.CONCLUSION: The high percentage of patients poorly responsive to PPI therapy may result from poor control of duodenogastroesophageal reflux. Many patients without esophagitis have simultaneous acid and bile reflux, which increases with increasing esophagitis grade.

  6. Dental erosion caused by gastroesophageal reflux disease: a case report

    OpenAIRE

    Cengiz,Seda; Cengiz, M ?nan?; Sara?, Y ?inasi

    2009-01-01

    Introduction Chronic regurgitation of gastric acids in patients with gastroesophageal reflux disease may cause dental erosion, which can lead in combination with attrition or bruxism to extensive loss of coronal tooth tissue. Case presentation This clinical report describes treatment of severe tooth wear of a gastroesophageal reflux disease patient who is 54-year-old Turkish male patient. After his medical treatment, severe tooth wear, bruxism and decreased vertical dimensions were determined...

  7. Health economics of gastroesophageal reflux disease.

    Science.gov (United States)

    Sadowski, D; Champion, M; Goeree, R; Leddin, D; Otten, N; Morris, G; Beck, I; Faloon, T; Fedorak, R N

    1997-09-01

    The present study provides an overview of the current state of health economics studies of gastroesophageal reflux disease (GERD). It indicates the strengths and weaknesses of individual studies, and the state of health economics analysis in general as they apply to GERD. Specifically, this study adopts a pharmacoeconomic perspective, which is a subsection of health economics analytical methods, to provide a comparative analysis of alternative courses of action based on cost and consequence. The pharmacoeconomic outlook is most effective when it considers a comprehensive societal perspective, with special consideration given to other relevant viewpoints, such as the payer, the primary provider and, most important, the patient. Pharmacoeconomics provides several specific analytical techniques for GERD-related health economics analysis. The Canadian Association of Gastroenterology consensus conference on GERD in 1996 thought that a cost effective analysis was the most appropriate technique to assess the pharmacoeconomics of GERD. Six previous studies on GERD health economics have been performed comparing omeprazole with H2 receptor antagonists. These studies vary in cost data collected and in analytical techniques. In general, the existing outcome measurements of these previous health economics studies are not ideal. Namely, they combine various GERD grades, use randomized controls, are endoscopically based, assess pharmaceutical therapy only and are short term. More appropriate health economic trials in GERD, which focus on GERD management strategies and therapeutic treatment of GERD, need to be designed and conducted. These economic assessments, however, should not replace detailed thinking, careful observation, good judgement and common sense.

  8. Biomarkers for Gastroesophageal Reflux in Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Össur Ingi Emilsson

    2013-01-01

    Full Text Available Gastroesophageal reflux (GER is commonly associated with respiratory symptoms, either through a vagal bronchoconstrictive reflex or through microaspiration of gastric contents. No diagnostic test is available, however, to diagnose when respiratory illnesses are caused by GER and when not, but research in this field has been moving forward. Various biomarkers in different types of biosamples have been studied in this context. The aim of this review is to summarize the present knowledge in this field. GER patients with respiratory diseases seem to have a different biochemical profile from similar patients without GER. Inflammatory biomarkers differ in asthmatics based on GER status, tachykinins are elevated in patients with GER-related cough, and bile acids are elevated in lung transplant patients with GER. However, studies on these biomarkers are often limited by their small size, methods of analysis, and case selections. The two pathogenesis mechanisms are associated with different respiratory illnesses and biochemical profiles. A reliable test to identify GER-induced respiratory disorders needs to be developed. Bronchoalveolar lavage is too invasive to be of use in most patients. Exhaled breath condensate samples need further evaluation and standardization. The newly developed particles in exhaled air measurements remain to be studied further.

  9. Cytoprotective effects of hydrogen sulfide in novel rat models of non-erosive esophagitis.

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    Oksana Zayachkivska

    Full Text Available Non-erosive esophagitis is a chronic inflammatory condition of the esophagus and is a form of gastroesophageal reflux disease. There are limited treatment options for non-erosive esophagitis, and it often progresses to Barrett's esophagus and esophageal carcinoma. Hydrogen sulfide has been demonstrated to be a critical mediator of gastric and intestinal mucosal protection and repair. However, roles for H2S in esophageal mucosal defence, inflammation and responses to injury have not been reported. We therefore examined the effects of endogenous and exogenous H2S in rat models of non-erosive esophagitis. Mild- and moderate-severity non-erosive esophagitis was induced in rats through supplementation of drinking water with fructose, plus or minus exposure to water-immersion stress. The effects of inhibitors of H2S synthesis or of an H2S donor on severity of esophagitis was then examined, along with changes in serum levels of a pro- and an anti-inflammatory cytokine (IL-17 and IL-10, respectively. Exposure to water-immersion stress after consumption of the fructose-supplemented water for 28 days resulted in submucosal esophageal edema and neutrophil infiltration and the development of lesions in the muscular lamina and basal cell hyperplasia. Inhibition of H2S synthesis resulted in significant exacerbation of inflammation and injury. Serum levels of IL-17 were significantly elevated, while serum IL-10 levels were reduced. Treatment with an H2S donor significantly reduced the severity of esophageal injury and inflammation and normalized the serum cytokine levels. The rat models used in this study provide novel tools for studying non-erosive esophagitis with a range of severity. H2S contributes significantly to mucosal defence in the esophagus, and H2S donors may have therapeutic value in treating esophageal inflammation and injury.

  10. Halimeter ppb Levels as the Predictor of Erosive Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Kim, Jung Gon; Kim, Yoon Jae; Yoo, Seung Hee; Lee, So Jung; Chung, Jun Won; Kim, Min Ho; Park, Dong Kyun; Hahm, Ki-Baik

    2010-09-01

    In a previous issue published in Gut and Liver, we found that erosive changes in the esophagogastroduodenal mucosa were strongly correlated with increased levels of volatile sulfur-containing compounds (VSC), suggesting that halitosis could be a symptom reflecting the erosive status of the upper gut mucosa. Together with other studies showing a possible association between halitosis and gastroesophageal reflux disease (GERD), under the premise that halitosis could be one of extraesophageal manifestations of erosive GERD (ERD), we investigated the significance of Halimeter ppb levels on ERD compared to non-erosive gastroesophageal reflux disease (NERD). Subjects were assigned to the NERD group if there was no evidence of esophageal erosive changes on endoscopy, despite reflux symptoms, and to the ERD group if they had GERD A, B, C, or D (according to the Los Angeles classification). The VSC levels were measured in all patients with either a Halimeter (before endoscopy) or by gas chromatography of the gastric juices aspirated during endoscopy. The VSC level differed significantly between the NERD and ERD groups (p24 kg/m(2) was significantly associated with ERD, there was no correlation with Halimeter ppb levels. Minimal-change lesions exhibited the highest VSC levels, signifying that minimal change lesions can be classified as ERD based on our finding that halimeter ppb levels were descrimitive of erosive change. Erosive changes in the esophageal mucosa were strongly associated with VSC levels, supporting the hypothesis that halitosis can be a potential biomarker for the discrimination between ERD and NERD, reflecting the presence of erosive change in the lower esophagogastric junction.

  11. Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Hubert M(o)nnikes; Robert C Heading; Holger Schmitt; Hubert Doerfler

    2011-01-01

    AIM: To investigate the influence of irritable bowel syndrome (IBS)-like symptoms on treatment outcomes with pantoprazole in gastroesophageal reflux disease (GERD) in a real life setting. METHODS: For this prospective, open-label, multinational, multicentre study, 1888 patients assessed by the investigators as suffering from GERD were recruited. The patients were additionally classified as with or without IBS-like symptoms at baseline. They were treated with pantoprazole 40 mg once daily and completed the Reflux Questionnaire? (ReQuest?) short version daily. Response rates and symptom scores were compared after 4 and 8 wk of treatment for subgroups defined by the subclasses of GERD [erosive(ERD) and non-erosive reflux disease (NERD)] and the presence of IBS-like symptoms. RESULTS: IBS-like symptoms were more prevalent in NERD than in ERD (18.3% vs 12.7%, P = 0.0015). Response rates after 4 and/or 8 wk of treatment were lower in patients with IBS-like symptoms than in patients without IBS-like symptoms in both ERD (Week 4: P < 0.0001, Week 8: P < 0.0339) and NERD (Week 8: P = 0.0088). At baseline, ReQuest? "lower abdominal complaints" symptom scores were highest in NERD patients with IBS-like symptoms. Additionally, these patients had the strongest symptom improvement after treatment compared with all other subgroups. CONCLUSION: IBS-like symptoms influence treatment outcome and symptom burden in GERD and should be considered in management. Proton pump inhibitors can improve IBS-like symptoms, particularly in NERD.

  12. Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    HubertM6nnikes; RobertCHeading; HolgerSchmitt; HubertDoerfler

    2011-01-01

    AIM: To investigate the influence of irritable bowel syndrome (IBS)-like symptoms on treatment outcomes with pantoprazole in gastroesophageal reflux disease (GERD) in a real life setting. METHODS: For this prospective, open-label, multinational, multicentre study, 1888 patients assessed by the investigators as suffering from GERD were recruited. The patients were additionally classified as with or without IBS-like symptoms at baseline. They were treated with pantoprazole 40 mg once daily and completed the Reflux Questionnaire (ReQuest) short version daily. Response rates and symptom scores were compared after 4 and 8 wk of treatment for subgroups defined by the subclasses of GERD [erosive(ERD) and non-erosive reflux disease (NERD)] and the presence of IBS-like symptoms. RESULTS: IBS-like symptoms were more prevalent in NERD than in ERD (18.3% vs 12.7%, P = 0.0015). Response rates after 4 and/or 8 wk of treatment were lower in patients with IBS-like symptoms than in patients without IBS-like symptoms in both ERD (Week 4: P 〈 0.0001, Week 8: P 〈 0.0339) and NERD (Week 8: P = 0.0088). At baseline, ReQuest "lower abdominal com- plaints" symptom scores were highest in NERD patients with IBS-like symptoms. Additionally, these patients had the strongest symptom improvement after treatment compared with all other subgroups. CONCLUSION: IBS-like symptoms influence treatment outcome and symptom burden in GERD and should be considered in management. Proton pump inhibitors can improve IBS-like symptoms, particularly in NERD.

  13. Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease.

    Science.gov (United States)

    Mönnikes, Hubert; Heading, Robert C; Schmitt, Holger; Doerfler, Hubert

    2011-07-21

    To investigate the influence of irritable bowel syndrome (IBS)-like symptoms on treatment outcomes with pantoprazole in gastroesophageal reflux disease (GERD) in a real life setting. For this prospective, open-label, multinational, multicentre study, 1888 patients assessed by the investigators as suffering from GERD were recruited. The patients were additionally classified as with or without IBS-like symptoms at baseline. They were treated with pantoprazole 40 mg once daily and completed the Reflux Questionnaire™ (ReQuest™) short version daily. Response rates and symptom scores were compared after 4 and 8 wk of treatment for subgroups defined by the subclasses of GERD [erosive (ERD) and non-erosive reflux disease (NERD)] and the presence of IBS-like symptoms. IBS-like symptoms were more prevalent in NERD than in ERD (18.3% vs 12.7%, P = 0.0015). Response rates after 4 and/or 8 wk of treatment were lower in patients with IBS-like symptoms than in patients without IBS-like symptoms in both ERD (Week 4: P < 0.0001, Week 8: P < 0.0339) and NERD (Week 8: P = 0.0088). At baseline, ReQuest™ "lower abdominal complaints" symptom scores were highest in NERD patients with IBS-like symptoms. Additionally, these patients had the strongest symptom improvement after treatment compared with all other subgroups. IBS-like symptoms influence treatment outcome and symptom burden in GERD and should be considered in management. Proton pump inhibitors can improve IBS-like symptoms, particularly in NERD.

  14. Helicobacter pylori and gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Nigro Casimiro

    2008-07-01

    Full Text Available Abstract Background The nature of the relationship between Helicobacter pylori and reflux oesophagitis is still not clear. To investigate the correlation between Helicobacter pylori infection and GERD taking into account endoscopic, pH-metric and histopathological data. Methods Between January 2001 and January 2003 a prospective study was performed in 146 patients with GERD in order to determine the prevalence of Helicobacter pylori infection at gastric mucosa; further the value of the De Meester score endoscopic, manometric and pH-metric parameters, i.e. reflux episodes, pathological reflux episodes and extent of oesophageal acid exposure, of the patients with and without Helicobacter pylori infection were studied and statistically compared. Finally, univariate analysis of the above mentioned data were performed in order to evaluate the statistical correlation with reflux esophagitis. Results There were no statistically significant differences between the two groups, HP infected and HP negative patients, regarding age, gender and type of symptoms. There was no statistical difference between the two groups regarding severity of symptoms and manometric parameters. The value of the De Meester score and the ph-metric parameters were similar in both groups. On univariate analysis, we observed that hiatal hernia (p = 0,01, LES size (p = 0,05, oesophageal wave length (p = 0,01 and pathological reflux number (p = 0,05 were significantly related to the presence of reflux oesophagitis. Conclusion Based on these findings, it seems that there is no significant evidence for an important role for H. pylori infection in the development of GERD and erosive esophagitis. Nevertheless, current data do not provide sufficient evidence to define the relationship between HP and GERD. Further assessments in prospective large studies are warranted.

  15. [Gastro-esophageal reflux and chronic respiratory diseases].

    Science.gov (United States)

    Dirou, S; Germaud, P; Bruley des Varannes, S; Magnan, A; Blanc, F-X

    2015-12-01

    Gastroesophageal reflux disease (GERD) frequently occurs in association with chronic respiratory diseases although the casual link is not always clear. Several pathophysiological and experimental factors are considered to support a role for GERD in respiratory disease. Conversely, respiratory diseases and bronchodilator treatment can themselves exacerbate GERD. When cough or severe asthma is being investigated, GERD does not need to be systematically looked for and a therapeutic test with proton pump inhibitors is not always recommended. pH impedance monitoring is now the reference diagnostic tool to detect non acid reflux, a form of reflux for which proton pump inhibitor treatment is ineffective. Recent data have shown a potential role of GERD in idiopathic pulmonary fibrosis and bronchiolitis obliterans following lung transplantation, leading to discussions about the place of surgery in this context. However, studies using pH impedance monitoring are still needed to better understand and manage the association between GERD and chronic respiratory diseases.

  16. How many cases of laryngopharyngeal reflux suspected by laryngoscopy are gastroesophageal reflux disease-related?

    Institute of Scientific and Technical Information of China (English)

    Nicola de Bortoli; Andrea Nacci; Edoardo Savarino; Irene Martinucci; Massimo Bellini; Bruno Fattori; Linda Ceccarelli

    2012-01-01

    AIM:To investigate the prevalence of gastroesophageal reflux disease (GERD) in patients with a laryngoscopic diagnosis of laryngopharyngeal reflux (LPR).METHODS:Between May 2011 and October 2011,41 consecutive patients with laryngopharyngeal symptoms (LPS) and laryngoscopic diagnosis of LPR were empirically treated with proton pump inhibitors (PPIs) for at least 8 wk,and the therapeutic outcome was assessed through validated questionnaires (GERD impact scale,GIS; visual analogue scale,VAS).LPR diagnosis was performed by ear,nose and throat specialists using the reflux finding score (RFS) and reflux symptom index (RSI).After a 16-d wash-out from PPIs,all patients underwent an upper endoscopy,stationary esophageal manometry,24-h multichannel intraluminal impedance and pH (MII-pH) esophageal monitoring.A positive correlation between LPR diagnosis and GERD was supposed based on the presence of esophagitis (ERD),pathological acid exposure time (AET) in the absence of esophageal erosions (NERD),and a positive correlation between symptoms and refluxes (hypersensitive esophagus,HE).RESULTS:The male/female ratio was 0.52 (14/27),the mean age ± SD was 51.5 ± 12.7 years,and the mean body mass index was 25.7 ± 3.4 kg/m2.All subjects reported one or more LPS.Twenty-five out of 41 patients also had typical GERD symptoms (heartburn and/or regurgitation).The most frequent laryngoscopic findings were posterior laryngeal hyperemia (38/41),linear indentation in the medial edge of the vocal fold (31/41),vocal fold nodules (6/41) and diffuse infraglottic oedema (25/41).The GIS analysis showed that 10/41 patients reported symptom relief with PPI therapy (P < 0.05); conversely,23/41 did not report any clinical improvement.At the same time,the VAS analysis showed a significant reduction in typical GERD symptoms after PPI therapy (P < 0.001).A significant reduction in LPS symptoms.On the other hand,such result was not recorded for LPS.Esophagitis was detected in 2/41 patients

  17. Reflux and acid peptic diseases in the elderly.

    Science.gov (United States)

    Soumekh, Amir; Schnoll-Sussman, Felice H; Katz, Philip O

    2014-02-01

    Gastroesophageal reflux disease (GERD) is a common disorder among elderly patients seeking medical care. Diagnosis and management of GERD in the older patient is a unique challenge for both the primary care provider and the gastroenterologist. Such patients may have atypical symptoms, more severe disease, and a higher rate of complications such as erosive esophagitis, Barrett esophagus, and esophageal cancer. Moreover, the elderly may be more sensitive to the morbidity and mortality of the available treatments for GERD. A careful and vigilant approach to the diagnosis, monitoring, and treatment of reflux disease in the elderly is warranted.

  18. Surgery for gastroesophageal reflux disease with Gaucher disease type 2.

    Science.gov (United States)

    Kubo, Hiroyuki; Shimono, Ryuichi; Tanaka, Aya; Fujii, Takayuki; Yasuda, Saneyuki; Koyano, Kosuke; Jinnai, Wataru; Kondo, Sonoko; Kondo, Takeo; Kusaka, Takashi

    2016-07-01

    Gaucher disease, the most common lysosomal storage disease, is sometimes complicated with gastroesophageal reflux disease (GERD). The present patient was a 136-day-old Japanese boy with Gaucher disease type 2. Enzyme replacement therapy and chemical chaperone therapy were successful for the skin disorders, joint contractures, hepatosplenomegaly and thrombocytopenia, but he also had GERD. Accordingly, a Nissen fundoplication with gastrostomy was performed. There was no vulnerability of organs, easy bleeding or difficulty of maintaining the visual field because of hepatosplenomegaly during operation. In the perioperative period, there was no prolonged wound healing or infection. GERD was improved. In the near future, the number of long-term survivors of Gaucher disease will increase due to improvements in medical therapy. Therefore, it is expected that the number of patients requiring fundoplication will also increase. In patients with successful medical therapy, surgical fundoplication can be safely and effectively performed.

  19. Comparison of Endoscopic Findings with Gastroesophageal Reflux Disease Questionnaires (GerdQ and Reflux Disease Questionnaire (RDQ for Gastroesophageal Reflux Disease in Medan

    Directory of Open Access Journals (Sweden)

    Gontar Alamsyah Siregar

    2015-12-01

    Full Text Available ABSTRACT Background: There are many questionnaires that have been developed to diagnose gastroesophageal reflux disease (GERD, i.e. reflux disease questionnaire (RDQ, and the recently developed, gastroesophageal reflux disease questionnaires (GerdQ. In this study, we tried to compare GerdQ and RDQ in terms of sensitivity and specificity to diagnose GERD and its relationship with endoscopic findings. Method: This study was a cross sectional analytical study. Subsequently, all the subjects were evaluated using the GerdQ and RDQ, then underwent esophagogastroduodenoscopy examination. The severity of endoscopically observed reflux esophagitis was graded with the Los Angeles classification. All endoscopy was performed by well-trained doctor. Results: A total of 85 patients were examined, 34 (40% patients had reflux esophagitis at endoscopy examination, including 15 (44.1% cases of grade A, 11 (32.3% cases of grade B, 4 (11.8% cases of grade C, and 4 (11.8% cases of grade D. Analysis study using sensitivity, specificity, and receiver operating characteristic (ROC test showed that GerdQ had sensitivity (49%, specificity (91%, and an area under the ROC of 0.701 (p value = 0.002. RDQ had sensitivity (24%, specificity (91%, and an area under the ROC of 0.574 (p value = 0.253. Taking 11 as the cut off point for GerdQ, a maximal sensitivity of 73.5%, specificity of 82.4%, and an area under the ROC of 0.779 was achieved. Conclusion: GerdQ and RDQ can be used to help diagnose GERD, but GerdQ is more superior than RDQ in diagnosing GERD. A multi-center study with larger samples is needed to determine the best GerdQ’s cut off point in Indonesia.

  20. Unmet Needs in the Treatment of Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Dickman, Ram; Maradey-Romero, Carla; Gingold-Belfer, Rachel; Fass, Ronnie

    2015-07-30

    Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder. Proton pump inhibitors have profoundly revolutionized the treatment of GERD. However, several areas of unmet need persist despite marked improvements in the ther-apeutic management of GERD. These include the advanced grades of erosive esophagitis, nonerosive reflux disease, main-tenance treatment of erosive esophagitis, refractory GERD, postprandial heartburn, atypical and extraesophageal manifestations of GERD, Barrett's esophagus, chronic protein pump inhibitor treatment, and post-bariatric surgery GERD. Consequently, any fu-ture development of novel therapeutic modalities for GERD (medical, endoscopic, or surgical), would likely focus on the afore-mentioned areas of unmet need.

  1. Chronic laryngitis as a result of gastro esophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Trajković Rada

    2014-01-01

    Full Text Available Reflux of gastric contents to the level of the pharynx and larynx is called laryngopharyngeal reflux, which can exist as such or laryngeal and pharyngeal reflux as separate entities, and in such form may lead to other diseases such as rhinitis, sinusitis, otitis media, and precancerous cancerous condition. To determine the relationship and impact of gastroesophageal reflux disease on the occurrence, frequency and duration of inflammatory processes and mucosal damage to the larynx. All patients were obtained anamnesticly, lab test done in all patients, indirect hipofaringo and laryngoscopy was performed in all patients. Based on the feedback reports gastroenterologists, we obtained data of gastroscopy. Results: 120 subjects were processed with dyspeptic symptoms. Based on history, all patients had some symptoms of upper respiratory tract disease.62 (51.66% male respondents and 58 (48.33% females. The average age of 54 years. In 82 (68.33% patients was increased salivation (one of the leading symptoms, of that number in 61 (74.39% participants laryngitis was present. In 68 (56.66% cases where the predominant symptom was cough, laryngitis was present in 26 (38.23%. In 70 (58.33% of patients with globus sensation, laryngitis was present in 38 (54.28% patients. Smoking has been represented with 65.83% (70 respondents, the percentage of patients with chronic laryngitis in this group was 69.62% (55 respondents. Been held after gastroscopy and otorinolaryngological examination in 62 (51.66% patients were diagnosed gastroesophageal reflux disease (GERD, of which, in 43 (69.35% patients laryngitis was present. After a three-month follow-up of patients with therapy (H2 blockers, proton pump inhibitors and antacids 28 (65.11% subjects (total treated, showed an improvement. The results of this study indicate a significant correlation between gastroesophageal reflux disease and chronic laryngitis, as well as the favorable impact and effect of antacid therapy

  2. A PROPOSITION FOR THE DIAGNOSIS AND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE IN CHILDREN - A REPORT FROM A WORKING GROUP ON GASTROESOPHAGEAL REFLUX DISEASE

    NARCIS (Netherlands)

    VANDENPLAS, Y; ASHKENAZI, A; BELLI, D; BOIGE, N; BOUQUET, J; CADRANEL, S; CEZARD, JP; CUCCHIARA, S; DUPONT, C; GEBOES, K; GOTTRAND, F; HEYMANS, HSA; JASINSKI, C; KNEEPKENS, CMF; KOLETZKO, S; MILLA, P; MOUGENOT, JF; NUSSLE, D; NAVARRO, J; NEWELL, SJ; OLAFSDOTTIR, E; PEETERS, S; RAVELLI, A; POLANCO, [No Value; SANDHU, BK; TOLBOOM, J

    1993-01-01

    In this paper, a Working Group on Gastro-Oesophageal Reflux discusses recommendations for the first line diagnostic and therapeutic approach of gastro-oesophageal reflux disease in infants and children. All members of the Working Group agreed that infants with uncomplicated gastro-oesophageal reflux

  3. [Severe interstitial lung disease from pathologic gastroesophageal reflux in children].

    Science.gov (United States)

    Ahrens, P; Weimer, B; Hofmann, D

    1999-07-01

    Interstitial lung diseases comprise a heterogeneous group of pulmonary conditions that cause restrictive lung disease of poor prognosis, especially if growth failure, pulmonary hypertension and fibrosis appears. We report on the case of a girl of 11 years of age who suffered from severe nonallergic asthma in early childhood and who developed severe interstitial pulmonary disease caused by gastro-oesophageal reflux at the age of 8 years. This diagnosis was established by lung biopsy, bronchoalveolar lavage and a high amount of lipid-laden alveolar macrophages, 2-level pH measurement and oesophageal biopsy. Because therapy with oral and inhaled steroids failed and Omeprazol showed benificial effects, hemifundoplication according to THAL was performed. At present the lung function is clearly normal and there is no need of any medicaments. Following the history, we can assume the pathological gastro-oesophageal reflux to be the cause of the disease. It is important to state that there were no typical symptoms at any time pointing to gastro-oesophageal reflux disease. The development of pulmonary disease by pathological reflux is very often caused by "silent aspiration". Very typically there are no symptoms such as vomiting, heartburn and pain but only signs of chronic lung disease.

  4. Is ineffective esophageal motility associated with gastropharyngeal reflux disease?

    Institute of Scientific and Technical Information of China (English)

    Kyung Yup Kim; Gwang Ha Kim; Dong Uk Kim; Soo Geun Wang; Byung Joo Lee; Jin Choon Lee; Do Youn Park; Geun Am Song

    2008-01-01

    AIM: To evaluate the association between IEM and gastropharyngeal reflux disease (GPRD) in patients who underwent ambulatory 24-h dual-probe pH monitoring for the evaluation of supraesophageal symptoms.METHODS: A total of 632 patients who underwent endoscopy, esophageal manometry and ambulatory 24-h dual-pH monitoring due to supraesophageal symptoms (e.g. globus, hoarseness, or cough) were enrolled. Of them, we selected the patients who had normal esophageal motility and IEM. The endoscopy and ambulatory pH monitoring findings were compared between the two groups.RESULTS: A total of 264 patients with normal esophageal motility and 195 patients with the diagnosis of IEM were included in this study. There was no difference in the frequency of reflux esophagitis and hiatal hernia between the two groups. All the variables showing gastroesophageal reflux and gastropharyngeal reflux were not different between the two groups. The frequency of GERD and GPRD, as defined by ambulatory pH monitoring, was not different between the two groups.CONCLUSION: There was no association between IEM and GPRD as well as between IEM and GERD. IEM alone cannot be considered as a definitive marker for reflux disease.

  5. LINX(™) Reflux Management System: magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease.

    Science.gov (United States)

    Bonavina, Luigi; DeMeester, Tom R; Ganz, Robert A

    2012-12-01

    Gastroesophageal reflux disease (GERD), commonly manifested by heartburn or regurgitation, is a chronic, progressive condition in which failed sphincter function allows the contents of the stomach to reflux into the esophagus, the airways and the mouth. Chronic GERD affects 10% of Western society. The majority of patients receive adequate relief from proton pump inhibitors, but up to 40% have incomplete relief of symptoms that cannot be addressed by increasing the dose of medications. The laparoscopic Nissen fundoplication is the surgical gold standard; however, the level of technical difficulty and its side effects have limited its use to less than 1% of the GERD population. These factors have contributed to the propensity of patients to persist with medical therapy, even when inadequate to control symptoms and complications of the disease. Consequently, a significant gap in the treatment continuum for GERD remains evident in current clinical practice. The LINX(™) Reflux Management System (Torax Medical) is designed to provide a permanent solution to GERD by augmenting the physiologic function of the sphincter barrier with a simple and reproducible laparoscopic procedure that does not alter gastric anatomy and can be easily reversed if necessary.

  6. Composite score of reflux symptoms in diagnosis of gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Jin-Hai Wang; Jin-Yan Luo; Lei Dong; Jun Gong; Ai-Li Zuo

    2004-01-01

    AIM: To evaluate the significance of the composite score of reflux symptoms in the diagnosis of gastroesophageal reflux disease (GERD), and to determine the relationship of the composite score with reflux esophagitis (RE) and pathological gastroesophageal reflux (PGER).METHODS: Upper digestive endoscopy and /or 24-h esophageal pH monitoring were performed in 244 subjects.Of these, 54 were consecutive patients attending our clinic with symptoms suggestive of GERD, and 190 were randomly selected from 2532 respondents who participated in our previous general population-based study on GERD. A standardized questionnaire was used to classify both the frequency and severity of typical symptoms of GERD(heartburn, acid and food regurgitation) using a 4-score scale, and the composite score of main reflux symptoms(score index: SI, range from 0 to 18) were calculated for every subject. RE was diagnosed according to the SavaryMiller criteria. Subjects with abnormal pH-metry (DeMeester score more than 14.7) were considered to have PGER.GERD patients were defined as the subjects with RE and/or PGER.RESULTS: The sensitivity of SI in the diagnosis of GERD was inversely associated with SI, but the specificity tended to increase with increased SI. With the cut-off of 8, the SI achieved the highest accuracy of 70.0%, with a sensitivity of 78.6% and a specificity of 69.2% in diagnosing GERD,followed by the cut-off of 3, which had an accuracy of 62.1%,a sensitivity of 96.4% and a specificity of 34.6%. The prevalence of RE, PGER and GERD was strongly associated with increased SI (P<0.01), but there was no significant association between the severity of RE and SI (P>0.05).Among patients with RE, 69.2% had PGER, and 30.8%were confirmed to have negative findings of pH monitoring.Among patients with PGER, 52.9% were identified to have RE and 47.1% had negative endscopic findings in esophagus.CONCLUSION: According to the composite score of main reflux symptoms, the diagnosis of GERD can

  7. Features of Motor and Secretory Disorders in Gastroesophageal Reflux Disease in Young Patients with Concomitant Obesity

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    O.A. Oparin

    2015-09-01

    Materials and Results of the Study. The study included 50 patients with gastroesophageal reflux disease, they we divided into 2 groups, depending on the presence of concomitant obesity. The first group included patients with gastroesophageal reflux disease and concomitant obesity, the second one — patients with gastroesophageal reflux disease without comorbidity. Control group consisted of 20 apparently healthy individuals. The study found that patients with gastroesophageal reflux disease and concomitant obesity had severe motor disturbances which were evaluated using ultrasound study (there were evaluated the diameter of esophageal hiatus, the thickness of esophageal wall, esophageal lumen width in the lower third, as well as the presence or absence of reflux, and were in close correlation with specific clinical manifestations of gastroesophageal reflux disease, measured by GERDQ questionnaires (international questionnaires for the diagnosis of gastroesophageal reflux disease compared with the group of patients with gastroesophageal reflux disease without comorbidity.

  8. Diagnosis and Treatment of Refractory Gastroesophageal Reflux Disease (GERD

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    Selfie

    2015-12-01

    Full Text Available Gastroesophageal reflux disease (GERD was a damage in mucosal layer caused by gastric acid reflux. GERD was found about 10-20% in Western Countries and less in Asia, about 2,6-6,7%. Among different type of GERD, refractory GERD was a problem found in daily clinical practice. This terminology was used in patients with regurgitation and heartburn symptoms which is not responsive to 8 weeks proton pump inhibitor (PPI therapy. There were several mechanisms underlying the etiology and pathophysiology of refractory GERD. In general, refractory GERD diagnosis was based on clinical findings, objective endoscopic examination, ambulatory reflux monitoring, and response to antiacid-secretion therapy. Reevaluation of patients compliance should be the first step in refractory GERD management. A further treatment strategies could be started, consist of medical and surgical therapies. A basic clinical knowledge of refractory GERD would help clinician in deciding the best approach for diagnosis and therapy.

  9. Erroneous Diagnosis of Gastroesophageal Reflux Disease in Achalasia

    NARCIS (Netherlands)

    B.F. Kessing; A.J. Bredenoord; A.J.P.M. Smout

    2011-01-01

    BACKGROUND & AIMS: Most experienced gastroenterologists have seen one or several cases of achalasia patients who have been erroneously diagnosed with gastroesophageal reflux disease (GERD) or even underwent antireflux surgery. We aim to describe the current knowledge about the diagnostic features of

  10. Gastroesophageal reflux disease: exaggerations, evidence and clinical practice

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    Cristina Targa Ferreira

    2014-04-01

    Full Text Available OBJECTIVE: there are many questions and little evidence regarding the diagnosis and treatment of gastroesophageal reflux disease (GERD in children. The association between GERD and cow's milk protein allergy (CMPA, overuse of abdominal ultrasonography for the diagnosis of GERD, and excessive pharmacological treatment, especially proton-pump inhibitors (PPIs are some aspects that need clarification. This review aimed to establish the current scientific evidence for the diagnosis and treatment of GERD in children. DATA SOURCE: a search was conducted in the MEDLINE, PubMed, LILACS, SciELO, and Cochrane Library electronic databases, using the following keywords: gastroesophageal reflux; gastroesophageal reflux disease; proton-pump inhibitors; and prokinetics; in different age groups of the pediatric age range; up to May of 2013. DATA SYNTHESIS: abdominal ultrasonography should not be recommended to investigate gastroesophageal reflux (GER. Simultaneous treatment of GERD and CMPA often results in unnecessary use of medication or elimination diet. There is insufficient evidence for the prescription of prokinetics to all patients with GER/GERD. There is little evidence to support acid suppression in the first year of life, to treat nonspecific symptoms suggestive of GERD. Conservative treatment has many benefits and with low cost and no side-effects. CONCLUSIONS: there have been few randomized controlled trials that assessed the management of GERD in children and no examination can be considered the gold standard for GERD diagnosis. For these reasons, there are exaggerations in the diagnosis and treatment of this disease, which need to be corrected.

  11. Esophageal cell proliferation in gastroesophageal reflux disease: Clinical-morphological data before and after pantoprazole

    Institute of Scientific and Technical Information of China (English)

    Carlo Calabrese; Davide Treré; Giuseppina Liguori; Veronica Gabusi; Manuela Vici; Giovanna Cenacchi; Massimo Derenzini; Giulio Di Febo

    2009-01-01

    AIM: To evaluate esophageal mucosal defense mechanisms at an epithelial level to establish if pantoprazole treatment can induce ultrastructural healing and improvement in the proliferation activity of the esophageal epithelium in gastroesophageal reflux disease (GERD). METHODS: This was a single-blinded study for pHmonitoring, and histological, ultrastructural and MIB1 immunostaining evaluation. Fifty eight patients with GERD were enrolled and underwent 24 h pH-monitoring and endoscopy. Patients were treated for 12 and 24 mo with pantoprazole. Esophageal specimens were taken for histological and ultrastructural evaluation, before and after the treatment. RESULTS: With transmission electron microscopy, all patients with GERD showed ultrastructural signs of damage with dilation of intercellular spaces (DIS). After 3 mo of therapy the mean DIS values showed a significant reduction and the mean MIB1-LI values of GERD showed an increase in cell proliferation. A further 3 mo of therapy significantly increased cell proliferation only in the erosive esophagitis (ERD) group. CONCLUSION: Three months of pantoprazole therapy induced ultrastructural healing of mucosal damage in 89% and 93% of ERD and non-erosion patients, respectively. Moreover, long-term pantoprazole treatment may be helpful in increasing the capability for esophageal cell proliferation in GERD, particularly in ERD patients.

  12. Gastroesophageal Reflux Disease in Children with Cystic Fibrosis.

    Science.gov (United States)

    Dziekiewicz, Marcin A; Banaszkiewicz, Aleksandra; Urzykowska, Agnieszka; Lisowska, Aleksandra; Rachel, Marta; Sands, Dorota; Walkowiak, Jaroslaw; Radzikowski, Andrzej; Albrecht, Piotr

    2015-01-01

    Previously published studies have indicated that gastroesophageal reflux (GER) disease is common in pediatric patients with cystic fibrosis. The aim of the present study was to get insight into the incidence of GER and to characterize the nature of reflux episodes in children with cystic fibrosis. This was a multicenter, prospective study of children with cystic fibrosis older than 18 months. Forty four consecutive patients (22 boys, mean age 10.4 ± 3.6, range 3.0-17.8 years) were enrolled into the study. All patients underwent 24 h pH-impedance monitoring. GER were classified according to the widely recognized criteria as an acid, weakly acid, weakly alkaline, or proximal. The pH-impedance trace was considered abnormal when acid exposure was >6 %. GER was diagnosed in 24/44 (54.5 %) children. A total of 1585 (median 35, range 7-128) reflux episodes were detected; 1199 (75.6 %) were acidic, 382 (24.1 %) weakly acidic, and 4 (0.3 %) weakly alkaline. Six hundred and ninety-one (43.6 %) reflux episodes reached the proximal esophagus. In 14/44 patients typical GER symptoms were present. We conclude that the incidence of GER in children with cystic fibrosis is very high. In the majority of patients typical GER symptoms are absent. Therefore, diagnostic procedures should be considered, regardless of lacking symptoms. Although acid reflux episodes predominate in children with cystic fibrosis, classical pH-metry may not constitute a sufficient diagnostic method in this population because of a relatively high number of proximal reflux episodes. Such episodes also indicate an increased risk for aspiration. The pH-impedance diagnostic measurement is advocated when suspecting GER in children with cystic fibrosis.

  13. Gastro-esophageal reflux disease and exacerbations in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Ingebrigtsen, Truls S; Marott, Jacob L; Vestbo, Jørgen

    2015-01-01

    applied a multivariable Cox regression analysis with adjustment for well-established risk factors associated with COPD exacerbations or gastro-esophageal reflux disease, including COPD severity, and symptoms. RESULTS: Individuals with COPD and gastro-esophageal reflux disease had more chronic bronchitis...

  14. Associations between peripheral vertigo and gastroesophageal reflux disease.

    Science.gov (United States)

    Viliušytė, Edita; Macaitytė, Raminta; Vaitkus, Antanas; Rastenytė, Daiva

    2015-09-01

    We hypothesize that peripheral vertigo is associated with gastroesophageal reflux disease (GERD). Two mechanisms could be considered – gastric acids may directly irritate the respiratory mucosa and cause inflammation, or Helicobacter pylori (H. pylori) could be present and cause local infection. Reflux material (Hydrochloric acid (HCl) and pepsin) could get into the middle ear via Eustachian tube and affect osseous structures directly. Disturbance of ossicles could cause tinnitus, which is more common for peripheral vertigo. H. pylori could also get in the esophagus and in the upper respiratory tract via gastroesophageal reflux, and could cause tympanosclerosis and fixation of ossicles. In our study group, 120 of 153 (78.4%) patients had gastroesophageal reflux disease (GERD). Diagnostic tests of H. pylori (rapid urease test or blood antibody test) were performed for 96 of 120 (80%) patients with GERD and were found positive for 32 of 96 (33.3%) patients. Peripheral vertigo was present in 93 of 120 (77.6%) patients with GERD compared to 33 of 126 (26%) patients without GERD (χ(2)=9.016, p=0.003). H. pylori and peripheral vertigo coexisted in 26 of 126 patients (20.6%) (OR 1.36; 95% CI 0.49-3.74, p=0.55). Our study demonstrated statistically significant association between peripheral vertigo and GERD but not between peripheral vertigo and H. pylori. Further more extensive investigations are needed in order to explore our hypothesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. PSYCHOSOMATIC ASPECTS IN THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE

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    V. I. Trofimov

    2015-01-01

    Full Text Available Gastroesophageal reflux disease is the most common disease of the esophagus, through the development of which is impaired motor function of the upper gastrointestinal system, allowing the disease to be quite be classified as psychosomatic, especially in the early stages of development, when no apparent organic complications that affect the structure of tissues. A significant percentage of mental disorders is observed in patients even before the development of somatic complaints. Patients in number of 105 people are examined. The first group — experienced (71 patient received complex treatment, which includes the basic pathogenetic, symptomatic, and psychotropic treatment in the form of anxiolytics and antidepressants. The choice of drug was based on the results of psychological testing. The second group — the comparison group (34 patients received only conventional treatment, without psychiatric support. Analysis was conducted of the astheno-vegetative syndrome, psychological characteristics of patients in relation to their disease, indicators of anxiety level and severity of depression. Patients with not erosive reflux disease have a frequency of detection of a depression and uneasiness was more than twice higher, than at patients with erosive reflux disease. After carrying out psychotropic treatment these indicators were practically made even. Prescription of psychotropic therapy in the form of antidepressants and anxiolytics has allowed to minimize the timing regression of clinical and psychosomatic manifestations of disease.

  16. Two Cases of Hiccups due to Gastroesophageal Reflux Disease

    OpenAIRE

    KOÇKAR, Cem; İşler, Mehmet; CÜRE, Erkan; Şenol, Altuğ; Bastürk, Abdulkadir

    2015-01-01

    Hiccup is a spasmodic, involuntary contraction of the inspiratory muscles, associated with delayed, abrupt glottic closure, causing a peculiar sound. There are numerous causes of hiccup, including diseases of the gastrointestinal tract. Hiccup is reported to represent an atypical manifestation of the gastroesophageal reflux disease (GERD).We report two cases with hiccup due to GERD. Endoscopic examinations showed esophagitis, Los Angeles class grade A and B, in two cases whose hiccups were im...

  17. Can yoga be used to treat gastroesophageal reflux disease?

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    Dharmesh Kaswala

    2013-01-01

    Full Text Available Yoga methods including Pranayama are the best ways to prevent many diseases and their progression. Even though, Yoga is widely practiced, its effects on certain medical conditions have not been studied or reported. Gastroesophageal reflux disease (GERD is one of them. GERD is extremely common condition requiring frequent consumption of over-the-counter or prescribed proton pump inhibitors (PPI. In severe symptoms of GERD and in the presence of multiple etiologies, PPIs are insufficient to relieve the symptoms of gastric reflux. Regular and proper use of the Yoga along with PPI can control the severe symptoms of GERD and can avoid or delay the necessity of invasive procedures. This evidence-based case report focuses on the effects of Yoga on GERD. Our case report showed that regular practice of Kapalbhati and Agnisar kriya along with PPI, patients with hiatal hernia had improvement in severe symptoms of GERD, which were initially refractory to PPI alone.

  18. Can yoga be used to treat gastroesophageal reflux disease?

    Science.gov (United States)

    Kaswala, Dharmesh; Shah, Shamik; Mishra, Avantika; Patel, Hardik; Patel, Nishith; Sangwan, Pravesh; Chodos, Ari; Brelvi, Zamir

    2013-01-01

    Yoga methods including Pranayama are the best ways to prevent many diseases and their progression. Even though, Yoga is widely practiced, its effects on certain medical conditions have not been studied or reported. Gastroesophageal reflux disease (GERD) is one of them. GERD is extremely common condition requiring frequent consumption of over-the-counter or prescribed proton pump inhibitors (PPI). In severe symptoms of GERD and in the presence of multiple etiologies, PPIs are insufficient to relieve the symptoms of gastric reflux. Regular and proper use of the Yoga along with PPI can control the severe symptoms of GERD and can avoid or delay the necessity of invasive procedures. This evidence-based case report focuses on the effects of Yoga on GERD. Our case report showed that regular practice of Kapalbhati and Agnisar kriya along with PPI, patients with hiatal hernia had improvement in severe symptoms of GERD, which were initially refractory to PPI alone. PMID:23930033

  19. [Esophageal diseases: gastroesophageal reflux disease, Barrett's esophagus, achalasia and eosinophilic esophagitis].

    Science.gov (United States)

    Calvet, Xavier; Villoria, Albert

    2013-10-01

    Important new advances were presented in esophageal disease in Digestive Disease Week 2013. A highlight was confirmation of the high efficacy of weight loss to treat symptoms of reflux and an interesting pilot study suggesting that a simple ligature with supra- and infracardial bands could be an effective technique in esophageal reflux. If the excellent results and safety and efficacy of this technique are confirmed in the long term, it could revolutionize the management of gastroesophageal reflux disease. Also of note this year was the presentation of multiple studies validating a new technique, peroral endoscopic myotomy (POEM) for the endoscopic treatment of achalasia. This technique seems to have excellent efficacy and safety.

  20. A proposition for the diagnosis and treatment of gastro-oesophageal reflux disease in children: A report from a working group on gastro-oesophageal reflux disease

    NARCIS (Netherlands)

    Y. Vandenplas (Yvan); A. Ashkenazi (A.); D. Belli (D.); N. Boige (N.); J. Bouquet (Jan); S. Cadranel (S.); J.P. Cezard (J.); S. Cucchiara (S.); C. Dupont (C.); K. Geboes (K.); F. Gottrand; H.S.A. Heymans (Hugo); C. Jasinski (C.); C.M.F. Kneepkens (Frank); S. Koletzko (Sybille); P. Milla (Peter); J.F. Mougenot (J.); D. Nusslé (D.); J. Navarro (J.); S.J. Newell (S.); E. Olafsdottir (E.); S. Peeters (S.); A. Ravelli (A.); I. Polanco (I.); B. Sandhu; J.J. Tolboom (Jules)

    1993-01-01

    textabstractIn this paper, a Working Group on Gastro-Oesophageal Reflux discusses recommendations for the first line diagnostic and therapeutic approach of gastro-oesophageal reflux disease in infants and children. All members of the Working Group agreed that infants with uncomplicated gastro-oesoph

  1. Associations of Circulating Gut Hormone and Adipocytokine Levels with the Spectrum of Gastroesophageal Reflux Disease.

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    Ping-Huei Tseng

    Full Text Available The pathogenesis of gastroesophageal reflux disease (GERD is complex and poorly understood. We aim to investigate the association of various circulating peptide hormones with heterogenous manifestations of GERD.One hundred and four patients that had experienced typical GERD symptoms (heartburn and/or acid regurgitation for at least 3 episodes per week in the past 3 months were enrolled. All patients received a baseline assessment of symptom severity and frequency with the Reflux Disease Questionnaire and an upper endoscopy to classify GERD into erosive esophagitis (EE, n = 67, non-erosive esophagitis (NE, n = 37, and Barrett's esophagus (BE, n = 8. Fifty asymptomatic subjects with an endoscopically normal esophagus were recruited as the control group. Complete anthropometric measures and blood biochemistry were obtained and fasting serum levels of adipocytokines (adiponectin and leptin and gut hormones (ghrelin and peptide YY (PYY were determined by enzyme-linked immunosorbent assay in all subjects.All circulating peptide hormone levels were not statistically different between the GERD and control groups. However, GERD patients appeared to have lower PYY levels [median (25th-75th percentile, 80.1 (49.8-108.3 vs. 99.4 (65.8-131.9 pg/ml, p = 0.057] compared with control subjects. Among the GERD patients, ghrelin levels were inversely associated with the frequency and severity of acid regurgitation. In male GERD patients, EE was associated with significantly higher PYY levels [107.0 (55.0-120.8 vs. 32.8 (28.7-84.5 pg/ml, p = 0.026] but lower adiponectin levels [6.7 (5.6-9.3 vs. 9.9 (9.6-10.6 μg/ml, p = 0.034] than NE. Patients with BE had significantly lower adiponectin levels [6.0 (5.1-9.2 vs. 9.2 (7.1-11.2 μg/ml, p = 0.026] than those without BE.Humoral derangement of circulating peptide hormones might participate in inflammation and symptom perception in patients suffering from GERD. Further studies to clarify the exact role of these hormones

  2. Gastroesophageal reflux disease update for the primary care physician.

    Science.gov (United States)

    Mitz, H S

    1999-08-01

    Gastroesophageal reflux disease (GERD) is one of the most common ailments that can decrease quality of life to below that of patients with congestive heart failure. Patients can present with typical, atypical, or serious symptoms, either alone or in combination. History, esophagogastroduodenoscopy, and 24-hour pH monitoring can help with the diagnosis; but all are not needed for each patient. This clinical review will help primary care physicians to make a rapid diagnosis, guide subsequent treatment, and indicate when to order additional testing or referral, or both.

  3. Gastroesophageal reflux disease at the turn of millennium

    Institute of Scientific and Technical Information of China (English)

    Lee-Guan Lim; Khek-Yu Ho

    2003-01-01

    Gastroesophageal reflux disease (GERD) has been an area of active research in the Asia-Pacific region in the recent years. This article outlines some of the interesting research findings. It comprises three parts. The first part dealt with recent data on the changing epidemiology of GERD in Asia.The second part summarized published studies on the relationship between GERD and Helicobacter pylori, relevant to the Asia-Pacific region. The last part discussed some of the recent advances in the treatment of GERD.

  4. Obesity and gastroesophageal reflux disease and gastroesophageal reflux symptoms in children

    Directory of Open Access Journals (Sweden)

    Hoda M Malaty, J Kennard Fraley

    2009-03-01

    Full Text Available Hoda M Malaty1, J Kennard Fraley1,2, Suhaib Abudayyeh1, Kenneth W Fairly1, Ussama S Javed1, et al1Department of Medicine, 2Children’s Nutrition Research Center (CNRC, 4Department of Pediatrics, 5Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA; 3Department of Gastroenterology, Oregon Health and Science University, Portland, OR, USABackground: The association between body mass index (BMI and gastroesophageal reflux disease (GERD has been extensively studied among adults but few studies have examined such association in children. Aims: 1 to determine the relationship between BMI in children and GERD, and 2 to use the National Center for Health Statistics (NCHS values for BMI as a valid source for comparison. Methods: We identified two cohorts of children aged between two and 17 years who were seen at Texas Children’s Hospital (TCH. The first cohort consisted of children diagnosed with GERD based on upper gastrointestinal endoscopic and histologic evaluation, which was recorded in the Pediatric Endoscopic Database System-Clinical Outcomes Research Initiative (PEDS-CORI at TCH. A diagnosis of GERD was based on the presence of erosive esophagitis or esophageal ulcers. Endoscopic reports that were incomplete or did not include demographic features, indications for endoscopy, or endoscopic findings were excluded. The second cohort consisted of all children with symptoms due to gastroesophageal reflux (GER who received outpatient gastrointestinal (GI consultation at TCH for any 9th revision of the International Statistical Classification of Diseases (ICD-9 code suggestive of GER. There was no overlap between the two cohorts as each child was indexed only once. Children with any comorbid illnesses were excluded.Measurements: The records for each child namely, age, gender, height, and weight were obtained on the same date as that of the diagnosis. Using the growth curves published by the NCHS, the gender/age specific weight

  5. Oesophagitis, signs of reflux, and gastric acid secretion in patients with symptoms of gastro-oesophageal reflux disease

    Energy Technology Data Exchange (ETDEWEB)

    Johansson, K.E.; Ask, P.; Boeryd, B.; Fransson, S.G.; Tibbling, L.

    1986-01-01

    In a study comprising 100 patients referred to a surgical clinic with symptons suggestive of gastro-oesophageal reflux disease, the value of different diagnostic procedures was investigated. Positive acid perfusion and 24-h pH tests were the commonest findings. Forty-nine per cent showed normal oesophageal mucosa or diffuse oesophagitis at endoscopy. The severity of heartburn and regurgitation did not differ between patients with normal oesophageal mucosa and oesophagitis of various severities. The severity of macroscopic oesophagitis was significantly corelated to the total reflux time, the presence of reflux or a hiatal hernia at radiology, an open cardia or reflux at endoscopy, pressure transmission or reflux, and low lower oesophageal sphincter pressure at manometry. Gastric hypersecretion was found in 66% of the patients. Gastric acid secretion was not correlated to the severity of oesophagitis or to the findings at 24-h pH test. In patients with severe oesophagitis the sensivity for radiologic, manometric and endoscopic signs of incompetence of the gastro-oesophageal junction was 94%.

  6. Factors that influence therapeutic outcomes in symptomatic gastroesophageal reflux disease.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2012-02-03

    The term "symptomatic gastroesophageal reflux disease" (GERD) refers to those patients who present with the typical GERD symptoms of heartburn and regurgitation, yet do not have endoscopic evidence of esophagitis. The primary goals of managing symptomatic GERD are to control symptoms and improve quality of life. A clinical assessment of the GERD patient can identify important clinical features, such as atypical and extraesophageal symptoms for which acid-suppressive agents tend to be less effective. Performing an endoscopy can further identify the patient as having nonerosive reflux disease, erosive esophagitis, or Barrett\\'s esophagus-diagnoses which can help determine treatment but may not prove predictive of therapeutic response. Determining acid exposure through pH testing can predict therapeutic response, with those revealing an abnormal acid exposure time being more responsive to acid-suppressive therapy. However, the performance of an endoscopy and pH testing on each patient is clearly not practical. Whereas the natural history of symptomatic GERD is still largely undefined, acid-suppressive therapy appears to be the best approach available for both the short-term and long-term management of this disease.

  7. Gastro-oesophageal reflux disease and non-asthma lung disease

    Directory of Open Access Journals (Sweden)

    R. S. Morehead

    2009-12-01

    Full Text Available Gastro-oesophageal reflux disease (GERD is a common disorder in Western countries, and its relationship to airways disorders (e.g. asthma has been well established. Lung diseases other than asthma have also been associated with GERD, but the nature and scope of this relationship has not been fully defined. Diseases that have been associated with GERD include bronchiolitis syndromes, idiopathic pulmonary fibrosis, scleroderma and nontubercular mycobacterial infection. Diagnostic evaluation centres upon proving both reflux and pulmonary aspiration, which may be accomplished in some cases by lung biopsy. However, in many cases a compatible clinical and radiographic picture coupled with proof of proximal reflux by combined oesophageal probe testing may suffice for a provisional diagnosis and allow institution of anti-reflux measures. Proton-pump inhibitors are the medications of choice for GERD; other interventions shown to reduce reflux are weight loss, elevation of the head of the bed and avoidance of recumbency after meals. However, acid suppression therapy does not address non-acid reflux that may be important in disease pathogenesis in select patients, and lifestyle modifications often fail. Laparoscopic fundoplication is the procedure of choice for medically refractory GERD with excellent short-term results with respect to respiratory symptoms associated with GERD; however, long-term studies document a significant percentage of patients requiring ongoing acid suppression therapy.

  8. The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    Andreas Nakos

    2011-01-01

    Full Text Available Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI. The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53 GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53 of patients with GERD and in 13% (2/15 of controls (=0.02. Severe esophageal lesions were significantly more common in BRI (+ patients (14/25 compared to BRI (− ones (=0.0049. Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa.

  9. The histological and immunohistochemical aspects of bile reflux in patients with gastroesophageal reflux disease.

    Science.gov (United States)

    Nakos, Andreas; Kouklakis, Georgios; Pitiakoudis, Michail; Zezos, Petros; Efraimidou, Eleni; Giatromanolaki, Alexandra; Polychronidis, Alexandros; Liratzopoulos, Nikolaos; Sivridis, Efthimios; Simopoulos, Konstantinos

    2011-01-01

    Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI). The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53 GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53) of patients with GERD and in 13% (2/15) of controls (P = 0.02). Severe esophageal lesions were significantly more common in BRI (+) patients (14/25) compared to BRI (-) ones (P = 0.0049). Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa.

  10. Strategy for treatment of nonerosive reflux disease in Asia

    Institute of Scientific and Technical Information of China (English)

    Toru Hiyama; Masaharu Yoshihara; Shinji Tanaka; Ken Haruma; Kazuaki Chayama

    2008-01-01

    The paper is to review the clinical and pathophysiologic differences between of nonerosive reflux disease (NERD) and reflux esophagitis (RE),and to propose a treatment strategy for NERD,especially for patients in Asia.A Nedline search was performed regarding the clinical and pathophysiologic differences between NERD and RE,and treatment of NERD and RE.The characteristics of NERD patients in Asia are as follows:(1) high proportion of female patients,(2)low frequency of hiatal hernia,(3) high frequency of H pylori infection,(4) severe glandular atrophy of the gastric mucosa,and (5) frequent resistance to proton pump inhibitor (PPI) therapy.In Asian NERD patients,exposure of the esophagus to acid is not increased,and esophageal motility is normal.These characteristics are similar to those of patients in Western countries.Our recommended first-choice treatment is administration of PPI in combination with a prokinetic agent.However,at present,because there is limited evidence regarding effective treatments for NERD,it is best to try several different treatment strategies to find the best treatment for each patient.

  11. Update on Gastroesophageal Reflux and Respiratory Disease in Children

    Directory of Open Access Journals (Sweden)

    Susan R Orenstein

    2000-01-01

    Full Text Available Pediatric respiratory diseases have been linked to gastroesophageal reflux disease (GERD, but evidence regarding the association and its potential mechanisms continues to accumulate, and important aspects remain to be determined. Evidence for the association in two common pediatric respiratory disorders - infantile apnea and asthma in older children - and difficult clinical issues associated with the diagnosis and treatment of these two disorders are reviewed. The provocative embryological and physiological connections between the upper gastrointestinal tract and the respiratory tract, and recent understanding of the compensatory anatomy and physiology that protect the normal individual from respiratory manifestations of GERD are also explored. Dysfunctions of these protections likely underlie the pathophysiology of these disorders.

  12. Systematic review: questionnaires for assessment of gastroesophageal reflux disease.

    Science.gov (United States)

    Bolier, E A; Kessing, B F; Smout, A J; Bredenoord, A J

    2015-01-01

    Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality of life of GERD patients. The aim of this review is to develop a complete overview of all available questionnaires, categorized per dimension of the assessment of GERD. A systematic search of the literature up to January 2013 using the Pubmed database and the Embase database, and search of references and conference abstract books were conducted. A total number of 65 questionnaires were extracted and evaluated. Thirty-nine questionnaires were found applicable for the assessment of GERD symptoms, three of which are generic gastrointestinal questionnaires. For the assessment of response to treatment, 14 questionnaires were considered applicable. Seven questionnaires with diagnostic purposes were found. In the assessment of quality of life in GERD patients, 18 questionnaires were found and evaluated. Twenty questionnaires were found to be used for more than one assessment dimension, and eight questionnaires were found for GERD assessment in infants and/or children. A wide variety of GERD questionnaires is available, of which the majority is used for assessment of GERD symptoms. Questionnaires differ in aspects such as design, validation and translations. Also, numerous multidimensional questionnaires are available, of which the Reflux Disease Questionnaire is widely applicable. We provided an overview of GERD questionnaires to aid investigators and clinicians in their search for the most appropriate questionnaire for their specific purposes. © 2013 International Society for Diseases of the Esophagus.

  13. [Holter monitoring data in children with gastroesophageal reflux disease].

    Science.gov (United States)

    Apenchenko, Iu S; Shcherbakov, P L; Gnusaev, S F; Ivanova, I I; Rozov, D N

    2014-01-01

    The aim of research is to estimate the functional state of the cardiovascular system in children with gastroesophageal reflux disease (GERD) with the help of Holter monitoring. 117 children of school age were examined: 69 children with GERD and 48 children with chronic gastroduodenitis. All children passed esophagogastroduodenoscopy, 24-hour pH-monitoring, electrocardiography and Holter monitoring. According to Holter monitoring data it was revealed that children with GERD had increased low-frequency components of frequency domain analyses, increased number of nocturnal PVCs and increased time of enhanced dispertion periods. Holter monitoring in patients with GERD can be used to detect preclinical ectopic rhythm, to evaluate autonomic dysfunction by frequency domain analyses, to predict nocturnal symptoms.

  14. Validation of the Reflux Disease Questionnaire into Greek

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    Eirini Oikonomidou

    2012-09-01

    Full Text Available Primary care physicians face challenges in diagnosing and managing gastroesophageal reflux disease (GERD. The Reflux Disease Questionnaire (RDQ meets the standards of validity, reliability, and practicability. This paper reports on the validation of the Greek translation of the RDQ. RDQ is a condition specific instrument. For the validation of the questionnaire, the internal consistency of its items was established using the alpha coefficient of Chronbach. The reproducibility (test-retest reliability was measured by kappa correlation coefficient and the criterion of validity was calculated against the diagnosis of another questionnaire already translated and validated into Greek (IDGP using kappa correlation coefficient. A factor analysis was also performed. Greek RDQ showed a high overall internal consistency (alpha value: 0.91 for individual comparison. All 8 items regarding heartburn and regurgitation, GERD, had good reproducibility (Cohen’s κ 0.60-0.79, while the remaining 4 items about dyspepsia had a moderate reproducibility (Cohen’s κ=’ 0.40-0.59 The kappa coefficient for criterion validity for GERD was rather poor (0.20, 95% CI: 0.04, 0.36 and the overall agreement between the results of the RDQ questionnaire and those based on the IDGP questionnaire was 70.5%. Factor analysis indicated 3 factors with Eigenvalue over 1.0, and responsible for 76.91% of variance. Regurgitation items correlated more strongly with the third component but pain behind sternum and upper stomach pain correlated with the second component. The Greek version of RDQ seems to be a reliable and valid instrument following the pattern of the original questionnaire, and could be used in primary care research in Greece.

  15. Esophagogastric Junction Contractility Integral Reflect the Anti-reflux Barrier Dysfunction in Patients with Gastroesophageal Reflux Disease

    Science.gov (United States)

    Xie, Chenxi; Wang, Jinhui; Li, Yuwen; Tan, Niandi; Cui, Yi; Chen, Minhu; Xiao, Yinglian

    2017-01-01

    Background/Aims Anti-reflux barrier dysfunction is one of the primary mechanisms in gastroesophageal reflux disease (GERD) pathogenesis. The esophagogastric junction contractile integral (EGJ-CI) is a new metric adopted to evaluate the EGJ contractility, which implies the anti-reflux barrier function. The aim of the current study was to validate this new metric in patients with GERD and its correlation with the esophageal acid exposure, as well as the efficacy of proton pump inhibitor treatment. Methods Ninety-eight patients with GERD and 21 healthy controls were included in the study. Upper endoscopy, high-resolution manometry (HRM) and 24-hour multichannel intraluminal impedance-pH monitoring were performed in all patients. Three respiration cycles were chosen at the initial HRM resting frame and the value computed with distal contractile integral tool was then divided by the duration of the cycles to yield EGJ-CI. All the patients were treated with esomeprazole 20 mg twice-daily for 8 weeks. Results EGJ-CI was lower in the patients with GERD than that of the controls (P < 0.05). For patients with GERD, EGJ-CI was lower in those with hiatal hernia (P < 0.05). The new metric correlated with esophageal acid exposure in the supine position (P < 0.05), and it also negatively correlated to the total reflux episodes (P < 0.05). There was no significant difference on EGJ-CI between patients with and without response to the esomeprazole treatment (P = 0.627). Conclusions EGJ-CI reflected the dysfunction of the anti-reflux barrier in patients with GERD, but it had little impact on the esomeprazole response. PMID:27426485

  16. Nickel sensitivity in patients with gastroesophageal reflux disease.

    Science.gov (United States)

    Aslan, Nurşad; Sezikli, Mesut; Erdal, Emel

    2017-12-01

    Various foods play important role in the pathogenesis of gastroesophageal reflux disease (GERD). These foods are shown to increase gastroesophageal reflux symptoms via various mechanisms and majority of these foods also contain nickel. The purpose of this study is to evaluate the relationship between Nickel sensitivity and GERD. Fifty-four patients diagnosed with GERD and 50 healthy volunteers who were admitted to our gastroenterology outpatient clinic were took part in the study. European standard patch test series, nickel-containing test units and corticosteroids were applied to the patient body; upper back. Evaluation was performed according to the scheme of the International Contact Dermatitis Research Group (ICDRG). The positive and negative reactions were recorded at the hours of 48, 72 and 96. Following the test implementations, 7 days later, the tests were reevaluated for late reactions. Statistics package for Social Sciences (SPSS) 17 package program was used for statistical evaluation and results of tests were compared between groups with the Chi-squared test. p < 0.05 was considered statistically significant. Individuals in both groups were statistically similar in terms of age and gender. Nickel sensitivity was found to be positive in 48.2 and %22 of the GERD patients and control group, respectively. Difference between groups was statistically significant (p = 0.008). Nickel sensitivity was significantly higher in GERD patients compared to the control group. In addition to imbalance between defensive and aggressive forces of the esophagus, there seems to be an association between nickel sensitivity and GERD.

  17. Asthma and gastroesophageal reflux disease: Effect of longterm pantoprazole therapy

    Institute of Scientific and Technical Information of China (English)

    Calabrese Carlo; Fabbri Anna; Areni Alessandra; Scialpi Carlo; Zahlane Desiree; Di Febo Giulio

    2005-01-01

    AIM: To define the prevalence of gastroesophageal reflux disease (GERD) in mild persistent asthma and to value the effect of pantoprazole therapy on asthmatic symptoms.METHODS: Seven of thirty-four asthmatic patients without GERD served as the non-GERD control group.Twenty-seven of thirty-four asthmatic patients had GERD (7/27 also had erosive esophagitis, sixteen of them presented GERD symptoms. An upper gastrointestinal endoscopy was performed in all the subjects to obtain five biopsy specimens from the lower 5 cm of the esophagus. Patients were considered to have GERD when they had a dilation of intercellular space (DIS)>0.74 μm at transmission electron microscopy.Patients with GERD were treated with pantoprazole,80 mg/day. Forced expiratory volume in one second (FEV1) was performed at entry and after 6 mo of treatment. Asthmatic symptoms were recorded. The required frequency of inhaling rapid acting 32-agonists was self-recorded in the patients' diaries.RESULTS: Seven symptomatic patients presented erosive esophagitis. Among the 18 asymptomatic patients, 11 presented DIS, while all symptomatic patients showed ultrastructural esophageal damage.Seven asymptomatic patients did not present DIS. At entry the mean of FEV1 was 1.91 L in symptomatic GERD patients and 1.88 L in asymptomatic GERD patients.After the treatment, 25 patients had a complete recovery of DIS and reflux symptoms. Twenty-three patients presented a regression of asthmatic symptoms with normalization of FEV1. Four patients reported a significant improvement of symptoms and their FEV1 was over 80%.CONCLUSION: GERD is a highly prevalent condition in asthma patients. Treatment with pantoprazole (80 mg/day)determines their improvement and complete regression.

  18. Dilated intercellular spaces in gastroesophageal reflux disease patients and the changes of intercellular spaces after omeprazole treatment

    Institute of Scientific and Technical Information of China (English)

    XUE Yan; ZHOU Li-ya; LIN San-ren

    2008-01-01

    Background Gastroesophageal reflux disease (GERD) is a common disorder. Dilation of intercellular spaces of esophageal epithelium has been revealed at transmission electron microscopy both in the rabbit acid-perfused esophagus and in esophageal biopsies from GERD patients. This study aimed to observe the changes of the intercellular spaces of squamous epithelium of lower esophagus in patients with GERD and the changes of intercellular spaces of patients with erosive esophagitis (EE) before and after omeprazole treatment.Methods Outpatients having GERD symptoms for more than 3 months and volunteers were collected. All of them underwent gastroendoscopy and 24-hour ambulatory pH monitoring. Biopsies were taken from the lower esophagus (2 cm above Z-line) for electron microscope examination. Five healthy volunteers, six non-erosive reflux disease (NERD) patients, and five EE patients were enrolled. Intercellular spaces of GERD patients and controls were calculated. Then we selected 20 patients with EE diagnosed by gastroendoscopy. All of them were treated with omeprazole (Losec, 20 mg bid) for 4 weeks then underwent gastroendoscopy again. Biopsies were taken from 2 cm above Z-line for electron microscope examination. All the patients completed the questionnaire about reflux symptoms before and after treatment.Results Intercellular spaces of esophageal epithelial cell in volunteers, NERD patients and EE patients were (0.37±0.07) μm, (1.31±0.08) μm, and (1.33±0.14) μm, respectively, with significant differences between the control group and the NERD group (P=0.000). In the 20 EE patients, the mean intercellular space before treatment was (1.14±0.15) μm. After treatment the intercellular space was (0.51±0.18) μm, a significant difference compared with pre-treatment measurements (P=0.000).Conclusions Dilated intercellular spaces (DIS) were seen in both NERD and EE cases. The dilated intercellularspaces of esophageal epithelium in EE patients could be recovered

  19. Current Advances in the Diagnosis and Treatment of Nonerosive Reflux Disease

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    Chien-Lin Chen

    2013-01-01

    Full Text Available Nonerosive reflux disease (NERD is a distinct pattern of gastroesophageal reflux disease (GERD. It is defined as a subcategory of GERD characterized by troublesome reflux-related symptoms in the absence of esophageal mucosal erosions/breaks at conventional endoscopy. In clinical practice, patients with reflux symptoms and negative endoscopic findings are markedly heterogeneous. The potential explanations for the symptom generation in NERD include microscopic inflammation, visceral hypersensitivity (stress and sleep, and sustained esophageal contractions. The use of 24-hour esophageal impedance and pH monitoring gives further insight into reflux characteristics and symptom association relevant to NERD. The treatment choice of NERD still relies on acid-suppression therapy. Initially, patients can be treated by a proton pump inhibitor (PPI; standard dose, once daily for 2–4 weeks. If initial treatment fails to elicit adequate symptom control, increasing the PPI dose (standard dose PPI twice daily is recommended. In patients with poor response to appropriate PPI treatment, 24-hour esophageal impedance and pH monitoring is indicated to differentiate acid-reflux-related NERD, weakly acid-reflux-related NERD (hypersensitive esophagus, nonacid-reflux-related NERD, and functional heartburn. The response is less effective in NERD as compared with erosive esophagitis.

  20. EMPIRIC THERAPY IN OTOLARYNGOLOGIC MANIFESTATIONS OF GASTROESOPHAGEAL REFLUX DISEASE

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    M. Mohammadi

    2005-04-01

    Full Text Available The review of literature shows that a strong relationship exists between the symptoms of otolaryngologic diseases and gastroesophageal reflux disease (GERD. It is commonly observed that an extended physical examination is needed to determine the occurrence of GERD. This non-randomized,prospective quasi-experimental study was performed to clinically verify the relationship between otolaryngologic symptoms and GERD and to show that a search for GERD is necessary under conditions that patients do not respond to initial routine treatment for otolaryngologic symptoms. Extended physical examination of patients who had been referred to an Ear, Nose and throat (ENThospital revealed that GERD-related laryngeal signs were present in 55 patients. Otolaryngologic symptoms detected in decreasing order of occurrence were posterior nasal drip, chronic pharyngitis, chronic cough, hoarseness, ear pain, chronic throat clearing and pruritus in the ear. Furthermore, 66% of the patients had gastrointestinal symptoms that included heartburn, dysphagia, odynophagia, aspiration, globus hystericus, dyspepsia and foreign body sensation. Signs observed during the physical examination were posterior pharyngitis, granular pharyngitis, inflamed arytenoids, contact granuloma, and pachyderma laryngitis. We administered proton pump inhibitor to all patients and recommended to change their life style. The follow up program was a 6-month period. Only 53 patients showed up for the follow up. The overall response rate to the therapeutic regimen was 83%. In treating otolaryngologic patients, especially those who are resistant to routine treatments, a careful extended physical examination including an indirect laryngoscopy for diagnosis of GERD is recommended.

  1. Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease

    NARCIS (Netherlands)

    Mauritz, F.A.; Rinsma, N.F.; Heurn, E.L. van; Sloots, C.E.; Siersema, P.D.; Houwen, R.H.; Zee, D.C. van der; Masclee, A.A.M.; Conchillo, J.M.; Herwaarden-Lindeboom, M.Y. van

    2017-01-01

    BACKGROUND: Esophageal intraluminal baseline impedance reflects the conductivity of the esophageal mucosa and may be an instrument for in vivo evaluation of mucosal integrity in children with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery (LARS) is a well-established

  2. Clinical characteristics of patients with gastroesophageal reflux disease in several centers of Northwest China

    Institute of Scientific and Technical Information of China (English)

    高麦仓

    2013-01-01

    Objective To investigate the clinical characteristics of gastroesophageal reflux disease (GERD) in several endoscopy centers of Northwest China.Methods From September 2008 to September 2009,a questionnaire survey was carried out in the endoscopy centers of four hospitals

  3. Psychological modulation in patients surgically intervened for gastroesophageal reflux disease.

    Science.gov (United States)

    Lara, F J Pérez; Carranque, G; Oehling, H; Hernández, J M; Oliva, H

    2014-08-01

    Gastroesophageal reflux disease (GERD) has been related with certain psychological dimensions. The influence of mood, emotional intelligence, and perceived quality of life on clinical symptoms and outcome of antireflux surgery was evaluated in GERD patients with and without hiatal hernia. The study included 61 patients who were diagnosed with GERD between 2003 and 2008: 16 of them without hiatal hernia (group A) and 45 of them with hiatal hernia (group B). All of these patients had undergone laparoscopic antireflux surgery. Patients were clinically examined and evaluated with the following instruments: Short Form (SF)-36 Health Survey, Gastrointestinal Quality of Life Index, Hospital Anxiety and Depression (HAD) Scale, and Trait Meta-Mood Scale (TMMS)-24. Proportions were compared by using the chi-squared test; averages were compared by using the Student's t-test (with Bonferroni's correction). In general, our patients intervened for GERD showed results lower than normal or close to the lower limit of normal in the administered tests. Patients in the group without hernia were younger (P frustration, fear, and worry. On the basis of such unfavorable phychoemotional results observed with GERD patients (especially those without hernia) in the different tests, we propose that improving our knowledge of the psychological profile of GERD patients - particularly those without hiatal hernia - could help in designing individualized medical and psychological therapies and increase success rates.

  4. Histologic definition of gastro-esophageal reflux disease.

    Science.gov (United States)

    Chandrasoma, Parakrama T

    2013-07-01

    To review recent data supporting the development of new histology-based definitions of gastro-esophageal reflux disease (GERD). Three precisely definable columnar epithelial types--cardiac, oxyntocardiac and intestinal--may be interposed between esophageal squamous epithelium and gastric oxyntic (acid secreting) mucosa. This enables definition of a new histologic concept: the squamo-oxyntic gap. The squamo-oxyntic gap is zero or very small in autopsies performed on patients without evidence of GERD. The gap progressively increases in length with the severity of GERD, indicating that the squamo-oxyntic gap is a marker for chronic GERD. The distal part of the gap lines gastric-type rugal folds and, therefore, is distal to the present endoscopic definition of the gastro-esophageal junction. I contend that this distal gap segment (which has esophageal submucosal glands) is actually the dilated distal esophagus; this is the pathologic correlate of destruction of the abdominal segment of the lower esophageal sphincter. The dilated distal esophagus is mistaken for 'gastric cardia' by present endoscopic definitions. I believe that these data support the adoption of novel histologic definitions of GERD as follows: the presence of any squamo-oxyntic gap defines GERD; the length of the gap is a measure of severity of chronic GERD; and the presence of intestinal metaplasia in the gap defines Barrett esophagus and cancer risk.

  5. Gastroesophagial reflux disease and asthma in pregnant women with dyspnea.

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    Katayoon Bidad

    2014-04-01

    Full Text Available Asthma and gastroesophageal reflux disease (GERD are two common problems in pregnancy and they affect pregnancy in several ways. In this study, we aimed to evaluate GERD and asthma in pregnant women who referred for prenatal care visits. One-hundred and seventy three pregnant women with a complaint of dyspnea were included in the study. A questionnaire was filled and lung function tests were performed. All patients were visited by a respiratory specialist and questionnaires were evaluated by a gastroenterologist. Out of the total number of women studied, 37% were diagnosed to have asthma and 36.4% were non-asthmatics. Twenty six percent of the pregnant women who had symptoms and signs of asthma with normal spirometry were classified as probable to have asthma. GERD was diagnosed in 80.9% of the pregnant women, but it was not significantly higher in asthmatic or probable asthmatic women compared to non-asthmatic ones. However, severity of GERD was significantly higher in asthmatic pregnant women compared to the others. In conclusion, the prevalence of GERD was quite high in pregnant women, irrespective of the fact that they were asthmatic or non-asthmatic. Further studies evaluating women throughout pregnancy will inform us more about this relationship.

  6. The relationship between helicobacter pylori infection and gastro-esophageal reflux disease

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    Batool M Mahdi

    2011-01-01

    Full Text Available Background : Gastro-esophageal reflux disease is a common condition, affecting 25%-40% of the population. Increasing attention has been paid to the relationship between Helicobacter pylori infection and reflux esophagitis. Aim: The aim of this study was to investigate the association between CagA+ H. pylori and endoscopically proven gastro-esophageal reflux disease. Patients and Methods: The study group included 60 hospital patients with gastro-esophageal reflux disease between 2007 and 2009 as compared with 30 healthy patients from a control group that was age and sex matched. Helicobacter pylori CagA+ was identified by an immunological test (Immunochromatography test (ACON, USA. Results : Helicobacter pylori CagA+ was present in 42/60 (70% of the patients with gastro-esophageal reflux disease and in 11/30 (36.6% patients in the control group (p=0.002. The Odds ratio = 0.8004 with 95% Confidence Interval = from 0.3188 to 2.0094. The relative risk=1.35 that indicates an association between Helicobacter pylori and disease. Conclusions: The presence of Helicobacter pylori is significantly increased in patients with gastro-esophageal reflux disease as compared with the control group.

  7. Reflux and GERD in Infants

    Science.gov (United States)

    ... Z Celiac Disease Eosinophilic Esophagitis Inflammatory Bowel Disease Nutrition & Obesity Reflux & GERD Reflux & GERD in Infants Symptoms & Diagnosis ... Nutrition (NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  8. Reflux and GERD (in Children)

    Science.gov (United States)

    ... Z Celiac Disease Eosinophilic Esophagitis Inflammatory Bowel Disease Nutrition & Obesity Reflux & GERD Reflux & GERD in Infants GERD in ... Nutrition (NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  9. Gastroesophageal reflux disease in COPD: links and risks

    Directory of Open Access Journals (Sweden)

    Lee AL

    2015-09-01

    Full Text Available Annemarie L Lee,1–3 Roger S Goldstein1,2,4 1West Park Healthcare Centre, 2Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; 3Institute for Breathing and Sleep, Austin Hospital, Melbourne, VIC, Australia; 4Department of Medicine, University of Toronto, Toronto, ON, Canada Abstract: COPD is a long-term condition associated with considerable disability with a clinical course characterized by episodes of worsening respiratory signs and symptoms associated with exacerbations. Gastroesophageal reflux disease (GERD is one of the most common gastrointestinal conditions in the general population and has emerged as a comorbidity of COPD. GERD may be diagnosed by both symptomatic approaches (including both typical and atypical symptoms and objective measurements. Based on a mix of diagnostic approaches, the prevalence of GERD in COPD ranges from 17% to 78%. Although GERD is usually confined to the lower esophagus in some individuals, it may be associated with pulmonary microaspiration of gastric contents. Possible mechanisms that may contribute to GERD in COPD originate from gastroesophageal dysfunction, including altered pressure in the lower esophageal sphincter (which normally protect against GERD and changes in esophageal motility. Proposed respiratory contributions to the development of GERD include respiratory medications that may alter esophageal sphincter tone and changes in respiratory mechanics, with increased lung hyperinflation compromising the antireflux barrier. Although the specific cause and effect relationship between GERD and COPD has not been fully elucidated, GERD may influence lung disease severity and has been identified as a significant predictor of acute exacerbations of COPD. Further clinical effects could include a poorer health-related quality of life and an increased cost in health care, although these factors require further clarification. There are both medical and surgical options available for the

  10. Risk factors of gastroesophageal reflux disease in Shiraz, southern Iran

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To determine the prevalence and symptoms of gastroesophageal reflux disease (GERD) in a healthy general population in relation to demographic, lifestyle and health-seeking behaviors in Shiraz, southern Iran. METHODS: A total of 1978 subjects aged > 35 years who referred to Gastroenterohepatology Research Center and who completed a questionnaire consisting of 27 questions for GERD in relation to demographic, lifestyle and health-seeking behaviors were included in this study for a period of five months. The validity and reliability of the questionnaire were determined.RESULTS: The prevalence of GERD was 15.4%, which was higher in females (17.3%), in rural areas (19.8%),and in illiterate subjects (21.5%) and those with a mean age of 50.25 years. The prevalence was significantly lower in subjects having fried food (14.8%), and fruit and vegetables (14.6%). More symptoms were noticed in subjects consuming pickles (22.1%), taking aspirin (21%)and in subjects with psychological distresses (27.2%)and headaches (22%). The correlation was statistically significant between GERD and halitosis (18.3%),dyspepsia (30.6%), anxiety (19.5%), nightmares (23.9%)and restlessness (18.5%). Their health seeking behavior showed that there was a significant restriction of diet (20%), consumption of herbal medicine (19%), using over-the-counter drugs (29.9%) and consulting with physicians (24.8%). Presence of GERD symptoms was also significantly related to a previous family history of the disease (22.3%).CONCLUSION: GERD is more common in females, rural and illiterate subjects and correlated with consumption of pickles, occurrence of headache, psychological distress,dyspepsia, halitosis, anxiety, nightmare and restlessness,and a family history of GERD and aspirin intake, but the correlation was negative with consumption of fat and fiber intake.

  11. [Nocturnal long-term monitoring of lung sounds in patients with gastro-oesophageal reflux disease].

    Science.gov (United States)

    Lenniger, P; Gross, V; Kunsch, S; Nell, C; Nolte, J E S; Sohrabi, A K; Koehler, U

    2010-04-01

    Gastro-oesophageal reflux disease (GERD) is one of the most common clinical conditions in the developed countries. Particular interest in pulmonary manifestations of this disease has arisen over the last few years. Although the high coincidence between reflux and chronic cough is unquestioned, the proof of a causal correlation is still lacking. In this paper we present the Marburger Lung-Sound-Monitoring as a new method for the detection of nocturnal respiratory symptoms such as cough, wheezing and throat clearing and their temporal correlation with reflux. This method will in future allow us to precisely record and to evaluate the extent and duration of reflux events and their correlation with respiratory symptoms. Georg Thieme Verlag KG Stuttgart . New York.

  12. Omeprazole for Refractory Gastroesophageal Reflux Disease during Pregnancy and Lactation

    Directory of Open Access Journals (Sweden)

    John K Marshall

    1998-01-01

    Full Text Available Symptomatic gastroesophageal reflux is a common complication of pregnancy and lactation. However, the safety of many effective medical therapies, including oral proton pump inhibitors, has not been well defined. The administration of oral omeprazole to a 41-year-old female during the third trimester of pregnancy, after ranitidine and cisapride failed to control her refractory gastroesophageal reflux, is reported. No adverse fetal effects were apparent, and the patient elected to continue omeprazole therapy (20 mg/day while breastfeeding. Peak omeprazole concentrations in breast milk (58 nM, 3 h after ingestion were less than 7% of the peak serum concentration (950 nM at 4 h, indicating minimal secretion. Although omeprazole is a potentially useful therapy for refractory gastroesophageal reflux during pregnancy and lactation, further data are needed to define better its safety and efficacy.

  13. Radiofrequency treatment on respiratory symptoms due to gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    GAO Xiang; TIAN Shu-rui; WANG Zhong-gao; WU Ji-min; JI Feng; ZHANG Cheng-chao; NING Ya-chan; LI Zhi-tong; HU Zhi-wei; CHEN Xiu

    2011-01-01

    Background Diagnosis and treatment for respiratory symptoms (RSs) of gastroesophageal reflux disease (GERD) is more difficult than that for common esophageal symptoms. The goal of this study was to evaluate the efficacy and safety of radiofrequency (RF) treatment on RSs of GERD in a preliminary 12-month follow-up observation.Methods From April 2006 to October 2008,505 GERD patients with mainly respiratory presentations such as wheezing,chronic cough or hoarseness,were treated by endoscopic RF. A questionnaire was completed before and after treatment,using a six-point scale ranging from 0 to 5 to assess symptom severity and frequency. The symptom score was the sum of frequency and severity.Results Symptom scores were significantly improved at the end of the follow-up period. The mean heartburn score decreased from 5.31 to 1.79. The mean regurgitation score decreased from 5.02 to 1.64;mean cough score decreased from 6.77 to 2.85;mean wheezing score decreased from 7.83 to 3.07;and mean hoarseness score decreased from 5.13 to 1.81 (P <0.01). No major complications or deaths occurred. Minor complications included temporary post-procedural retrosternal unease or pain (n=106;21.0%),mild fever (n=86;17.0%),transient nausea/vomiting (n=97;19.2%),and transient dysphagia (n=42;9.3%). Thirty-five (6.9%) patients had recurrence of symptoms. Endoscopic RF treatment was repeated in six patients,and laparoscopic fundoplication was performed in seven.Conclusion Endoscopic RF is an effective and safe means to treat RSs in patients with GERD.

  14. Prevalence of gastroesophageal reflux in end-stage lung disease candidates for lung transplant.

    Science.gov (United States)

    D'Ovidio, Frank; Singer, Lianne G; Hadjiliadis, Denis; Pierre, Andrew; Waddell, Thomas K; de Perrot, Marc; Hutcheon, Micheal; Miller, Linda; Darling, Gail; Keshavjee, Shaf

    2005-10-01

    Aspiration secondary to gastroesophageal reflux has been postulated to be a contributing factor in bronchiolitis obliterans after lung transplantation. It is not clear whether gastroesophageal reflux is a preexisting condition or secondary to intraoperative vagal injury or drug-induced prolonged gastric emptying. The prevalence of gastroesophageal reflux was examined in 78 consecutive end-stage lung disease patients assessed for lung transplantation: emphysema, 21; cystic fibrosis, 5; idiopathic pulmonary fibrosis, 26; scleroderma, 10; and miscellaneous diseases, 16. All underwent esophageal manometry. Two-channel esophageal 24-hour pH testing was completed in 76 patients. Gastric emptying studies were conducted in 36 patients. Typical gastroesophageal reflux symptoms were documented in 63% of patients. The lower esophageal sphincter was hypotensive in 72% of patients, and 33% had esophageal body dysmotility. Prolonged gastric emptying was documented in 44%, and 38% had abnormal pH testing. The overall DeMeester score was above normal in 32% of patients, and 20% had abnormal proximal pH probe readings. Gastroesophageal reflux is highly prevalent in end-stage lung disease patients who are candidates for lung transplantation. Further investigation is needed to study the prevalence of gastroesophageal reflux after lung transplantation and its contribution to chronic allograft dysfunction.

  15. [Oesophageal diseases: gastroesophageal reflux disease, Barrett's disease, achalasia and eosinophilic oesophagitis].

    Science.gov (United States)

    Calvet, Xavier

    2015-09-01

    The most important novel findings presented on oesophageal disease in DDW 2015 were the following: 1) GERD: a) hypervigilance seems to be a key pathogenic factor in reflux symptoms refractory to PPI; b) post-reflux swallowing-induced peristaltic waves could be an excellent diagnostic criterion for GERD; c) laryngeal pH-metry is not useful in the diagnosis of extra-oesophageal symptoms; d) the recommendation of weight loss adequately recorded in the clinical reports of patients with GERD and obesity or overweight is an excellent quality indicator and is associated with better outcomes. 2) Barrett's oesophagus: a) persistent low-grade dysplasia in more than one endoscopy and a diagnosis of "indefinite for dysplasia" are associated with a high risk of neoplastic progression; b) narrow-band imaging allows areas of dysplasia on Barrett's oesophagus to be identified with high sensitivity and specificity; c) initial endoscopy fails to identify a high percentage of advanced neoplasms in Barrett's oesophagus. Early re-endoscopy should be considered; d) endoscopists specialized in Barret's oesophagus obtain a much higher yield in the diagnosis of advanced lesions. Patients at high risk-men, older patients, smokers and those with long-segment Barrett's oesophagus-could benefit from follow-up in a referral center. 3) Achalasia: POEM seems safe and effective, independently from patient characteristics (age, comorbidity) and the technical variations used. 4) Eosinophilic esophagitis: topical budesonide and exclusion diets are reasonably effective in PPI non-responders.

  16. Knowledge of pediatrician on gastroesophageal reflux/gastroesophageal reflux disease in children: a preliminary study

    Directory of Open Access Journals (Sweden)

    Edward Surjono

    2016-10-01

    Full Text Available Background Gastroesophageal reflux (OER is involuntary movement of gastric content into esophagus due to transient lower esophageal sphincter relaxation. This condition usually ignored by physician. Many GER cases have severe complication before properly managed. Ten years after incorporating GER into Indonesia pediatric training curriculum, the knowledge of GER among pediatrician need to be measured. Objectives To measure pediatrician's knowledge of GER/GERD in children. Methods This was a cross sectional study using questionnaire and interview. Result There were 387 respondents who filled the questionnaire and being interviewed. The majority of respondents were between 25-45 years old (33.6%. Respondents who graduated before the year 2000 were 48.3%, and after 2000 were 51.7%. Majority of respondents were general pediatrician (90.2% and 41.3% working in teaching hospitals Among pediatricians graduated after year 2000,6 6%,5 0.5% and 57.5% could gave more than 80% correct answer to questions about general knowledge, diagnosis and management of GERD as compared to 49.2%, 42.2% and 47% subjects graduated before year 2000. More pediatricians graduated before year 2000 answered the questions on general knowledge, diagnosis and management < 60% correctly compared to those graduated after year 2000 (42.2%, 25.2% and 28.3% vs. 14%,11.5% and 12%, respectively. Fifty five of 160 (34.4% respondents who working in teaching hospital gave more than 80% correct answer to questions about GERD. Compared to those working in non-teaching hospitals, only 17.6% were able to correctly answer more than 80% of questions. Conclusions Better knowledge about GER/GERD are found among pediatricians graduated after the topics has been introduced to the curriculum and among those practicing in teaching hospitals.

  17. Review article: gastro-oesophageal reflux disease--the health economic implications.

    Science.gov (United States)

    Mason, J; Hungin, A P S

    2005-08-01

    For the vast majority of patients with gastro-oesophageal reflux disease appropriate care involves the management of symptoms with lifestyle advice and drugs. However, there is dissension about the appropriate use of endoscopy, whether drugs should be stepped up or down according to potency, how long drugs should be used for, the role of lifestyle advice, and, related to this, the role of patients' lifestyle choices. This exploration of the economics of gastro-oesophageal reflux disease reviews its cost burden to the UK, assesses published economic models for their strengths and weaknesses and examines current recommendations for gastro-oesophageal reflux disease management from a socioeconomic perspective. Drugs prescribed predominantly for dyspepsia cost the UK National Health Service a projected pound sterling 625 million in 2004, 7% of the primary care prescribing budget. When general practitioners consultations, endoscopies, over-the-counter sales and sickness absences are included the UK cost rises to pound sterling 1.5 billion: approximately half of this cost can be ascribed to gastro-oesophageal reflux disease. Emphasis upon regular review and stepping down treatment (while maintaining adequate symptom relief) is both clinically appropriate and resource efficient. Other cost-effectiveness issues largely lack objective answers because investment in treatment for gastro-oesophageal reflux disease depends upon how much more, at the margin, society wishes to invest for further but diminishing symptom relief.

  18. Levels of serologic markers of celiac disease in patients with reflux esophagitis

    Institute of Scientific and Technical Information of China (English)

    Sait Bagci; C Nuri Ercin; Zeki Yesilova; Ayhan Ozcan; Bulent Degertekin; Kemal Dagalp

    2006-01-01

    AIM: To investigate the prevalence of celiac disease serologic markers (antigliadin IgA, IgG, and antiendomysial IgA) in patients with reflux esophagitis and to detect the relationship between reflux esophagitis and celiac disease (CD).METHODS: This study was performed prospectively between January 2003 and January 2004. Sixty-eight adult reflux esophagitis patients and 40 people as control group for symptoms related with gastrointestinal system were enrolled in this study. The diagnostic work-up included an accurate medical history with gastrointestinal symptoms, routine laboratory measurements, the detection of antibodies against gliadin (IgA and IgG)and endomysium (IgA), and an upper endoscopy with postbulbar biopsy.RESULTS: IgA-AGA and IgG-AGA were positive at 8.8%and 10.3% in patients with reflux esophagitis. In control group, it was found that 10% people had positive IgAAGA, and 7.5% people had positive IgG-AGA. There was no significant relationship between patients and control group regarding positive IgA-AGA and IgGAGA. The patients and persons in control group had no positive IgA-EMA. On postbulbar biopsies, no finding was detected concerning celiac disease. There were no symptoms and signs for gluten enteropathy in patients and control group.CONCLUSION: This review supports that an association does not exist between celiac disease and reflux esophagitis. We think these diseases exist independently from each other.

  19. Patient symptoms correlate poorly with objective measures among patients with gastroesophageal reflux disease.

    Science.gov (United States)

    Levy, Salomon; Plymale, Margaret; Davenport, Daniel L; Moreno Ponte, Oscar I; Roth, J Scott

    2014-09-01

    Presentation of gastroesophageal reflux disease (GERD) varies among patients. To attempt to understand the patient's perception of the severity of their reflux symptoms, we developed a questionnaire on which patients rated symptom severity at each office visit. After receiving Institutional Review Board approval, we retrospectively reviewed patient charts of all patients seen by one surgeon for GERD symptoms and/or presence of hiatal hernia (HH) from September 2012 to April 2013. Data from patient questionnaires combined with objective findings from subsequent or prior workup and eventual operative information were recorded. A total of 144 questionnaires were reviewed from 108 patients. Frequencies were calculated for categorical variables. Patients were divided into four categories based on size of the HH on the endoscopic report; 10 patients had no HH, 15 had small HH, 20 had medium HH, and 31 patients had large HH. Size of HH was not available for three patients. Pre- and postoperative questionnaire responses were obtained for 15 patients. A combined reflux score was calculated using the median for each symptom. Patient perception of severity of symptoms does not necessarily predict presence of pathological reflux or HH nor is there a perfect combination of symptoms to predict the presence of pathological reflux or HH based on our sample. The workup of this pathology must be comprehensive, and the confirmation of reflux is imperative when the diagnosis is unclear.

  20. Is scintigraphy of value in the diagnosis of gastrooesophageal reflux disease

    Energy Technology Data Exchange (ETDEWEB)

    Kjellen, G.; Brudin, L.; Haakansson, H.O. (Centrallasarettet, Kalmar (Sweden))

    1991-01-01

    110 patients with suspected oesophageal symptoms were investigated by means of oesophageal endoscopy (OE), 24-h pH- metry, and oesophageal scintigraphy (ES). When 24-h pH-metry formed the basis for diagnosis of gastrooesophageal reflux disease (GERD), the sensitivity for ES at abdominal compression was 64%, but no statistically significant differences were found among erect refluxers, supine refluxers, and comibined refluxers. Only 4% of the GERD patients had pathologic oesophageal clearing at ES. The more severe the macroscopic oesophagitis found by OE, the more pronounced were the abnormal findings at 24-h pH-metry and at ES with abdominal compression. Increased postprandial reflux was associated with gastro-oesophageal reflux and hiatal hernia at ES with abdominal compression and the most severe form of oesophagitis, respectively. It is concluded that ES has too low sensitivity to be recommended as a screening test for GERD. Nevertheless, the specificity of 76% can to some extent help us to rule out GERD in patients. 19 refs., 7 tabs.

  1. Functional dyspepsia and nonerosive reflux disease: clinical interactions and their implications.

    Science.gov (United States)

    Keohane, John; Quigley, Eamonn M M

    2007-08-08

    Functional dyspepsia or nonulcer dyspepsia, and nonerosive reflux disease (NERD) or endoscopy-negative reflux disease, are common reasons for referral to a gastroenterologist. Although there is much confusion with regard to definition, recent research would suggest that these 2 conditions are linked and may represent components in the spectrum of the same disease entity, in terms of both symptoms and pathophysiology. Several theories have been proposed regarding the etiology of these disorders, including acid exposure, visceral hypersensitivity, impaired fundal accommodation, delayed gastric emptying, and Helicobacter pylori infection.

  2. [Differencial diagnosis of gastroesophageal reflux disease -- eosinophilic esophagitis: case report].

    Science.gov (United States)

    Franzius, M; Stolte, M; Porschen, R

    2005-04-01

    We report on a 22-year-old man with dysphagia and repeated bolus impaction in the esophagus for 10 years. Bolus impactions were frequently mobilised using an endoscope. At endoscopy, esophagitis IV degrees was described. After treatment with omeprazol there was no improvement. The patient was submitted to our hospital for fundoplication. pH-metry demonstrated an increased reflux. At endoscopy of the esophagus, we found red stripes which did not show the typical appearance of erosions. Manometry and X-ray films of the esophagus did not reveal any pathological findings. In combination with anamnesis, symptoms, and endoscopy, the diagnosis of eosinophilic esophagitis was documented by histology. After administration of oral corticosteroids a rapid improvement of the clinical symptoms was observed. The diagnosis of eosinophilic esophagitis should be kept in mind in patients with chronic symptoms of gastroesophageal reflux persisting despite medical therapy, pathological pH-metry and repeated bolus impactions.

  3. Reflux symptom questionnaire in the diagnosis of reflux oesophagitis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li; MENG Ling-mei; ZHANG Dong-hong; HUANG Shu-mei; QU Xue-fu; ZHOU Li-ya; LIN San-ren; DING Shi-gang; HUANG Yong-hui; GU Fang; LI Yuan; ZHANG Jing; YAN Xiu-e

    2007-01-01

    @@ Reflux symptom questionnaire (RSQ) is a useful tool in epidemiological study of gastroesophageal reflux disease (GERD),(1,2) but the correlation between RSQ and the refluX oesophagitis (RE) is still unclear.

  4. Maior prevalência de obesidade na doença do refluxo gastroesofagiano erosiva Higher prevalence of obesity in erosive gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Beatriz N. Biccas

    2009-03-01

    macroscopic erosion on the esophageal mucosa. Hiatal hernia was considered when the gastroesophageal junction was positioned 2 cm or more above the diaphragm. Patients with Barrett's esophagus or esophageal peptic stenosis were excluded. The population was categorized according to body mass index as normal weight (body mass index between 20 and 24.9; over-weight (between 25 and 29.9, and obese (greater than 30. The diagnosis as well as the intensity of abnormal gastroesophageal reflux were obtained through the analysis of the results of pH monitoring in patients with and without erosive esophagitis and in the various categories of body mass index. RESULTS: Among the 362 patients there were 148 (41% with erosive esophagitis and 214 (59% without erosive esophagitis, while the pH monitoring was abnormal in 100% and 57%, respectively. Among the 148 individuals with erosive esophagitis (61% male, median age 50 years, 41 (28% had normal weight, 82 (55% had over-weight and 25 (17% were obese. There were 88 (60% patients with hiatal hernia, which was present in 29 (71% of patients with normal weight, 45 (55% of patients with over-weight and 14 (56% of obese individuals. In 121 patients without erosive esophagitis who had abnormal pH monitoring, diagnosed as non erosive reflux disease (38% male, median age 50 years, 51 (42% patients had normal weight, 55 (46% had over-weight and 15 (12% were obese. Hiatal hernia was detected in 52 out of 121 (43% patients and in 21 (41% out of 51 individuals with normal weight, 24 (44% of over-weight and 7 (47% of obese. In the group of 93 patients without erosive esophagitis and normal pH monitoring (29% male, median age 43 years, 26 (28% had hiatal hernia and there were 43 (46% individuals with normal weight, 38 (41% with over-weight and 12 (13% were obese. The number of patients with obesity and over-weight was significantly higher in the group with erosive esophagitis compared to the ones without erosive esophagitis. The prevalence of hiatal

  5. Metabolic changes in the lower esophageal sphincter influencing the result of anti-reflux surgical interventions in chronic gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Aron Altorjay; Arpad Juhasz; Viola Kellner; Gellert Sohar; Matyas Fekete; Istvan Sohar

    2005-01-01

    AIM: With the availability of a minimally invasive approach, anti-reflux surgery has recently experienced a renaissance as a cost-effective alternative to life-long medical treatment in patients with gastroesophageal reflux disease (GERD). We are not aware of the fact whether reflux episodes causing complaints for a long time i.e., at least for one year are associated with metabolic changes in the lower esophageal sphincter, and if so,whether these may influence functional results achieved after anti-reflux surgery.METHODS: Between 1 January 2001 and 31 December 2002 we performed anti-reflux surgery on 79 patients.Muscle samples were taken from the lower esophageal sphincter (LES) in 33 patients during anti-reflux surgery.Inclusion criteria were: LES resting pressure below 10 mmHg and a marked, pH proven acid exposure to the esophagus of at least one year's duration, causing subjective complaints and requiring continuous proton pump inhibitor treatment. Control samples were obtained from muscle tissue in the gastroesophageal junction that had been removed from 17 patients undergoing gastric or esophageal resection. Metabolic and lysosomal enzyme activities and special protein concentrations 16 parameters in total were evaluated in tissue taken from control specimens and tissue taken from patients with GERD. The biochemical parameters of these intra-operative biopsies were used to correlate the results of anti-reflux operations (Visick I and II-III).RESULTS: In the reflux-type muscle, we found a significant increase of the energy-enzyme activities e.g., creatine kinase, lactate dehydrogenase, β-hydroxybutyrate dehydrogenase, and aspartate aminotransaminase-. The concentration of the structural protein S-100 and the myofibrillar protein troponin I were also significantly increased. Among lysosomal enzymes, we found that the activities of cathepsin B, tripeptidyl-peptidase I, dipeptidylpeptidase II, β-hexosaminidase B, β-mannosidase and β-galactosidase were

  6. CHRONOBIOLOGICAL APPROACH TO ESTIMATION OF CLINICAL COURSE AND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE

    Directory of Open Access Journals (Sweden)

    R.V. Lyakisheva

    2008-09-01

    Full Text Available The article presents analysis of ratio of biorhythm in patients with gastroesophageal reflux disease and time of clinical symptoms appearance. Itwas determined thatcircadian rhythm, estimated according to Kerdo index, is correlated with appearance of disease symptoms in 24 hours. Taking into consideration its characteristics while managing drug therapy allows to raise therapy’s efficacy.

  7. The Association Between Gastroesophageal Reflux Disease and Recurrent Respiratory Papillomatosis : A Systematic Review

    NARCIS (Netherlands)

    San Giorgi, Michel R. M.; Helder, Herman M.; Lindeman, Robbert-Jan S.; de Bock, Geertruida H.; Dikkers, Frederik G.

    2016-01-01

    Objectives/Hypothesis: Antireflux therapy is incorporated in many treatment protocols for recurrent respiratory papillomatosis (RRP) because gastroesophageal reflux (GERD) is thought to worsen the disease course of RRP. It is unclear if GERD really aggravates the disease course. The aims of this sys

  8. The association between gastroesophageal reflux disease and recurrent respiratory papillomatosis : A systematic review

    NARCIS (Netherlands)

    San Giorgi, Michel R M; Helder, Herman M; Lindeman, Robbert-Jan S; de Bock, Geertruida H; Dikkers, Frederik G

    2016-01-01

    OBJECTIVES/HYPOTHESIS: Antireflux therapy is incorporated in many treatment protocols for recurrent respiratory papillomatosis (RRP) because gastroesophageal reflux (GERD) is thought to worsen the disease course of RRP. It is unclear if GERD really aggravates the disease course. The aims of this sys

  9. Endoscopic and symptoms analysis in Mexican patients with irritable Bowel syndrome, dyspepsia, and gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Santiago Camacho

    2010-12-01

    Full Text Available The aim of this study was to analyze the data of endoscopy and symptoms in 118 Mexican patients with irritable bowel syndrome (IBS, dyspepsia, non-erosive reflux disease (NERD and erosive esophagitis (EE. IBS criteria were fulfilling for dyspepsia patients in 47%, for NERD in 48%, and for EE patients in 48% of cases. Esophagitis was present in 42% of patients with IBS and in 45% of patients with dyspepsia. A higher prevalence of hiatus hernia was found in EE vs. NERD. Heartburn and acid eructation were associated with the presence of esophagitis; acid eructation, regurgitation and nocturnal pain with duodenitis; and heartburn and regurgitation with hiatus hernia. Males more frequently reported: ucus in feces, abdoinal distension, nausea and gastritis; and oen ore frequently reported esophagitis and duodenitis. Patients with NERD (OR 2.54, 95% CI 1.08 to 5.99, p=0.04, tenesmus and early satiety, and men had an increase risk for reporting hard or lumpy stools. In conclusion, nearly half of the Mexican patients with NERD, EE and dyspepsia fulfill criteria for IBS. A large number of symptoms were correlated with endoscopy, which can be used to improve the indication of the endoscopy and its implementation in clinical studies.O objetivo deste estudo foi analisar os dados de endoscopia e sintomas de 118 pacientes mexicanos com síndrome do intestino irritável (IBS, dispepsia, doença do refluxo não-erosiva (NERD e esofagite erosiva (EE. Os pacientes com IBS preencheram os critérios para dispepsia em 47%, para NERD em 48%, e para pacientes EE em 48% dos casos. Esofagite estava presente em 42% dos pacientes com IBS e em 45% dos pacientes com dispepsia. A maior prevalência de hérnia de hiato foi encontrada na EE em comparação com NERD. Azia e eructação ácida foram associadas à presença de esofagite; eructação ácida, regurgitação e dor noturna, com duodenite; e azia e regurgitação com hérnia de hiato. Os homens relataram mais

  10. Technical problems produced by the Bravo pH test in nonerosive reflux disease patients

    Institute of Scientific and Technical Information of China (English)

    Andrés; de; Hoyos; Edgar; Alain; Esparza

    2010-01-01

    AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive reflux disease patients who received a Bravo pH test. The number and frequency of all technical failures were documented, quantified and analyzed. RESULTS: A total of 66 patients, with a mean age of 41.7 years, were studied. Technical failures occurred in 15.15% of the sample. The most frequent...

  11. FEATURES OF CLINICAL COURSE OF GASTROESOPHAGEAL REFLUX DISEASE IN NEWLY RECRUITED WITH CONNECTIVE TISSUE UNDIFFERENTIATED DYSPLASIA SYNDROME

    Directory of Open Access Journals (Sweden)

    E.I. Kashkina

    2008-12-01

    Full Text Available The presence of connective tissue undifferentiated dysplasia syndrome against a background of psychological stress at newly recruited can promote the risk of gastroesophageal reflux disease occurrence. To the utmost, correlation between the gastroesophageal reflux disease and such manifestations of connective tissue undifferentiated dysplasia syndrome as asthenic constitution, chest deformation, Gothic palate and hypermobility of joints was found

  12. Prevalence of chronic rhinosinusitis in a population of patients with gastroesophageal reflux disease

    DEFF Research Database (Denmark)

    Bohnhorst, Idar; Jawad, Samir; Lange, Bibi;

    2015-01-01

    BACKGROUND: An increased coexistence of gastroesophageal reflux disease (GERD) and chronic rhinosinusitis (CRS) has been reported in epidemiologic and register studies, and reflux has been shown more frequently in patients with CRS in studies using esophagus pH manometry compared to participants....... The results were compared with those of a randomly assigned control group from the general Danish population. METHOD: In this case-control study, 82 patients with GERD were examined for CRS using the European Position Paper on Rhinosinusitis and Nasal Polyps criteria, which combine patient history...

  13. Endoscopic pH Monitoring for Patients with Suspected or Refractory Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    Brian G Turner

    2007-01-01

    Full Text Available BACKGROUND: Wireless pH studies can offer prolonged pH monitoring, which may potentially facilitate the diagnosis and management of patients with gastroesophageal reflux disease (GERD. The aim of the present study was to evaluate the detection rate of abnormal esophageal acid exposure using prolonged pH monitoring in patients with suspected or refractory GERD symptoms.

  14. IT IS GASTROESOPHAGEAL REFLUX DISEASE,NOT ASTHMA: A CASE REPORT

    Institute of Scientific and Technical Information of China (English)

    Zhong-gao Wang

    2006-01-01

    @@ THE incidence of gastroesophageal reflux disease (GERD) is high in Western nations. Its extraesophageal manifestations such as asthma, paroxysmal laryngospasm, and excessive throat phlegm, chronic cough, laryngal disorders, postnasal drip, and other lesser ear, nose, and throat symptoms, have been widely recognized and reported.

  15. The Role of Vegetative Dysfunction and Its Correction in Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    G.V. Osyodlo

    2014-06-01

    Full Text Available The article analyzes the findings regarding the effect of vegetative dysfunction on the course of gastroesophageal reflux disease, the expediency of autonomic imbalance correction by phenibut on the background of antisecretory therapy with pantoprazole is shown, it helps to improve the immediate and long-term results.

  16. Prospective randomized controlled trial of an injectable esophageal prosthesis versus a sham procedure for endoscopic treatment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    P. Fockens; L. Cohen; S.A. Edmundowicz; K. Binmoeller; R.I. Rothstein; D. Smith; E. Lin; N. Nickl; B. Overholt; P.J. Kahrilas; N. Vakil; A.M. Abdel Aziz Hassan; G.A. Lehman

    2010-01-01

    This study aimed to assess whether endoscopic implantation of an injectable esophageal prosthesis, the Gatekeeper Reflux Repair System (GK), is a safe and effective therapy for controlling gastroesophageal reflux disease (GERD). A prospective, randomized, sham-controlled, single-blinded, internation

  17. Pulmonary Disease Secondary to Reflux Mimicking Interstitial Pneumonia in Systemic Sclerosis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ricardo Azêdo de Luca Montes

    2016-01-01

    Full Text Available Systemic sclerosis is a complex disease due to the variety of clinical presentations, often superimposed on other conditions, related or not to the connective tissue. We report a 43-year-old Brazilian woman with limited systemic sclerosis and pulmonary symptoms secondary to gastroesophageal reflux disease, with a clinical presentation similar to a diffuse interstitial lung disease. Because of the frequency of interstitial lung injury due to systemic sclerosis, this was an important differential diagnosis, which could be excluded after optimized treatment of reflux disease, with clinical and radiological improvement. Clinical management of patients with collagen diseases requires clinician skills to identify the natural history and understand its nuances. This is a common situation in clinical practice, but with a few discussions in international literature.

  18. Ultrasonographic study of postcibal gastro-esophageal reflux and gastric emptying in infants with recurrent respiratory disease

    Institute of Scientific and Technical Information of China (English)

    Agostino Di Ciaula; Piero Portincasa; Leonardo Di Terlizzi; Domenico Paternostro; Giuseppe Palasciano

    2005-01-01

    AIM: To check the utility of postcibal ultrasonography for the evaluation of reflux in relation to gastric emptying in infants with recurrent respiratory symptoms and to link imaging with clinical data.METHODS: Esophageal reflux (hyperechoic retrograde filling) and gastric emptying (antral areas) were quantified before and after ingestion of a standard formula in 35 untreated infants (13 with chronic cough,22 with recurrent bronchitis) and in 31 controls.RESULTS: The prevalence of abnormal (≥8 episodes)postcibal refluxes was 74% in patients and 3% in controls. Number, duration of the longest episode and extent of refluxes were significantly higher in patients compared to controls. Number of refluxes was higher in patients with symptomatic refluxes than in those without.Infants with recurrent bronchitis had more refluxes than those with chronic cough and controls. Extent and timing of gastric emptying were similar in patients and controls.CONCLUSION: Esophageal ultrasonography is a useful and physiological test in infants with recurrent respiratory diseases, which have a high prevalence of abnormal postcibal esophageal reflux and a gastric emptying similar to that of normal controls. Esophageal reflux is more severe in subjects with recurrent bronchitis than in those with chronic cough.

  19. The potential therapeutic effect of melatonin in gastro-esophageal reflux disease

    Directory of Open Access Journals (Sweden)

    El-Gendy Ahmed A

    2010-01-01

    Full Text Available Abstract Background Gastro-Esophageal Reflux Disease (GERD defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Many drugs are used for the treatment of GERD such as omeprazole (a proton pump inhibitor which is a widely used antiulcer drug demonstrated to protect against esophageal mucosal injury. Melatonin has been found to protect the gastrointestinal mucosa from oxidative damage caused by reactive oxygen species in different experimental ulcer models. The aim of this study is to evaluate the role of exogenous melatonin in the treatment of reflux disease in humans either alone or in combination with omeprazole therapy. Methods 36 persons were divided into 4 groups (control subjects, patients with reflux disease treated with melatonin alone, omeprazole alone and a combination of melatonin and omeprazole for 4 and 8 weeks Each group consisted of 9 persons. Persons were subjected to thorough history taking, clinical examination, and investigations including laboratory, endoscopic, record of esophageal motility, pH-metry, basal acid output and serum gastrin. Results Melatonin has a role in the improvement of Gastro-esophageal reflux disease when used alone or in combination with omeprazole. Meanwhile, omeprazole alone is better used in the treatment of GERD than melatonin alone. Conclusion The present study showed that oral melatonin is a promising therapeutic agent for the treatment of GERD. It is an effective line of treatment in relieving epigastric pain and heartburn. However, further studies are required to confirm the efficacy and long-term safety of melatonin before being recommended for routine clinical use. Trial Registration QA13NCT00915616

  20. Gastroesophageal reflux disease (GERD) and inflammatory bowel disease (IBD): attachment styles and parental bonding.

    Science.gov (United States)

    Ercolani, Mauro; Farinelli, Marina; Agostini, Alessandro; Baldoni, Franco; Baracchini, Federica; Ravegnani, Gianni; Bortolotti, Mauro

    2010-10-01

    The attachment styles and parental bonding by 64 patients (M age = 43.2 yr., SD = 13.3) with Gastroesophageal Reflux Disease (GERD) were compared with those of 64 patients (M age = 42.2 yr., SD = 13.5) with Inflammatory Bowel Disease (IBD) and 126 Healthy participants (M age = 42.2 yr., SD = 12.1). Analysis of scores on the Attachment Style Questionnaire indicated insecure attachment in both the patient and control groups. The Parental Bonding scores indicated perceptions of Affectionless Control by parents in both patient groups. In particular, the mean Father-Protection subscale scores were significantly higher for in the GERD group than in the Healthy and IBD groups.

  1. Diagnosis of Gastroesophageal Reflux Disease Using Real-time Magnetic Resonance Imaging.

    Science.gov (United States)

    Zhang, Shuo; Joseph, Arun A; Gross, Lisa; Ghadimi, Michael; Frahm, Jens; Beham, Alexander W

    2015-07-15

    A small angle (His angle) between the oesophagus and the fundus of the stomach is considered to act as flap valve and anti-reflux barrier. A wide angle results in dysfunction of the oesophagogastric junction and subsequently in gastroesophageal reflux disease (GERD). Here, we used real-time magnetic resonance imaging (MRI) at 50 ms resolution (20 frames per second) in 12 volunteers and 12 patients with GERD to assess transport of pineapple juice through the oesophagogastric junction and reflux during Valsalva. We found that the intra-abdominal part of the oesophagus was bended towards the left side resulting in an angle of 75.3 ± 17.4, which was significantly larger during Valsava (P = 0.017). Reflux and several underlying pathologies were detected in 11 out of 12 patients. Our data visualize oesophagogastric junction physiology and disprove the flap valve hypothesis. Further, non-invasive real-time MRI has considerable potential for the diagnosis of causative pathologies leading to GERD.

  2. Managing peptic ulcer and gastroesophageal reflux disease in elderly Chinese patients – focus on esomeprazole

    Directory of Open Access Journals (Sweden)

    Tang RS

    2013-10-01

    Full Text Available Raymond SY Tang, Justin CY Wu Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Abstract: Peptic ulcer disease (PUD and gastroesophageal reflux disease (GERD are not uncommon in elderly patients. Clinical presentations of these acid-related disorders may be atypical in the geriatric population. Older individuals are at increased risk for poor outcomes in complicated PUD and for development of GERD complications. Multiple risk factors (eg, Helicobacter pylori [HP], use of nonsteroidal anti-inflammatory drugs [NSAIDs], aspirin contribute to the development of PUD. Recent data has shown that HP-negative, NSAID-negative idiopathic peptic ulcers are on the rise and carry a higher risk of recurrent ulcer bleeding and mortality. Effective management of PUD in the geriatric population relies on identification and modification of treatable risk factors. Elderly patients with GERD often require long-term acid suppressive therapy. Proton pump inhibitors (PPI including esomeprazole are effective in the treatment of reflux esophagitis, maintenance of GERD symptomatic control, and management of PUD as well as its complications. Potential safety concerns of long-term PPI use have been reported in the literature. Clinicians should balance the risks and benefits before committing elderly patients to long-term PPI therapy. Keywords: elderly patients, peptic ulcer disease, gastroesophageal reflux disease, proton pump inhibitor, esomeprazole

  3. The role of dexlansoprazole modified-release in the management of gastroesophageal reflux disease

    Science.gov (United States)

    Fass, Ronnie; Frazier, Rosita

    2017-01-01

    Dexlansoprazole modified-release (MR) is the R-enantiomer of lansoprazole and is currently the only proton-pump inhibitor (PPI) with a novel dual delayed release (DDR) formulation. Overall, dexlansoprazole MR demonstrates a similar safety and side-effect profile as lansoprazole. Dexlansoprazole MR has been shown to be highly efficacious in healing erosive esophagitis, maintaining healed esophageal mucosa in patients with erosive esophagitis and controlling symptoms of patients with nonerosive reflux disease (NERD). Recent studies have also demonstrated that dexlansoprazole MR is highly effective in improving nocturnal heartburn, gastroesophageal reflux disease (GERD) related sleep disturbances and bothersome regurgitation. Dexlansoprazole MR is well tolerated and can be taken without regard to food. PMID:28203282

  4. [An association between adenoid hypertrophy and exstra-gastroesophageal reflux disease].

    Science.gov (United States)

    Ren, Jianjun; Zhao, Yu; Ren, Xue

    2015-08-01

    Adenoid hypertrophy is a disease that mostly occurs among children of 3-5 years old. It is caused by repeated inflammation and infection of nasopharynx and its adjoin parts, or the adenoid itself, which will finally leads to pathological hyperplasia of adenoid. With so much information we have acquired about this disease, its specific mechanism remains unknown. In recent years, some researches have indicated that adenoid hypertrophy may have something to do with extra-gastroesophageal reflux, in which pepsin plays a very important role, and pepsin will do a series of pathological damages to the upper airway as it reaches the upper respiratory tract. Based on relative domestic and foreign literature, this paper attempts to make a review about the relationship between gastroesophageal reflux and adenoid hypertrophy.

  5. Evidence-based appraisal in laparoscopic Nissen and Toupet fundoplications for gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To demonstrate the optimal surgical procedure for gastroesophageal reflux disease. METHODS: The electronic databases of Medline, Elsevier, Springerlink and Embase over the last 16 years were searched. All clinical trials involved in the outcomes of laparoscopic Nissen fundoplication (LNF) and laparoscopic Toupet fundoplication (LTF) were identified. The data of assessment in benefits and adverse results of LNF and LTF were extracted and compared using metaanalysis. RESULTS: We ultimately identified a t...

  6. Association Between Halitosis Diagnosed by a Questionnaire and Halimeter and Symptoms of Gastroesophageal Reflux Disease

    OpenAIRE

    LEE, Hyo-Jung; Kim, Hee Man; Kim, Nayoung; Oh, Jane C; Jo, Hyun Jin; Lee, Jung-Tae; Chang, Hee-Yung; Chang, Na-Hee; Ahn, Soyeon; Lee, Jeong-Yun

    2014-01-01

    Background/Aims The relationship between halitosis and gastroesophageal reflux disease (GERD) remains controversial. The aim of this study was to investigate an association between subjective and objective halitosis and GERD. Methods The subjects were enrolled from participants who visited a health promotion center at Seoul National University Bundang Hospital. For diagnosis of halitosis, a questionnaire was requested, and volatile sulfur compounds (VSCs) were measured by Halimeter. Self-cons...

  7. Salivary parameters and teeth erosions in patients with gastroesophageal reflux disease

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    Maria Carolina Canteras Scarillo Falotico Corrêa

    2012-09-01

    Full Text Available CONTEXT: In the gastroesophageal reflux disease (GERD, a highly prevalent digestive disorder, gastric content may return to the esophagus and reach the mouth, thus leading to a small number of carious lesions and high incidence of dental erosion. Since saliva plays a major role in oral homeostasis, evaluating salivary parameters is necessary in attempting to explain such outcome. OBJECTIVES: This study aimed at analyzing salivary parameters (salivary flow, pH and buffering capacity, bacterial count, caries index and dental erosion in patients with GERD. MATERIALS: Sixty patients were studied, and of these, 30 had GERD (group 1, and 30 were controls (group 2. Gastroesophageal reflux disease diagnosis confirmation was achieved by means of endoscopy, manometry and pH metric esophageal monitoring. The above mentioned salivary parameters were evaluated in patients from groups 1 and 2. RESULTS: The number of erosions in patients with GERD (group 1 was larger than in controls (P<0.001. The number of carious teeth was smaller in group 1 than in group 2 (P<0.001. Salivary flow (non-stimulated and stimulated and pH did not show differences between the 2 groups (P = 0.49; P = 0.80 and P = 0.85, respectively. Salivary buffering capacity in patients with GERD showed lower values in controls (P = 0.018. The number of bacteria (Lactobacilli and Streptococci was smaller in patients with gastroesophageal reflux disease than in controls (P = 0.0067 and P = 0.0017, respectively. CONCLUSION: It was concluded that the large number of erosions must be a result of GERD patients reduced salivary buffering capacity. The reduced number of caries of patients in group 1 can be explained by the low prevalence of bacteria (Lactobacilli and Streptococci, observed in the saliva of patients with chronic reflux.

  8. Neuro-regulation of lower esophageal sphincter function as treatment for gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Anupender Singh Sidhu; George Triadafilopoulos

    2008-01-01

    The junction between the esophagus and the stomach is a specialized region,composed of lower esophageal sphincter (LES) and its adjacent anatomical structures,the gastric sling and crural diaphragm.Together these structures work in a coordinated manner to allow ingested food into the stomach while preventing reflux of gastric contents across the esophago-gastric junction (EGJ) into the esophagus.The same zone also permits retrograde passage of air and gastric contents into esophagus during belching and vomiting.The precise coordination required to execute such a complicated task is achieved by a finely-regulated high-pressure zone.This zone keeps the junction between esophagus and stomach continuously closed,but is still able to relax briefly via input from inhibitory neurons that are responsible for its innervation.Alterations of the structure and function of the EGJ and the LES may predispose to gastroesophageal reflux disease (GERD).

  9. Markers of Chronic Kidney Disease in Children with Obstructive Uropathy or Vesicoureteral Reflux

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    E. M. Chichuga

    2015-01-01

    Full Text Available Background. Identification of markers of chronic kidney disease and its progression in the early stages of the disease is important, however, the most of research concerns late (3–5 stages of the disease.Objective. Identification of the markers of chronic kidney disease (CKD and its progression in the early stages of the disease in children with obstructive uropathy and vesicoureteral reflux.Methods. Prospective follow-up (for 5 years of 92 children with obstructive and reflux uropathies (1st to 4th stages of CKD. All patients had episodes of urinary tract infections, mostly pyelonephritis, minimum once a year.Results. High prevalence of proteinuria (60.9%, reduced renal functional reserve (88.7% and disorders of cortical renal blood flow (by Doppler Color Flow Imaging (69.6% were found in children with 1st stage of CKD. Groups of children with proteinuria and a reduced renal functional reserve had a higher level of systolic and diastolic blood pressure in comparison with the patients without proteinuria and the reduced renal functional reserve (p < 0.05. In patients with 2–4 stages of CKD the glomerular filtration rate (GFR correlated with atypical flora in the etiology of urinary tract infections (rpb = 0.66; n = 23; p = 0.0006, sex (boys had lower levels of GFR, rpb = 0.61; n = 23; p = 0.001, bilateral renal abnormalities (rpb = -0.53; n = 23; p = 0.009 the level of hemoglobin (r = 0.45; n = 23; p = 0.02. Conclusion. Markers of CKD of children with obstructive and reflux uropathies are: proteinuria, arterial hypertension, reduction of renal functional reserve and the impaired cortical renal blood flow (by Doppler Color Flow Imaging. The importance of arterial hypertension and proteinuria as markers of the progression of CKD of children with urinary tract obstruction and vesicoureteral reflux was confirmed. Additional markers for the progression of CKD in children with obstructive and reflux uropaties might be: male sex

  10. Relationship among symptoms, mucosal injury, and acid exposure in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    XU Ding-ting; FENG Gui-jian; ZHAO Li-li; LIU Yu-lan

    2013-01-01

    Background Symptoms,endoscopy,and pH monitoring form the basis of diagnosis of gastroesophageal reflux disease (GERD).Their relationship was meaningful for primary care physicians,but still unclear.Our research aimed to compare questionnaire,endoscopy,and pH monitoring and to analyze their correlations.Methods Three hundred patients who underwent the Reflux Disease Questionnaire (RDQ),endoscopy,and esophageal 24-hour pH monitoring from March 2007 to December 2010 in Peking University People's Hospital were enrolled.We analyzed the characteristics of different investigations and their relationships.Results Male (OR for mild reflux esophagitis (RE) =2.433,severe RE =8.386),body mass index (BMI) (OR for mild RE =1.222,severe RE =1.297),and hernia (OR for mild RE =6.059,severe RE =17.547),were found to be the risk factors for RE; age (OR=1.074) was correlated with severe RE.The consistency of questionnaire,endoscopy,and pH monitoring was poor:RDQ did not agree well with pH monitoring (K=0.061),nor with endoscopy (K=0.044); pH monitoring did not agree well with endoscopy (K=0.316).However,the severity of mucosa injury in RE was associated with pathological acid exposure (PAE):reflux episodes of >5 minutes (P=0.035),the percentage time pH <4 (P=0.017),and the DeMeester score (P=0.016) increased significantly in patients with severe RE.Chest pain had poor relationship with RE or PAE.Conclusions Male,age,BMI,and hernia were probably risk factors for esophagitis.RDQ,endoscopy,and pH monitoring have their own focus and reinforce each other in diagnosis.Of the GERD symptoms,chest pain had negative correlation with RE or PAE.

  11. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate.

    Science.gov (United States)

    Kahrilas, Peter J; Smith, Jaclyn A; Dicpinigaitis, Peter V

    2014-02-01

    Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies of chronic cough. Indeed, cough management guidelines published by numerous respiratory societies worldwide recommend evaluation and treatment of GERD as an integral component of the diagnostic/therapeutic algorithm for the management of chronic cough. However, a significant number of patients with chronic cough presumed due to GERD do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of nonacid or weakly acidic reflux. Further contributing to the controversy are recent studies that demonstrate that patients with chronic cough do not have excessive reflux events relative to healthy volunteers. Although a temporal relationship between cough and reflux events has been suggested by studies utilizing impedance-pH monitoring of reflux events and objective cough recording, consensus is lacking in terms of whether this temporal relationship proves a causal link between reflux and cough. The fourth American Cough Conference (New York, June 2013) provided an ideal forum for the debate of this issue between two internationally recognized experts in the field of reflux and chronic cough.

  12. Refractory gastroesophageal reflux disease Doença do refluxo gastroesofágico refratária

    OpenAIRE

    Joaquim Prado P. Moraes-Filho

    2012-01-01

    CONTEXT: Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Its pathophysiology, diagnosis and treatment have frequently been analyzed but it is interesting to review some aspects of the GERD refractory patients to the proton pump inhibitors treatment. The treatment encompasses behavioral measures and pharmacological therapy. The majority of the patients respond well to proton pump inhibito...

  13. Nissen fundoplication for gastro-oesophageal reflux disease: long-term results.

    Science.gov (United States)

    Luostarinen, M

    1995-01-01

    Since its introduction by Rudolph Nissen in 1956, fundoplication has become the most commonly used antireflux procedure. Following fundoplication the majority (80 to 90%) of the patients become symptomfree or have only mild and occasional reflux symptoms in the long run. With a short and loose fundic wrap postoperative dysphagia is not a clinical problem, providing that preoperative manometry shows adequate peristalsis. Flatus is increased after fundoplication, but rarely to a disturbing extent. Patients who have problems with flatus preoperatively are also prone to have complaints postoperatively. Bloating is decreased rather than increased after fundoplication. At endoscopy as intact seen fundic wrap (the main determinant of the long-term outcome) is observed in 70% to 80% of the cases 10 to 20 years after the operation. Oesophageal 24-hour pH-recording is normal and oesophagitis cured in similar number of patients. In conclusion, Nissen fundoplication gives effective cure of symptoms of gastro-oesophageal reflux disease and reliably corrects reflux oesophagitis. Postoperative adverse effects are rare and well tolerable and do not detract from the success of the operation in correctly selected patients.

  14. Heartburn during sleep: a clinical marker of gastro-oesophageal reflux disease in morbidly obese patients.

    Science.gov (United States)

    Fornari, F; Madalosso, C A S; Callegari-Jacques, S M; Gurski, R R

    2009-02-01

    Gastro-oesophageal reflux disease (GORD) and morbid obesity are entities with increasing prevalence. New clinical strategies are cornerstones for their management. The aim of this study was to assess the prevalence of heartburn during sleep (HDS) and whether this symptom predicts the presence of objective GORD parameters and increased heartburn perception in morbidly obese patients. Ninety-one consecutive morbidly obese patients underwent clinical evaluation, upper gastrointestinal endoscopy and oesophageal pH monitoring. HDS was characterized when patients replied positively to the question, 'Does heartburn wake you from sleep?'. A General Score for Heartburn (GSH) ranging between 0 and 5 was assessed with the question 'How bad is your heartburn?'. HDS was reported by 33 patients (36%). More patients with HDS had abnormal acid contact time or reflux oesophagitis than patients without HDS (94%vs 57%, P HDS had a positive predictive value of 94% (0.95 CI 82-98), sensitivity of 48% (0.95 CI 37-60%) and specificity of 93% (0.95 CI 77-98%) for detection of GORD. A higher proportion of patients with HDS perceived heartburn preceded by acid reflux in diurnal (39%vs 9%; P HDS patients showed higher GSH (2.4 +/- 0.5 vs 1.7 +/- 0.4; P HDS but reported diurnal heartburn. HDS occurs in a significant minority of patients with morbid obesity and has high positive predictive value for GORD. Symptomatic reflux during the sleep seems to be a marker of increased heartburn perception in this population.

  15. Laparoscopic Nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease

    Science.gov (United States)

    Du, Xing; Wu, Ji-Min; Hu, Zhi-Wei; Wang, Feng; Wang, Zhong-Gao; Zhang, Chao; Yan, Chao; Chen, Mei-Ping

    2017-01-01

    Abstract Background: Laparoscopic Nissen fundoplication (LNF) has been the gold standard for the surgical management of Gastro-esophageal reflux disease (GERD). Laparoscopic anterior 180° fundoplication (180° LAF) is reported to reduce the incidence of postoperative complications while obtaining similar control of reflux. The present meta-analysis was conducted to confirm the value of the 2 techniques. Methods: PubMed, Medline, Embase, Cochrane Library, Springerlink, and China National Knowledge Infrastructure Platform databases were searched for randomized controlled trials (RCTs) comparing LNF and 180° LAF. Data regarding the benefits and adverse results of 2 techniques were extracted and compared using a meta-analysis. Results: Six eligible RCTs comparing LNF (n = 266) and 180° LAF (n = 265) were identified. There were no significant differences between LNF and 180° LAF with regard to operating time, perioperative complications, length of hospital stay, patient satisfaction, willingness to undergo surgery again, quality of life, postoperative heartburn, proton pump inhibitor (PPI) use, postoperative DeMeester scores, postoperative lower esophageal sphincter (LES) pressure, postoperative gas-bloating, unable to belch, diarrhea, or overall reoperation. LNF was associated with a higher prevalence of postoperative dysphagia compared with 180° LAF, while 180° LAF was followed by more reoperation for recurrent reflux symptoms. Conclusion: LNF and 180° LAF are equally effective in controlling reflux symptoms and obtain a comparable prevalence of patient satisfaction. 180° LAF can reduce the incidence of postoperative dysphagia while this is offset by a higher risk of reoperation for recurrent symptoms. The risk of recurrent symptoms should need to be balanced against the risk of dysphagia when surgeons choose surgical procedures for each individual with GERD. PMID:28906412

  16. The Incidence of Lesions of Different Systems and Organs in Children with Gastroesophageal Reflux Disease

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    O.Z. Gnateyko

    2016-11-01

    Full Text Available Introduction. Gastroesophageal reflux disease (GERD — a chronic recurrent disease caused by the disturbances of the motor-evacuating function of the gastroesophageal zone and is characterized by spontaneous and/or regular reflux of the gastric or duodenal fluid that leads to the damage of the distal part of the esophagus. GERD is one of the most frequent diseases that affect the esophagus. Taking into the account the huge amount of the causes, which may lead to GERD, its etiology is still not well defined, and the contribution of each factor requires further analysis. The aim of the study was to analyze the peculiarities and the incidence of GERD association with other organ and system pathologies.Materials and methods. Clinical analysis of 73 cases of GERD in school-aged children has been performed. The incidence of GERD combination with other system and organ pathologies has been evaluated using thorough anamnesis and patient’s medical history analysis. Results. In 66 % of children with GERD, the association of this pathology with other digestive tract diseases has been revealed, in 50.7 % — with lesions of musculoskeletal system, in 12.3 % — with urinary tract pathology. Almost one third of children with GERD suffered from congenital defects of different organs and systems, such as dolichosigmoid, mitral valve prolapse, nephroptosis/rotation of the kidneys/pyelectasis/bladder-pelvic reflux, gallbladder deformities. The article presents the analysis of a clinical case of the combination of cardiovascular, digestive and urinary lesions that enables us to assume the presence of possible common etiology factor of the diagnosed diseases. The analyzed data regarding the association of GERD with other organ and system pathologies, as well as the results of other research groups indicate a probable common component in their etiology. The common factor in the described cases of the combination of pathologies may be a violation of the

  17. GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH FUNCTIONAL DYSPEPSIA AND CONSTIPATION PREDOMINANT IRRITABLE BOWEL SYNDROME: CLINICAL FEATURES AND EFFICACY OF LACTULOSE AND ITOPRIDE HYDROCHLORIDE

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    O. V. Krapivnaya

    2014-01-01

    Full Text Available Background: The frequent coexistence of gastroesophageal reflux disease (GERD with functional dyspepsia (FD and an irritable bowel syndrome (IBS has been described in the literature. Aim: To study the specific features of GERD clinical course and diagnosis in patients with GERD in combination with FD and constipation predominant IBS (IBS-C in comparison to patients with isolated GERD; to assess the efficacy of lactulose and itopride hydrochloride. Materials and methods: A total of 60 patients with GERD, FD (Rome criteria III, and IBS-C (Rome criteria III and 29 patients with isolated GERD were examined. GERD diagnosis was based on clinical, endoscopic, and pH-metric criteria. For 4 weeks 10 patients with combination of non-erosive reflux disease (NERD, FD and IBS-C received lactulose monotherapy and other 10 patients received combination of lactulose with itopride hydrochloride. Clinical symptoms and pH-metric parameters were assessed before and 4 weeks after treatment. Results: Combination of GERD, FD and IBS-C was noted more frequently in women under 40 with normal body mass index (р<0.05. Classic GERD symptoms were absent in 43.4% of patients with gastrointestinal comorbidity and in 10.3% of patients with isolated GERD (р=0.004. A higher prevalence of belching and nausea was found in patients, suffering from GERD, FD and IBS-C, than in those with isolated GERD (р<0.05. After 4-week lactulose and itopride hydrochloride treatment all the patients with GERD, FD and IBS-C showed a reduction of clinical symptoms (p<0.05 and normalization of pH-metric parameters (р<0.001. Conclusion: GERD course in patients with concomitant FD and IBS-C has the following peculiarities: predominance of women, absence of classic GERD-symptoms in almost half of these patients, and frequent combination with other functional symptoms. Combination therapy with lactulose and itopride hydrochloride enables successful control of GERD and FD symptoms as well as

  18. Esophagogastric junction contractile integral and morphology: Two high-resolution manometry metrics of the anti-reflux barrier.

    Science.gov (United States)

    Ham, Hyoju; Cho, Yu Kyung; Lee, Han Hee; Yoon, Seung Bae; Lim, Chul-Hyun; Kim, Jin Su; Park, Jae Myung; Choi, Myung-Gyu

    2017-08-01

    We evaluated associations of esophagogastric junction (EGJ) metrics as an anti-reflux barrier with impedance-pH, endoscopic esophagitis, and lower esophageal sphincter (LES) metrics. We reviewed high-resolution manometry data from consecutive patients with gastroesophageal reflux disease (GERD) symptoms who underwent impedance-pH and endoscopy, and asymptomatic volunteers. The EGJ contractile integral (CI) was calculated as the mean contractile integral/second during three respiratory cycles. EGJ morphology was classified according to LES-crural diaphragm (CD) separation. In total, 137 patients (65 male, age 55 years) and 23 (9 male, age 33 years) controls were enrolled. Twenty-five patients had erosive reflux disease (ERD), 16 had non-erosive reflux disease (NERD), 5 had reflux hypersensitivity, and 91 were not GERD. EGJ-CI were lower in patients with GERD (22.6 [13.8-29.2] mmHg cm) than non-GERD (50.3 [31-69.9] mmHg cm, P integral showed good diagnostic accuracy with high specificity in predicting GERD. LES-CD separation is associated with an increase in acid reflux, but EGJ-CI was associated more strongly with GERD than was EGJ morphology. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  19. Overlapping gastroesophageal reflux disease and irritable bowel syndrome:Increased dysfunctional symptoms

    Institute of Scientific and Technical Information of China (English)

    Shadi; Sadeghi; Yarandi; Siavosh; Nasseri-Moghaddam; Pardis; Mostajabi; Reza; Malekzadeh

    2010-01-01

    AIM:To investigate the association of gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) in Iranian patients and examine the prevalence of functional symptoms of the gastrointestinal tract in patients presenting with either IBS, GERD or both.METHODS: Six thousand four hundred and seventy six patients presented to the Gastro-intestinal (GI) clinic with symptoms of functional dysfunction of GI tract, 1419 patients (62.0% women, 38.0% men; mean age: 37.4±11.5 years) met Rome or Rome crit...

  20. Residence of liquids in the infra-junctional portion of the proximal stomach in patients with gastroesophageal reflux disease

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    Barbieri C.L.A.

    2005-01-01

    Full Text Available Patients with gastroesophageal reflux disease may have disturbances of gastric motility, which could play a role in the pathophysiology of the disease. Recent studies have suggested that the gastric region just below the gastroesophageal junction may have a distinct physiological behavior. We determined whether patients with gastroesophageal reflux disease have abnormal residence of food in the infra-junctional portion of the stomach after ingesting a liquid nutrient meal. Fasted adult patients with reflux disease (N = 11 and healthy volunteers (N = 10 ingested a liquid meal (320 ml; 437 kcal labeled with 99m technetium-phytate and their total gastric emptying half-time and regional emptying from the stomach infra-junctional region were determined. In 8 patients, episodes of postprandial acidic reflux to the esophagus were measured for 2 h using pH monitoring. There were no differences between reflux patients and controls regarding total gastric emptying time (median: 68 min; range: 39-123 min vs 65 min and 60-99 min, respectively; P > 0.50. Food residence in the infra-junctional area was similar for patients and controls: 23% (range: 20-30 vs 27% (range: 19-30%; P = 0.28 and emptying from this area paralleled total gastric emptying (Rs = 0.79; P = 0.04. There was no correlation between residence of food in the infra-junctional area and episodes of gastroesophageal reflux (Rs = 0.06; P = 0.88. We conclude that it is unlikely that regional motor disturbances involving the infra-junctional region of the stomach play a relevant role in the pathogenesis of acidic gastroesophageal reflux.

  1. LATE EVALUATION OF PATIENTS OPERATED FOR GASTROESOPHAGEAL REFLUX DISEASE BY NISSEN FUNDOPLICATION

    Science.gov (United States)

    RIBEIRO, Maxwel Capsy Boga; de ARAÚJO, Amanda Bueno; TERRA-JÚNIOR, Juverson Alves; CREMA, Eduardo; ANDREOLLO, Nelson Adami

    2016-01-01

    ABSTRACT Background: Surgical treatment of GERD by Nissen fundoplication is effective and safe, providing good results in the control of the disease. However, some authors have questioned the efficacy of this procedure and few studies on the long-term outcomes are available in the literature, especially in Brazil. Aim: To evaluate patients operated for gastro-esophageal reflux disease, for at least 10 years, by Nissen fundoplication. Methods: Thirty-two patients were interviewed and underwent upper digestive endoscopy, esophageal manometry, 24 h pH monitoring and barium esophagogram, before and after Nissen fundoplication. Results: Most patients were asymptomatic, satisfied with the result of surgery (87.5%) 10 years after operation, due to better symptom control compared with preoperative and, would do it again (84.38%). However, 62.5% were in use of some type of anti-reflux drugs. The manometry revealed lower esophageal sphincter with a mean pressure of 11.7 cm H2O and an average length of 2.85 cm. The average DeMeester index in pH monitoring was 11.47. The endoscopy revealed that most patients had a normal result (58.06%) or mild esophagitis (35.48%). Barium swallow revealed mild esophageal dilatation in 25,80% and hiatal hernia in 12.9% of cases. Conclusion: After at least a decade, most patients were satisfied with the operation, asymptomatic or had milder symptoms of GERD, being better and with easier control, compared to the preoperative period. Nevertheless, a considerable percentage still employed anti-reflux medications. PMID:27759771

  2. Comorbidities in severe asthma: frequency of rhinitis, nasal polyposis, gastroesophageal reflux disease, vocal cord dysfunction and bronchiectasis

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    Carla Bisaccioni

    2009-01-01

    Full Text Available OBJECTIVES: Severe asthma is found in approximately 10% of patients with asthma. Some factors associated with worse asthma control include rhinitis, gastroesophageal reflux disease, vocal cord dysfunction (VCD, nasal polyposis and bronchiectasis. Therefore, we evaluated the prevalence of these illnesses in patients with severe asthma. METHODS: We conducted a retrospective analysis of data obtained from electronic medical records of patients with severe asthma between January 2006 and June 2008. Symptoms of rhinitis and gastroesophageal reflux disease were evaluated as well as intolerance to nonsteroidal anti-inflammatory drugs. We evaluated the results of esophagogastroduodenoscopy, videolaryngoscopy and CT scans of the chest in order to confirm gastroesophageal reflux disease, nasal polyposis, vocal cord dysfunction and bronchiectasis. RESULTS: We evaluated 245 patients. Rhinitis symptoms were present in 224 patients (91.4%; 18 (7.3% had intolerance to nonsteroidal anti-inflammatory drugs, and 8 (3.3% had nasal polyposis. Symptoms of gastroesophageal reflux disease were reported for 173 (70.6% patients, although the diagnosis of gastroesophageal reflux disease was confirmed based on esophagogastroduodenoscopy or laryngoscopy findings in just 58 (33.6% patients. Vocal cord dysfunction was suspected in 16 (6.5% and confirmed through laryngoscopy in 4 (1.6%. The patient records provided CT scans of the chest for 105 patients, and 26 (24.8% showed bronchiectasis. DISCUSSION: Rhinitis and gastroesophageal reflux disease were the most common comorbidities observed, in addition to bronchiectasis. Therefore, in patients with severe asthma, associated diseases should be investigated as the cause of respiratory symptoms and uncontrolled asthma.

  3. Weight Loss Can Lead to Resolution of Gastroesophageal Reflux Disease Symptoms: A Prospective Intervention Trial

    Science.gov (United States)

    Singh, Mandeep; Lee, Jaehoon; Gupta, Neil; Gaddam, Srinivas; Smith, Bryan K.; Wani, Sachin B.; Sullivan, Debra K.; Rastogi, Amit; Bansal, Ajay; Donnelly, Joseph E.; Sharma, Prateek

    2013-01-01

    Objective Weight gain is an important risk factor for gastroesophageal reflux disease (GERD); however, whether weight loss can lead to resolution of GERD symptoms is not clear. Our aim was to measure the impact of weight loss on GERD symptoms. Design and Methods In a prospective cohort study at a tertiary referral center, overweight/obese subjects (BMI 25-39.9 kg/m2) were enrolled in a structured weight loss program. Weight loss strategies included dietary modifications, increased physical activity and behavioral changes. At baseline and at 6 months, BMI and waist circumference were measured and all participants completed a validated reflux disease questionnaire. Results A total of 332 adult subjects, mean age 46 years and 66% women were prospectively enrolled. At baseline, the mean body weight, BMI, and waist circumference were 101 (±18) kg, 35 (±5) kg/m2 and 103 (±13) cm. At 6 months, majority of the subjects (97%) lost weight (average weight loss: 13 ± 7.7 kg) and as compared with baseline, there was a significant decrease in the overall prevalence of GERD (15 vs. 37%; P weight loss and reduction in GERD symptom scores (r = 0.17, P weight loss program can lead to complete resolution of GERD symptoms in the majority of these subjects. PMID:23532991

  4. Electrical stimulation for gastroesophageal reflux disease: current state of the art

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    Kim SE

    2016-01-01

    Full Text Available Sharon E Kim, Edy Soffer Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Abstract: Patients with gastroesophageal reflux disease (GERD who are not satisfied with acid suppression therapy can benefit primarily from fundoplication, a surgical intervention. Fundoplication has been the standard surgical procedure for GERD. It is effective but is associated with adverse effects, resulting in a declining number of interventions, creating a need for alternative interventions that are effective, yet have a better adverse effect profile. One such alternative involves the application of electrical stimulation to the lower esophageal sphincter. A number of animal studies showed that such stimulation can increase resting lower esophageal sphincter pressure. An acute human study confirmed this effect, and was followed by two open-label studies, with a follow-up of up to 3 years. Results thus far show that the therapy is associated with a significant improvement in symptoms, a significant reduction in esophageal acid exposure, and a very good safety profile. This review will describe the evolution of electrical stimulation therapy for GERD, as well as the safety and efficacy of this intervention. Keywords: gastroesophageal reflux disease, lower esophageal sphincter, health-related quality of life

  5. A proton pump inhibitor, lansoprazole, ameliorates asthma symptoms in asthmatic patients with gastroesophageal reflux disease.

    Science.gov (United States)

    Shimizu, Yasuo; Dobashi, Kunio; Kobayashi, Setsuo; Ohki, Ichiro; Tokushima, Masahiko; Kusano, Motoyasu; Kawamura, Osamu; Shimoyama, Yasuyuki; Utsugi, Mitsuyoshi; Sunaga, Noriaki; Ishizuka, Tamotsu; Mori, Masatomo

    2006-07-01

    Aspiration of acid to the airway causes airway inflammation, and acid stress to the airway caused by gastroesophageal reflux disease (GERD) has been known as a potential mechanism of deteriorated asthma symptoms. However, the efficacy of the acid suppressive drugs, H(2)-receptor blockers (H(2) blocker) and proton pump inhibitors, on asthma symptoms and pulmonary functions remains controversial. We therefore designed the randomized prospective study to determine the efficacy of an H(2) blocker (roxatidine, 150 mg/day) and a proton pump inhibitor (lansoprazole, 30 mg/day) on asthma symptoms of 30 asthmatic patients with GERD. These patients were divided in the two groups (15 patients for each group) and treated with either roxatidine or lansoprazole. The diagnosis of GERD was established by the method of Los Angeles classification including mucosal minimum change of Grade M and questionnaire for the diagnosis of reflux disease (QUEST) score. The efficacy of acid suppressive drugs was evaluated by peak expiratory flow (PEF), asthma control questionnaire (ACQ) that evaluates the improvement of asthma symptoms, and forced expiratory volume in 1 second (FEV(1.0)). Lansoprazole, but not roxatidine, significantly improved PEF and ACQ scores (p < 0.05) with the improved QUEST scores. However, these acid suppressive drugs did not change the pulmonary function of FEV(1.0) in asthmatic patients. In conclusion, treatment with a proton pump inhibitor, lansoprazole, appears to be useful in improvement of asthma symptoms in asthmatic patients with GERD.

  6. The Reflux Disease Questionnaire: a measure for assessment of treatment response in clinical trials

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    Junghard Ola

    2008-04-01

    Full Text Available Abstract Background Critical needs for treatment trials in gastroesophageal reflux disease (GERD include assessing response to treatment, evaluating symptom severity, and translation of symptom questionnaires into multiple languages. We evaluated the previously validated Reflux Disease Questionnaire (RDQ for internal consistency, reliability, responsiveness to change during treatment and the concordance between RDQ and specialty physician assessment of symptom severity, after translation into Swedish and Norwegian. Methods Performance of the RDQ after translation into Swedish and Norwegian was evaluated in 439 patients with presumed GERD in a randomized, double-blind trial of active treatment with a proton pump inhibitor. Results The responsiveness was excellent across three RDQ indicators. Mean change scores in patients on active treatment were large, also reflected in effect sizes that ranged from a low of 1.05 (dyspepsia to a high of 2.05 (heartburn and standardized response means 0.99 (dyspepsia and 1.52 (heartburn. A good positive correlation between physician severity ratings and RDQ scale scores was seen. The internal consistency reliability using alpha coefficients of the scales, regardless of language, ranged from 0.67 to 0.89. Conclusion The results provide strong evidence that the RDQ is amenable to translation and represents a viable instrument for assessing response to treatment, and symptom severity.

  7. Managing peptic ulcer and gastroesophageal reflux disease in elderly Chinese patients--focus on esomeprazole.

    Science.gov (United States)

    Tang, Raymond S Y; Wu, Justin C Y

    2013-01-01

    Peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD) are not uncommon in elderly patients. Clinical presentations of these acid-related disorders may be atypical in the geriatric population. Older individuals are at increased risk for poor outcomes in complicated PUD and for development of GERD complications. Multiple risk factors (eg, Helicobacter pylori [HP], use of nonsteroidal anti-inflammatory drugs [NSAIDs], aspirin) contribute to the development of PUD. Recent data has shown that HP-negative, NSAID-negative idiopathic peptic ulcers are on the rise and carry a higher risk of recurrent ulcer bleeding and mortality. Effective management of PUD in the geriatric population relies on identification and modification of treatable risk factors. Elderly patients with GERD often require long-term acid suppressive therapy. Proton pump inhibitors (PPI) including esomeprazole are effective in the treatment of reflux esophagitis, maintenance of GERD symptomatic control, and management of PUD as well as its complications. Potential safety concerns of long-term PPI use have been reported in the literature. Clinicians should balance the risks and benefits before committing elderly patients to long-term PPI therapy.

  8. The effects of tegaserod (HTF 919) on oesophageal acid exposure in gastro-oesophageal reflux disease.

    Science.gov (United States)

    Kahrilas, P J; Quigley, E M; Castell, D O; Spechler, S J

    2000-11-01

    Tegaserod (HTF 919), a 5-HT4 receptor partial agonist, has prokinetic effects that might be useful in decreasing acid reflux in gastro-oesophageal reflux disease (GERD). To investigate the potential clinical utility of tegaserod in GERD, a five-period crossover study (balanced Latin square) was designed to evaluate the efficacy of 4 b.d. doses of tegaserod vs. placebo. Four-hour manometry (1 h fasting and 3 h postprandial) with continuous recording of lower oesophageal sphincter pressure and distal oesophageal pH, was performed at the end of each 2-week treatment period in 19 patients with mild-to-moderate GERD. Recordings were scored for mean lower oesophageal sphincter pressure, number of transient lower oesophageal sphincter relaxations, and distal oesophageal acid exposure. Tegaserod (1 mg/day and 4 mg/day) caused a more than 50% decrease in acid exposure in the postprandial period in patients with abnormal acid exposure, although only the 1 mg/day tegaserod treatment elicited statistically significant decreasing (P < 0.05) for the entire treatment group (percentage time for which pH < 4: placebo=13%; 1 mg/day dose=5%; 4 mg/day dose=8%). A decreased number of reflux episodes was demonstrated with both the 1 mg/day and 4 mg/day tegaserod doses. There was no apparent effect on mean lower oesophageal sphincter pressure, whilst transient lower oesophageal sphincter relaxations frequency decreased in the 1-2.5 h post-dose. Tegaserod in a dose of 1 mg/day causes a significant decrease in postprandial oesophageal acid exposure. The reduction in oesophageal acid exposure with tegaserod treatment may result from enhanced oesophageal acid clearance, improved gastric emptying, and/or reduced transient lower oesophageal sphincter relaxations.

  9. Scintigraphy in laryngopharyngeal and gastroesophageal reflux disease: a definitive diagnostic test?

    Science.gov (United States)

    Falk, Gregory L; Beattie, John; Ing, Alvin; Falk, S E; Magee, Michael; Burton, Leticia; Van der Wall, Hans

    2015-03-28

    To investigate the utility of scintigraphic studies in predicting response to laparoscopic fundoplication (LF) for chronic laryngopharyngeal reflux symptoms. Patients with upper aero-digestive symptoms that remained undiagnosed after a period of 2 mo were studied with conventional pH and manometric studies. Patients mainly complained of cough, sore throat, dysphonia and globus. These patients were imaged after ingestion of 99m-technetium diethylene triamine pentaacetic acid. Studies were quantified with time activity curves over the pharynx, upper and lower oesophagus and background. Late studies of the lungs were obtained for aspiration. Patients underwent LF with post-operative review at 3 mo after surgery. Thirty four patients (20 F, 14 M) with an average age of 57 years and average duration of symptoms of 4.8 years were studied. Twenty four hour pH and manometry studies were abnormal in all patients. On scintigraphy, 27/34 patients demonstrated pharyngeal contamination and a rising or flat pharyngeal curve. Lung aspiration was evident in 50% of patients. There was evidence of pulmonary aspiration in 17 of 34 patients in the delayed study (50%). Pharyngeal contamination was found in 27 patients. All patients with aspiration showed pharyngeal contamination. In the 17 patients with aspiration, graphical time activity curve showed rising activity in the pharynx in 9 patients and a flat curve in 8 patients. In those 17 patients without pulmonary aspiration, 29% (5 patients) had either a rising or flat pharyngeal graph. A rising or flat curve predicted aspiration with a positive predictive value of 77% and a negative predictive value of 100%. Over 90% of patients reported a satisfactory symptomatic response to LF with an acceptable side-effect profile. Scintigraphic reflux studies offer a good screening tool for pharyngeal contamination and aspiration in patients with gastroesophageal reflux disease.

  10. Quality of life scales for patients with gastroesophageal reflux disease: A literature review

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    Xiao-Li Guan

    2015-03-01

    Full Text Available Gastroesophageal reflux disease (GERD is a common chronic disease of the gastrointestinal tract that occurs in 3.1% of the Chinese population [1]. Heartburn, acid regurgitation and epigastric pain are typical clinical symptoms of GERD. These symptoms can affect patients' work productivity, sleep, diet and daily activities, thus resulting in a reduced quality of life (QOL [2]. Although patient QOL is increasingly being considered as a medical outcome index in the evaluation of the impact of GERD symptoms on patients' health status, measuring patient QOL in clinical trials can be challenging due to the lack of a standard assessment tool. Therefore, we aim to review the commonly used generic, disease-specific and hybrid QOL questionnaires to evaluate patients with GERD to provide a reference for clinical nursing work.

  11. Evidence-based appraisal in laparoscopic Nissen and Toupet fundoplications for gastroesophageal reflux disease

    Science.gov (United States)

    Shan, Cheng-Xiang; Zhang, Wei; Zheng, Xiang-Min; Jiang, Dao-Zhen; Liu, Sheng; Qiu, Ming

    2010-01-01

    AIM: To demonstrate the optimal surgical procedure for gastroesophageal reflux disease. METHODS: The electronic databases of Medline, Elsevier, Springerlink and Embase over the last 16 years were searched. All clinical trials involved in the outcomes of laparoscopic Nissen fundoplication (LNF) and laparoscopic Toupet fundoplication (LTF) were identified. The data of assessment in benefits and adverse results of LNF and LTF were extracted and compared using meta-analysis. RESULTS: We ultimately identified a total of 32 references reporting nine randomized controlled trials, eight prospective cohort trials and 15 retrospective trials. These studies reported a total of 6236 patients, of whom 4252 (68.18%) underwent LNF and 1984 (31.82%) underwent LTF. There were no differences between LNF and LTF in patients’ satisfaction, perioperative complications, postoperative heartburn, reflux recurrence and re-operation. Both LNF and LTF enhanced the function of lower esophageal sphincter and improved esophagitis. The postoperative dysphagia, gas-bloating syndrome, inability to belch and the need for dilatation after LNF were more common than after LTF. Subgroup analyses showed that dysphagia after LNF and LTF was similar in patients with normal esophageal peristalsis (EP), but occurred more frequently in patients with weak EP after LNF than after LTF. Furthermore, patients with normal EP after LNF still had a higher risk of developing dysphagia than did patients with abnormal EP after LTF. CONCLUSION: Compared with LNF, LTF offers equivalent symptom relief and reduces adverse results. PMID:20572311

  12. National consensus on the management of gastroesophageal reflux disease in Indonesia.

    Science.gov (United States)

    2014-07-01

    Gastroesophageal reflux disease (GERD) is a disorder, which gastric content repeatedly reflux into the esophagus causing disturbing symptoms and/or complications. Various epidemiological studies show that there is regional difference on the aspect of prevalence and clinical manifestation. Regional data also demonstrates increased incidence of complications such as the Barret's Esophagus and adenocarcinoma. In response to the situation, the Asia-Pacific GERD experts, including Indonesia, had published a consensus on the management of GERD in 2004, which was subsequently revised in 2008. Advances in medical technology, especially on gastrointestinal endoscopy technique and other diagnostic instruments such as 24-hour pH-metry and manometry, have improved the capacity of management of GERD. On the other hand, we feel that adequate knowledge and skills of doctors, both for general physicians and specialists of internal medicine in our country are not well-distributed. Moreover, the availability of instruments for diagnostic and therapeutical supports differs from one region to the others. The Organizing Committee of Indonesian Society of Gastroenterology or Pengurus Besar Perkumpulan Gastroenterologi Indonesia (PB PGI) considers that it is important to revise the National Consensus on the Management of GERD in Indonesia 2004, which is expected to be the guideline of GERD management.

  13. Association between Gastroesophageal Reflux Disease and Appendicitis: A Population-Based Case-Control Study.

    Science.gov (United States)

    Kao, Li-Ting; Tsai, Ming-Chieh; Lin, Herng-Ching; Lee, Cha-Ze

    2016-03-02

    Appendicitis and gastroesophageal reflux disease (GERD) are both prevalent diseases and might share similar pathological mechanisms. The aim of this study was to investigate the association between GERD and appendicitis using a large population-based dataset. This study used administrative claims data from the Taiwan Longitudinal Health Insurance Database 2005. We identified 7113 patients with appendicitis as cases, and 28452 matched patients without appendicitis as controls. This study revealed that GERD was found in 359 (5.05%) cases and 728 (2.56%) controls (p appendicitis were 1.96 (95% CI: 1.56~2.47), 2.36 (95% CI: 1.94~2.88), and 1.71 (95% CI: 1.31~2.22) than controls, respectively. We concluded that patients with appendicitis had higher odds of prior GERD than those without appendicitis regardless of age group.

  14. Prosthetic Rehabilitation of a Patient with Gastroesophageal Reflux Disease: 4-Year Followup

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    Ricardo Coelho Okida

    2014-01-01

    Full Text Available The gastroesophageal reflux disease (GERD is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment.

  15. Does a melatonin supplement alter the course of gastroesophageal reflux disease?

    Institute of Scientific and Technical Information of China (English)

    Mariusz; H; Madalinski

    2011-01-01

    Symptomatic gastro-esophageal reflux disease(GERD) is a very common disease.The consequence of GERD is not only erosive esophagitis,but also esophageal stricture,Barrett’s esophagus and extra-esophageal damage(including the lungs,throat,sinuses,middle ear and teeth).GERD and Barrett’s esophagus are also identif ied as major risk factors for esophageal carcinoma.Therapy with melatonin prevents esophageal injury from acid-pepsin and acid-pepsin-bile exposure in animals,then further studies are required in humans to establish whether a melatonin supplement is able to protect the patients with GERD from erosions,Barrett’s and neoplasia.

  16. Efficacy of noofen use in the treatment of gastroesophageal reflux disease in schoolchildren

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    S.L. Nyankovskyy

    2017-05-01

    Full Text Available We examined 40 children aged 10–18 years, who were diagnosed with gastroesophageal reflux disease (GERD. According to a survey by O.M. Vein, all patients had manifestations of autonomic dysfunction. The children were divided into 2 groups. The control group consisted of 20 patients, who received standard antisecretory therapy. The main group consisted of 20 children, who received standard antisecretory therapy and phenibut (Noofen®, OlainFarm, Latvia at a dose of 250 mg 2 times a day for 21 days. After 1 month of starting the treatment, an evaluation of its efficacy was conducted. Clinical evaluation of the dynamics of autonomic nervous system status in schoolchildren with GERD suggests that inclusion of Noofen into the complex of therapy for this disease provides good stabilizing effect, which manifests by a restoration of autonomic nervous system balance in schoolchildren.

  17. Duodenal lipid-induced symptom generation in gastroesophageal reflux disease : role of apolipoprotein A-IV and cholecystokinin

    NARCIS (Netherlands)

    Van Boxel, O. S.; Ter Linde, J. J. M.; Oors, J.; Otto, B.; Feinle-Bisset, C.; Smout, A. J. P. M.; Siersema, P. D.

    2012-01-01

    Background Duodenal lipid intensifies the perception of esophageal acid perfusion. Recently, we showed that genes implicated in lipid absorption were upregulated in the duodenum of fasting gastro-esophageal reflux disease (GERD) patients. This suggests that chylomicron production and secretion may b

  18. Validation of the GSFQ, a Self-Administered Symptom Frequency Questionnaire for Patients with Gastroesophageal Reflux Disease

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    Pierre Paré

    2003-01-01

    Full Text Available BACKGROUND: Although the diagnosis of gastroesophageal reflux disease (GERD is based primarily on symptoms experienced by a patient, relatively little attention has been paid to the development and validation of self-administered questionnaires specific to GERD symptoms. The present article presents the validation of the short, self-administered GERD Symptom Frequency Questionnaire (GSFQ.

  19. Nonerosive gastroesophageal reflux disease and mild degree of esophagitis: Comparison of symptoms endoscopic, manometric and pH-metric patterns

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    Grande Michele

    2012-05-01

    Full Text Available Abstract Background Our aim in the present study was to compare patients presenting with gastroesophageal reflux disease in the presence or absence of mild-grade esophagitis (grade I or II according to the Savary-Miller classification. Methods Between 2005 and 2007, 215 patients with gastroesophageal reflux disease (67 with reflux associated with grade I or II esophagitis and 148 without esophagitis were evaluated at the Department of Surgery, University Hospital Tor Vergata, Rome, and were included in the present study. The evaluations consisted of clinical interviews, endoscopy of the high digestive tract, esophageal manometry and pH monitoring. Results There was no significant difference between the two groups with regard to age, sex or symptoms. The incidence of heartburn associated with noncardiac chest pain was greater in the esophagitis group than in the dysphagia group. The incidence of hiatal hernia was similar in both groups. Although the motor pattern was similar in both groups, the length of the abdominal esophagus was greater in patients without esophagitis (1.6 cm vs 1.1 cm; P  Conclusions Gastroesophageal reflux without esophagitis must be regarded not as a milder form of the disease but as part of a single disease. Furthermore, these patients often demonstrate lower rates of symptom improvement after antireflux treatment in comparison with patients with erosive esophagitis. Therefore, further trials to assess the treatment algorithm for these patients are warranted.

  20. A New Pathologic Assessment of Gastroesophageal Reflux Disease: The Squamo-Oxyntic Gap.

    Science.gov (United States)

    Chandrasoma, Parakrama; DeMeester, Tom

    Diagnosis of gastroesophageal reflux disease (GORD) is delayed by the lack of uniform histopathologic criteria for diagnosis. The only practical value of pathology is the assessment of columnar lined esophagus (CLO). As a result, GORD is treated with acid suppressive drug therapy until there is a failure to control symptoms and/or advanced adenocarcinoma develops. The reasons why there is a failure of pathologic diagnosis are two false dogmas that result in two widely believed fundamental errors. These are the belief that cardiac epithelium normally lines the proximal stomach (1) and that the gastroesophageal junction (GOJ) is defined by the proximal limit of rugal folds (2). When these false dogmas are eradicated by existing powerful evidence, the pathology of GERD falls into the following stages, all defined by histology: (a) The normal state where the esophageal squamous epithelium transitions at the GOJ to gastric oxyntic epithelium with no intervening cardiac epithelium; (b) cardiac metaplasia of the squamous epithelium due to exposure to gastric juice results in cephalad movement of the squamo-columnar junction (SCJ). This creates the squamo-oxyntic gap and the dilated distal esophagus, which is distal to the endoscopic GOJ. The length of the squamo-oxyntic gap in the dilated distal esophagus is concordant with the shortening of the abdominal segment of the lower esophageal sphincter (LOS); (c) in the early stages, the gap is gap increases in length, concordant with the amount of shortening of the LOS, which becomes increasingly incompetent. At a gap length of 5-15 mm, reflux is sufficient to cause symptoms, but in most patients, symptoms are controllable and the patients are normal at endoscopy. The gap is entirely within the dilated distal esophagus, which is mistaken by present criteria for proximal stomach. (e) The last stage of GORD is when the squamo-oxyntic gap is >15 mm. In these patients, reflux is severe with increasingly uncontrollable symptoms and

  1. Systematic review: the effects of carbonated beverages on gastro-oesophageal reflux disease.

    Science.gov (United States)

    Johnson, T; Gerson, L; Hershcovici, T; Stave, C; Fass, R

    2010-03-01

    Carbonated beverages have unique properties that may potentially exacerbate gastro-oesophageal reflux disease (GERD), such as high acidity and carbonation. Cessation of carbonated beverage consumption is commonly recommended as part of lifestyle modifications for patients with GERD. To evaluate the relationship of carbonated beverages with oesophageal pH, oesophageal motility, oesophageal damage, GERD symptoms and GERD complications. A systematic review. Carbonated beverage consumption results in a very short decline in intra-oesophageal pH. In addition, carbonated beverages may lead to a transient reduction in lower oesophageal sphincter basal pressure. There is no evidence that carbonated beverages directly cause oesophageal damage. Carbonated beverages have not been consistently shown to cause GERD-related symptoms. Furthermore, there is no evidence that these popular drinks lead to GERD complications or oesophageal cancer. Based on the currently available literature, it appears that there is no direct evidence that carbonated beverages promote or exacerbate GERD.

  2. Experimental human pain models in gastro-esophageal reflux disease and unexplained chest pain

    Institute of Scientific and Technical Information of China (English)

    Asbj(φ)rn Mohr Drewes; Lars Arendt-Nielsen; Peter Funch-Jensen; Hans Gregersen

    2006-01-01

    Methods related to experimental human pain research aim at activating different nociceptors, evoke pain from different organs and activate specific pathways and mechanisms. The different possibilities for using mechanical, electrical, thermal and chemical methods in visceral pain research are discussed with emphasis of combinations (e.g., the multimodal approach). The methods have been used widely in assessment of pain mechanisms in the esophagus and have contributed to our understanding of the symptoms reported in these patients. Hence abnormal activation and plastic changes of central pain pathways seem to play a major role in the symptoms in some patients with gastro-esophageal reflux disease and in patients with functional chest pain of esophageal origin. These findings may lead to an alternative approach for treatment in patients that does not respond to conventional medical or surgical therapy.

  3. The Effects of Gastroesophageal Reflux Disease on Forensic Breath Alcohol Testing.

    Science.gov (United States)

    Booker, James L; Renfroe, Kathryn

    2015-11-01

    Fifteen test subjects, 10 of whom were diagnosed with gastroesophageal reflux disease (GERD), were dosed with alcohol to BACs above 0.150 g/dL. Blood and breath assays taken at 20-min intervals for 8 h after dosing demonstrated close agreement between postabsorptive BAC and BrAC values. Three subjects exhibited elevated breath alcohol concentrations up to 0.105 g/dL during the absorptive phase that were apparently due to the passage of gastric alcohol through the lower esophageal sphincter not attributable to eruction or regurgitation. The effect of gastric alcohol was not consistently proportional to the amount of unabsorbed gastric alcohol. Absorption of alcohol in the esophagus explains the nonproportionality. Breath samples contaminated by GERD-related alcohol leakage from the stomach into a breath sample were found only when there was a high concentration of alcohol in the stomach. When contaminated breath samples were encountered, they were irreproducible in magnitude.

  4. Experience of antireflux surgery application for the treatment of gastroesophageal reflux disease

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    Tolstokorov A.S.

    2015-12-01

    Full Text Available Purpose of the study: post-hoc analysis of mid-term and late results of various types of antireflux surgery performed to treat hiatal hernia. Material and methods. We have studied results of post-surgery examination of 118 patients diagnosed with hiatal hernia, the examination being performed at various time intervals after surgeries. Results. The only benefits of using laparoscopic treatment include cosmetic effect, shorter terms of hospital stay and recovery of person's capacity to work. Conclusion. Analysis of immediate and late results of surgical treatment of gastroesophageal reflux disease as well as frequency of postsurgical relapses provided no certain evidence of significant beneficial effect for choosing laparoscopic surgical methods over traditional open surgery.

  5. Electrical stimulation therapy of the lower oesophageal sphincter for refractory gastro-oesophageal reflux disease - interim results of an international multicentre trial

    NARCIS (Netherlands)

    Kappelle, W.F.; Bredenoord, A.J.; Conchillo, J.M.; Ruurda, J.P.; Bouvy, N.D.; Henegouwen, M.I. van Berge; Chiu, P.W.; Booth, M.; Hani, A.; Reddy, D.N.; Bogte, A.; Smout, A.J.P.M.; Wu, J.C.; Escalona, A.; Valdovinos, M.A.; Torres-Villalobos, G.; Siersema, P.D.

    2015-01-01

    BACKGROUND: A previous single-centre study showed that lower oesophageal sphincter electrical stimulation therapy (LES-EST) in gastro-oesophageal reflux disease (GERD) patients improves reflux symptoms and decreases oesophageal acid exposure. AIM: To evaluate safety and efficacy of LES-EST in GERD p

  6. The endoscopic and clinical characteristics of patients with erosive reflux disease diagnosed in gastroscopy unit of a regional hospital

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    Mustafa Yakut

    2012-06-01

    Full Text Available Objectives: Gastroesophageal reflux disease (GERDis a common gastrointestinal disorder, presenting witha broad spectrum of symptoms and can be associatedwith a variety of complication. It has been defined intothree groups of patients: nonerosive reflux disease, erosiveesophagitis, and Barrett’s esophagus. The aim of thestudy was to evaluate patients with erosive reflux diseasein our endoscopic unit.Materials and methods: All patients underwent gastroscopywere evaluated retrospectively. H.pylori statuseswere evaluated in erosive reflux disease (ERD patients.All patients were evaluated by videoendoscopy. Evaluationwas made by the same operator at single center.Biopsy specimen was taken for H.pylori. Diagnosis ofesophagitis was done based on Los Angeles classificationcriteria.Results: All patients that underwent gastroscopy in ourEndoscopy Unit are evaluated. Endoscopically ERD wasdetected in 104 (13.5% of 773 patients. The mean age ofthe ERD patients evaluated in the study was 43.74±18.79years. Sixty five (62.3% patients were female, and 39(38.7% were male. In 104 patients with ERD, the slidinghiatal hernia and Barrett’s esophagus was seen in 18 and10 patients, respectively. H.pylori was positive in 50.9% of104 ERD patients.Conclusion: GERD is a common gastrointestinal disorderand should always be considered during gastroscopy.J Clin Exp Invest 2012; 3(2: 260-262

  7. Correlation of gastroesophageal reflux disease with positive family history and headache in Shiraz city, Southern Iran

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    Saberi-Firoozi Mehdi

    2007-01-01

    Full Text Available Background/Aims: To analyze the potential correlation of a positive family history of gastroesophageal reflux disease (GERD and the history of headaches as a risk factor for and complication of the disease. Materials and Methods: Three thousand and six hundred subjects were selected by cluster random sampling from all seven districts of Shiraz city, who were invited for interview. In five months, 1956 subjects participated in this study. A questionnaire organized into three sections of demographic, signs and symptoms of GERD, headache and family history of GERD was completed for each patient. Social and demographic variables were also recorded. Results: The presence of GERD symptoms (72% had a significant correlation with a positive family history of the disease ( P = 0.000. Patients showed a variable frequency of headache, ranging from once daily (16.7%, three to five times a week (5.6%, once-twice a week (26.7%, once to three times a month (15.0% and less than once a month (8.3%. There was a significant correlation between the headaches and the GERD symptoms ( P = 0.000. Conclusion: A positive family history of GERD can be considered as a risk factor for the disease and the presence of headache at the time of diagnosis as a complication of this disease. Therefore, in the management of GERD, attention should be given to these factors.

  8. Prevalence of linked angina and gastroesophageal reflux disease in general practice

    Institute of Scientific and Technical Information of China (English)

    Hirohito Kato; Takamasa Ishii; Tatsuo Akimoto; Yoshihisa Urita; Motonobu Sugimoto

    2009-01-01

    AIM: To evaluate the association between gastroesophageal reflux diseases (GERD) and coronary heart diseases. METHODS: One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography (ECG) was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as Stsegment depression based on the Minnesota code. RESULTS: Among 712 patients (36%) with GERD, ECG was performed in 171 (24%), and ischemic changes were detected in eight (5%). Four (50%) of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients (0.6%; 4/712) were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 (7%) had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% (8/1970 patients). CONCLUSION: The present study suggested that ischemic heart disease might be found although apatient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms.

  9. Evaluation of the Serum Zinc Level in Erosive and Non-Erosive Oral Lichen Planus

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    Gholizadeh N.

    2013-10-01

    Full Text Available Statement of Problem: Lichen planus is a chronic inflammatory immunologic-based disease involving skin and mucosa. This disease is generally divided into two categories: erosive and non-erosive. Many etiologic factors are deliberated regarding the disease; however, the disorders of immune system and the role of cytotoxic T-lymphocytes and monocytes are more highlighted. Zinc is an imperative element for the growth of epithelium and its deficiency induces the cytotoxic activity of T-helper2 cells which seems to be associated with lichen planus. Purpose: This study aimed to evaluate the levels of serum zinc in erosive and non-erosive oral lichen planus (OLP and compares it with the healthy control group to find out any feasible inference. Materials and Method: A total of 22 patients with erosive oral lichen planus, 22 pa-tients with non erosive OLP and 44 healthy individuals as the control group were recruited in this descriptive-comparative study. All the participants were selected from the referees to the department of oral medicine, school of dentistry, Tabriz University of medical sciences. Serum zinc level was examined for all the individuals with liquid-stat kit (Beckman Instruments Inc., Carlsbad, CA. Data were analyzed by adopting the ANOVA and Tukey tests through SPSS 16 statistical software. Results: The mean age of patients with erosive and non-erosive LP was 41.7 and 41.3 years, respectively. The mean age of the healthy control group was 34.4 years .The mean serum zinc levels in the erosive and non erosive lichen planus groups and control groups were 8.3 (1.15, 11.15 (0.92 and 15.74 (1.75 μg/dl respectively. The difference was statistically significant (p< 0.05. Conclusion: The serum zinc levels were decreased in patients with erosive oral lichen planus. This finding may probably indicate the promising role of zinc in development of oral lichen planus.

  10. Relationship between esomeprazole dose and timing to heartburn resolution in selected patients with gastroesophageal reflux disease

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    Roy C Orlando

    2010-09-01

    Full Text Available Roy C Orlando1, Sherry Liu2, Marta Illueca31Department of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA, 2Department of Statistics and Informatics, 3Department of Clinical Development, AstraZeneca LP, Wilmington, DE, USAObjective: To increase response rates to therapy by increasing the dosage of proton pump inhibitor (PPI therapy in patients with gastroesophageal reflux disease (GERD whose symptoms are predominantly associated with acid reflux.Methods: In this double-blind, randomized, proof-of-concept study, 369 patients with GERD and moderate heartburn lasting ≥three days/week, a history of response to antacids/acid suppression therapy, and a positive esophageal acid perfusion test result were randomized to esomeprazole 20 or 40 mg once daily, or to 40 mg twice daily for four weeks. Heartburn symptom relief/resolution was subsequently evaluated.Results: In this study population, no relationship was apparent between esomeprazole dosage and efficacy variables for sustained heartburn resolution (seven days without symptoms at week 4 (48.0%, 44.0%, and 41.4% for esomeprazole 20 mg once daily, 40 mg once daily, and 40 mg twice daily, respectively. Nocturnal heartburn resolution with esomeprazole 40 mg twice daily showed a numeric improvement trend versus esomeprazole 20 and 40 mg once daily, but this was not statistically significant.Conclusions: Heartburn resolution rates at four weeks were similar for all esomeprazole dosages and comparable with rates reported previously, suggesting a plateau effect in terms of clinical response to acid suppression with PPI therapy in this population of selected GERD patients.Keywords: acid suppressive therapy, GERD, proton pump inhibitor

  11. Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Matthijs; P; Schwartz; J; Rieneke; C; Schreinemakers; André; J; P; M; Smout

    2013-01-01

    AIM:To evaluate the long-term effect of Endocinch treatment for gastroesophageal reflux disease(GERD).METHODS:After unblinding and crossover,50 patients(32 males,18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized,placebo-controlled,single-center study,and included in the present prospective open-label follow-up study.Initially,three gastroplications using the Endocinch device were placed under deep sedation in a standardized manner.Optional retreatment was offered in the first year with 1 or 2 extra gastroplications.At baseline,3 mo after(re) treatment and yearly proton pump inhibitor(PPI) use,GERD symptoms,quality of life(QoL) scores,adverse events and treatment failures(defined as:patients using > 50% of their baseline PPI dose or receiving alternative antireflux therapy) were assessed.Intention-to-treat analysis was performed.RESULTS:Median follow-up was 48 mo [interquartile range(IQR):38-52].Three patients were lost to follow-up.In 44% of patients retreatment was done after a median of 4 mo(IQR:3-8).No serious adverse events occurred.At the end of follow-up,symptom scores and4 out of 6 QoL subscales were improved(all P < 0.01compared to baseline).However,80% of patients required PPIs for their GERD symptoms.Ultimately,64% of patients were classified as treatment failures.In 60% a post-procedural endoscopy was carried out,of which in 16% reflux esophagitis was diagnosed.CONCLUSION:In the 4-year follow-up period,the subset of GERD patients that benefit from endoscopic gastroplication kept declining gradually,nearly half opted for retreatment and 80% required PPIs eventually.

  12. Prevalence and risk factors of gastroesophageal reflux disease in Qashqai migrating nomads, southern Iran

    Institute of Scientific and Technical Information of China (English)

    Ahmad Mostaghni; Davood Mehrabani; Farnaz Khademolhosseini; Seyed Jalil Masoumi; Fariba Moradi; Najaf Zare; Mehdi Saberi-Firoozi

    2009-01-01

    AIM: To investigate the prevalence and risk factors of gastroesophageal reflux disease (GERD) symptoms in Qashqai migrating nomads with a different life style in Fars province, southern Iran. METHODS: In summer 2006, 748 Qashqai migrating nomads aged 25 years or more were enrolled using a multiple-stage stratified cluster random sampling method. A questionnaire consisting of demographic characteristics, lifestyle and GERD symptoms (heartburn, regurgitation, chest pain, dysphagia, hoarseness and cough) as completed for each subject. RESULTS: The questionnaire was completed in 717 subjects. The prevalence rate of GERD, defined as reflux occurring at least one time per week in the preceding year, was 33% (237 subjects). The prevalence was higher in older individuals (36.0% vs 28.9%, P < 0 . 0 5 ) a n d i n t h o s e w i t h o t h e r gastrointestinal complaints (51.0% vs 27.8%, P < 0.001), but not different in obese and non-obese subjects. It was also higher in those consuming fruits and vegetables more than once a week (36.2% vs 17.3%, P < 0.001). GERD had a positive correlation with smoking (42.1% vs 27.8%, P < 0.001), but a negative relation with non-alcoholic beverages. The association between GERD and non-steroidal antiinflammatory drugs (NSAIDs) consumption was also significant (40.2% vs 25.4%, P < 0.001). CONCLUSION: The prevalence of GERD (33%) is very high in Qashqai migrating nomads which may be due to a lower socioeconomic and educational level of these people and difference in the life style. Older age, frequent consumption of fruits and vegetables, smoking and NSAIDs are risk factors for GERD in this population.

  13. The Evaluation of Gastroesophageal Reflux Disease with Esophageal pH Monitorization in Children

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    Gülin Erdemir

    2009-12-01

    Full Text Available Introduction: Gastroesophageal reflux disease is named when gastroesophageal reflux becomes symptomatic, influences the life comfort, and results in morbidity. In this study, we aimed to evaluate the patients admitted with GER-associated symptoms with demographic characteristics, 24-hour esophageal pH monitorization results, and responses to different treatment protocols. Materials and Method: The data of patients who admitted to Uludag University Pediatrics Outpatient Clinic between January 2008 and September 2009 with GERD-associated symptoms and underwent esophageal pH monitorization was collected retrospectively. The associations between initial symptoms, 24-hour esophageal pH monitorization results, presence of accompanying disease, sociocultural conditions, and therapy responses were evaluated. Results: Ninety-two patients (37 female, 55 male were included and mean age was 4.42±4.33 (1 mo-18 years. The frequency of cough, vomiting and abdominal pain at admission were 49.5%, 47.3% and 22% respectively. Esophageal pH monitorization diagnosed GERD in 21 patients (22.8%. The frequency of symptoms in GERD patients who diagnosed with esophageal pH monitorization was; cough (n:15, 33.4%, vomiting (n:11, 25.6%, and abdominal pain (n:5, 22.3%. Among all complaints, cough was found to be significantly associated with GERD (p=0.041. Accompanying neurological disease was present in 13.1% (n:12, immunodeficiency 13.1% (n:12 and bronchial reactivity 13.1% (n:12. Therapy success was achieved in 57.7% of patients. Therapy response were similar with different therapy protocols (proton pump inhibitor+prokinetic+sucralfate, proton pump inhibitor+prokinetic, H2 receptor blocker+sucralfate, proton pump inhibitor+sucralfate, H2 receptor blocker+ prokinetic, monotherapy with proton pump inhibitor or H2 receptor blocker (p=0.068.Conclusion: GERD is a common childhood disease. Currently, diagnosis and treatment of GERD in children is still controversial. The

  14. Correlation between severity of endoscopic findings and apnea-hypopnea index in patients with gastroesophageal reflux disease and obstructive sleep apnea

    Institute of Scientific and Technical Information of China (English)

    P(a)l Demeter; Katalin V(a)rdi Visy; P(a)l Magyar

    2005-01-01

    AIM: To assess the relationship between severity of gastroesophageal reflux disease and apnea-hypopnea index (AHI) as an indicator of the severity of obstructive sleep apnea.METHODS: Data of 57 patients with proven obstructive sleep apnea and gastroesophageal reflux disease were analyzed. Patients were divided into two groups according to severity of the sleep apnea: "mild-moderate" (A)-AHI ≥5-30, n = 27, "severe" (B)-AHI >30, n = 30. All patients underwent apnea monitoring during the night, upper panendoscopy and were asked about typical reflux symptoms.RESULTS: All examined patients in both groups showed a significant overweight and there was a positive correlation between body mass index and the degree of sleep apnea (P = 0.0002). The occurence of erosive reflux disease was significantly higher in "severe" group (P = 0.0001).Using a logistic regression analysis a positive correlation was found between the endoscopic severity of reflux disease and the AHI (P = 0.016). Forty-nine point five percent of the patients experienced the typical symptoms of reflux disease at least three times a week and there was no significant difference between the two groups.CONCLUSION: A positive correlation can be found between the severity of gastroesophageal reflux disease and obstructive sleep apnea.

  15. REFLUX ESOPHAGITIS IN INFANTS AND CHILDREN - A REPORT FROM THE WORKING GROUP ON GASTROESOPHAGEAL REFLUX DISEASE OF THE EUROPEAN-SOCIETY-OF-PEDIATRIC-GASTROENTEROLOGY-AND-NUTRITION

    NARCIS (Netherlands)

    VANDENPLAS, Y; ASHKENAZI, A; BELLI, D; BLECKER, U; BOIGE, N; BOUQUET, J; CADRANEL, S; CEZARD, JP; CUCCHIARA, S; DEVREKER, T; DUPONT, C; GEBOES, K; GOTTRAND, F; HEYMANS, HSA; JASINSKI, C; KNEEPKENS, CMF; KOLETZKO, S; MILLA, P; MOUGENOT, JF; NAVARRO, J; NEWELL, SJ; NUSSLE, D; OLAFSDOTTIR, E; POLANCO, [No Value; RAVELLI, A; SANDHU, BK; TOLBOOM, J

    1994-01-01

    In this article, the Working Group on Gastro-Oesophageal Reflux of the European Society of Paediatric Gastroenterology and Nutrition presents and discusses a definition of reflux esophagitis and recommends a diagnostic approach and therapeutic management for this condition. Histologic criteria for r

  16. The Effects of Baclofen for the Treatment of Gastroesophageal Reflux Disease: A Meta-Analysis of Randomized Controlled Trials

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    Shujie Li

    2014-01-01

    Full Text Available Objectives. Baclofen can relieve gastroesophageal reflux-related symptoms in healthy subjects and gastroesophageal reflux disease (GERD patients by reducing the incidence of transient lower esophageal sphincter relaxation. This meta-analysis aimed to evaluate the efficacy and safety of baclofen for the treatment of GERD. Methods. We systematically searched randomized controlled trials published prior to November 2013 from PubMed, Medline, Embase, ScienceDirect, ClinicalTrials.gov, and the Cochrane Central Register of Randomized Controlled Trials. We performed a meta-analysis of all eligible trials. Results. Nine studies were identified with a total of 283 GERD patients and healthy subjects. Comparative analysis provided high quality data supporting the ability of baclofen to promote a short-term decrease in the number of reflux episodes per patient, the average length of reflux episodes, and the incidence of transient lower esophageal sphincter relaxation. No serious adverse events or death events were reported, and there were no significant differences in the overall adverse events between baclofen and placebo. All reported side effects of baclofen were of mild-to-moderate intensity, and the drug was well tolerated. Conclusion. Abundant evidence suggests that baclofen may be a useful approach for the treatment of GERD patients; however, a larger well-designed research study would further confirm this recommendation.

  17. Gastroesophageal reflux.

    Science.gov (United States)

    Slater, Bethany J; Rothenberg, Steven S

    2017-04-01

    Gastroesophageal reflux disease (GERD) is a very common condition and affects approximately 7-20% of the pediatric population. Symptoms from pathological GERD include regurgitation, irritability when feeding, respiratory problems, and substernal pain. Treatment typically starts with dietary modifications and postural changes. Antireflux medications may then be added. Indications for operative management in the pediatric population include failure of medical therapy with poor weight gain or failure to thrive, continued respiratory symptoms, and complications such as esophagitis. Laparoscopic Nissen fundoplication has become the standard of care for surgical treatment of children with GERD. The key technical aspects of laparoscopic Nissen fundoplication include creation of an adequate intra-abdominal esophagus, minimal dissection of the hiatus with exposure of the right crus to identify the gastroesophageal junction, crural repair, and creation of floppy, 360° wrap that is oriented at the 11 o׳clock position. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. COMPARISON OF EROSION AND PRIODONTAL INDICES IN PATIENTS WITH AND WITHOUT GASTROESOPHAGEAL REFLUX DISEASE

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    A. Khorsand

    2005-09-01

    Full Text Available Gastrocsphagcnl reflux disease (CiERD is a systemic disease with intraoral manifestations. The aim ofthis study was (0 compare erosion (Loss Ot'IOOlh structure due In a chemical process without bacterial cause and periodontal indices including: calculus index (Cll. plaque index (PI. gingival index (GI, clinical auachmcnt level (CAL and probing pocket depth (PPD in patients with (iERD and in non CiERD subjects that was done in 2002 in Imam Khomeini Hospital. .IS Patients with CiERI (test group and .IS subjects without GERD (Control group were selected randomly for this study. Statistical analysis for comparing differences between the test and Control groups were Performed using chi square and Fisher exact test. Tile results showed that the prevalence or erosion was significantly higher in test group (I,;LV~'n CiERD. 62.(Y~,'( non CiERD. Then: was also a significant difference in (;1, PI. Cl and PPD between test and control groups. CAL did not show any significant difference between the two groups. Also Hcticobnctcr pylori was significantly higher in test group (~('I,,( test. 54'1,; control group. According to the results. communication between dentist and internist leads to diagnosis and control of GERD. and prevents changes of teeth and periodontal structures.

  19. Electroesophagogram in gastroesophageal reflux disease with a new theory on the pathogenesis of its electric changes

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    Shafik Ismail

    2004-10-01

    Full Text Available Abstract Background In view of the disturbed esophageal peristaltic activity and abnormal esophageal motility in gastroesophageal reflux disease, (GERD, we investigated the hypothesis that these changes result from a disordered myoelectric activity of the esophagus. Methods The electric activity of the esophagus (electroesophagogram, EEG was studied in 27 patients with GERD (16 men, 11 women, mean age 42.6 ± 5.2 years and 10 healthy volunteers as controls (6 men, 4 women, mean age 41.4 ± 4.9 years. According to the Feussner scoring system, 7 patients had a mild (score 1, 10 a moderate (score 2 and 10 a severe (score 3 stage of the disease. One electrode was applied to the upper third and a second to the lower third of the esophagus, and the electric activity was recorded. The test was repeated after the upper electrode had been moved to the mid-esophagus. Results The EEG of the healthy volunteers showed slow waves and exhibited the same frequency, amplitude and conduction velocity from the 2 electrodes of the individual subject, regardless of their location in the upper, middle or lower esophagus. Action potentials occurred randomly. In GERD patients, score 1 exhibited electric waves' variables similar to those of the healthy volunteers. In score 2, the waves recorded irregular rhythm and lower variables than the controls. Score 3 showed a "silent" EEG without waves. Conclusion The electric activity in GERD exhibited 3 different patterns depending on the stages of GERD. Score 1 exhibited a normal EEG which apparently denotes normal esophageal motility. Score 2 recorded irregular electric waves variables which are presumably indicative of decreased esophageal motility and reflux clearance. In score 3, a "silent" EEG was recorded with probably no acid clearance. It is postulated that the interstitial cells of Cajal which are the electric activity generators, are involved in the inflammatory process of GERD. Destruction of these cells appears to

  20. A pilot study of Helicobacter pylori genotypes and cytokine gene polymorphisms in reflux oesophagitis and peptic ulcer disease.

    Science.gov (United States)

    Akdogan, R A; Ozgur, O; Gucuyeter, S; Kaklikkaya, N; Cobanoglu, U; Aydin, F

    2014-01-01

    Helicobacter pylori causes various diseases such as chronic gastritis, peptic ulcer and gastric cancer. While majority of the people infected with H. pylori is asymptomatic, 15-20 % of them develop such diseases. The main factors, which determine the development of H. pylori related diseases might be bacterial virulence, host genetic and environmental factors.The aim of this study was to reveal the factors that play a role in the disease development in patients with reflux esophagitis and peptic ulcer, infected with Helicobacter pylori. Environmental factors such as medical agents, smoking and body mass index were evaluated. The factors specific to bacteria such as vacA, CagA, babA and iceA virulence genotypes and the host factors such as IL-1, IL-2, IL-4, IL-6, IL-10, IL-12, interferon-γ, TNF-α, ve TGF-β1 gene polymorphisms were compared between the two groups.H. pylori infected twenty five patients with reflux esophagitis and peptic ulcer were enrolled in the study. There was no statistical difference between the two groups regarding environmental factors. IL-2 -330T +166T (p=0.037) and IL10 -1082A; -819C (p=0.049) gene polymorphisms were significantly more common in the group of patients with peptic ulcer compared to the group with reflux esophagitis. In both groups of patients, either with reflux esophagitis or peptic ulcer, multiple H. pylori virulence genotypes (cagA, vacA, babA) (mean values 74 %, 78 %, 54 % respectively) were observed.In this study, we revealed that cytokine gene polymorphisms may play a role in the development peptic ulcer while H. pylori virulence genotypes seem to be crucial for the development of associated diseases (Tab. 4, Ref. 51).

  1. Disease due to gastroesophageal reflux in children Enfermedad por reflujo gastroesofágico en niños

    OpenAIRE

    Leonor Adriana Castiblanco Galvis; Etty Paola Cortés Ramírez; Claudia Paola Acevedo Villafañe; Carlos Alberto Velasco Benítez

    1997-01-01

    In normal infants gastroesophageal reflux (GER) is usually self-limited but GER disease (GERD) is a frequent cause of morbidity in childhood, causing severe respiratory, gastrointestinal and feeding problems. This review describes the pathophysiology, clinical aspects,diagnosis, treatment and complications of GERD in children. En niños normales el reflujo gastroesofágico (RGE) es usualmente autolimitado. La enfermedad por RGE (ERGE) causa severos problemas respiratorios, gastrointestinales y ...

  2. Prevalence and clinical picture of gastroesophageal prolapse in gastroesophageal reflux disease.

    Science.gov (United States)

    Aramini, B; Mattioli, S; Lugaresi, M; Brusori, S; Di Simone, M P; D'Ovidio, F

    2012-08-01

    The prevalence of gastroesophageal (GE) mucosal prolapse in patients with gastroesophageal reflux disease (GERD) was investigated as well as the clinical profile and treatment outcome of these patients. Of the patients who were referred to our service between 1980 and 2008, those patients who received a complete diagnostic work-up, and were successively treated and followed up at our center with interviews, radiology studies, endoscopy, and, when indicated, esophageal manometry and pH recording were selected. The prevalence of GE prolapse in GERD patients was 13.5% (70/516) (40 males and 30 females with a median age of 48, interquartile range 38-57). All patients had dysphagia and reflux symptoms, and 98% (69/70) had epigastric or retrosternal pain. Belching decreased the intensity or resolved the pain in 70% (49/70) of the cases, gross esophagitis was documented in 90% (63/70) of the cases, and hiatus hernias were observed in 62% (43/70) of the cases. GE prolapse in GERD patients was accompanied by more severe pain (P < 0.05) usually associated with belching, more severe esophagitis, and dysphagia (P < 0.05). A fundoplication was offered to 100% of the patients and was accepted by 56% (39/70) (median follow up 60 months, interquartile range 54-72), which included two Collis-Nissen techniques for true short esophagus. Patients who did not accept surgery were medically treated (median follow up 60 months, interquartile range 21-72). Persistent pain was reported in 98% (30/31) of medical cases, belching was reported in 45% (14/31), and GERD symptoms and esophagitis were reported in 81% (25/31). After surgery, pain was resolved in 98% (38/39) of the operative cases, and 79% (31/39) of them were free of GERD symptoms and esophagitis. GE prolapse has a relatively low prevalence in GERD patients. It is characterized by epigastric or retrosternal pain, and the need to belch to attenuate or resolve the pain. The pain is allegedly a result of the mechanical consequences of

  3. Taste and Smell Disturbances in Patients with Gastroparesis and Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Kabadi, Alisha; Saadi, Mohammed; Schey, Ron; Parkman, Henry P

    2017-07-30

    Patients with gastroparesis and gastroesophageal reflux disease (GERD) often report decreased enjoyment when eating. Some patients remark that food does not smell or taste the same. To determine if taste and/or smell disturbances are present in patients with gastroparesis and/or GERD and relate these to gastrointestinal symptom severity. Patients with gastroparesis and/or GERD completed questionnaires evaluating taste and smell (Taste and Smell Survey [TSS]), Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM), and Demographics. TSS questioned the nature of taste/smell changes and the impact on quality of life. PAGI-SYM was used to calculate Gastroparesis Cardinal Symptom Index (GCSI) and Heartburn and Regurgitation Score (HB/RG). Seventy-six subjects were enrolled: healthy controls (n = 13), gastroparesis alone (n = 30), GERD alone (n = 10), and both gastroparesis and GERD (n = 23). Taste and smell disturbances were higher in patients with gastroparesis, GERD, and both gastroparesis and GERD compared to healthy controls. Taste and smell abnormalities were significantly correlated (r = 0.530, P Smell score was also strongly correlated to HB/RG (r = 0.513, P smell abnormalities are prominent in gastroparesis and GERD patients. Abnormalities in taste and smell are significantly correlated with both gastroparesis and GERD symptom severity. Awareness of this high prevalence of taste and smell dysfunction among patients with gastroparesis and GERD may help to better understand the food intolerances these patients often have.

  4. Prevalence of Attention Deficit Hyperactivity Disorder in Pediatrics Patients Newly Diagnosed with Gastroesophageal Reflux Disease

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    Mohammad Effatpanah

    2017-09-01

    Full Text Available Background: Gastroesophageal reflux disease (GERD is associated with a number of comorbidities in pediatrics. However, its association with attention deficit hyperactivity disorder (ADHD has not been reported. The aim of the present study was to investigate the prevalence of ADHD in pediatric patients newly diagnosed with GERD. Materials and Methods: Sixty newly-diagnosed treatment naive GERD patients and sixty healthy controls aging between 5 to 12 years referring to the Children and Adolescent’s medical center, Tehran, Iran were recruited in a case-control study during the year 2015. Then patients were evaluated for ADHD by a psychiatrist according to the DSM-IV criteria. The revised Conners' Parent Rating Scale (CPRS-R was used for assessment of the symptoms of ADHD. To screen for psychiatry disorders other than ADHD, the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL questionnaire was used. Logistic regression analysis was used for modeling the association between GERD and ADHD in the study sample. Results: The mean age of GERD patients was 5.77±2.27 and for non-GERD controls was 6.03±2.52 (P= 0.543. Thirty-three out of 60 (55% GERD patients and 37 out of 60(61.66% non-GERD controls were male (P: 0.579. Prevalence of ADHD was 33.60 (55% in GERD patients and 10.60 (16.66% in non-GERD (P

  5. Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori

    Science.gov (United States)

    Bor, Serhat; Kitapcioglu, Gul; Kasap, Elmas

    2017-01-01

    AIM To evaluate the prevalence of gastroesophageal reflux disease (GERD) with additional symptoms, relationship with Helicobacter pylori (H. pylori) of this country-wide study. METHODS Data from 3214 adults were obtained with validated questionnaire. Eight hundred and forty-one subjects were randomized to be tested for H. pylori via the urea breath test. "Frequent symptoms" were defined heartburn and/or regurgitation occurring at least weekly. RESULTS The prevalence of GERD was 22.8%, frequent and occasional heartburn were 9.3%-12.7%, regurgitation were 16.6%-18.7%, respectively. Body mass index (BMI) ≤ 18.5 showed a prevalence of 15%, BMI > 30 was 28.5%. The GERD prevalence was higher in women (26.2%) than men (18.9%) (P Turkey which reflects both Western and Eastern lifestyles with high rate of H. pylori. The presence of H. pylori had no effect on either the prevalence or the symptom profile of GERD. Subjects showing classical symptoms occasionally exhibit more additional symptoms compared with those without classical symptoms. PMID:28210089

  6. Changes in Ghrelin-Related Factors in Gastroesophageal Reflux Disease in Rats

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    Miwa Nahata

    2013-01-01

    Full Text Available To examine gastrointestinal hormone profiles and functional changes in gastroesophageal reflux disease (GERD, blood levels of the orexigenic hormone ghrelin were measured in rats with experimentally induced GERD. During the experiment, plasma acyl ghrelin levels in GERD rats were higher than those in sham-operated rats, although food intake was reduced in GERD rats. Although plasma levels of the appetite-suppressing hormone leptin were significantly decreased in GERD rats, no changes were observed in cholecystokinin levels. Repeated administration of rat ghrelin to GERD rats had no effect on the reduction in body weight or food intake. Therefore, these results suggest that aberrantly increased secretion of peripheral ghrelin and decreased ghrelin responsiveness may occur in GERD rats. Neuropeptide Y and agouti-related peptide mRNA expression in the hypothalamus of GERD rats was significantly increased, whereas proopiomelanocortin mRNA expression was significantly decreased compared to that in sham-operated rats. However, melanin-concentrating hormone (MCH and prepro-orexin mRNA expression in the hypothalamus of GERD rats was similar to that in sham-operated rats. These results suggest that although GERD rats have higher plasma ghrelin levels, ghrelin signaling in GERD rats may be suppressed due to reduced MCH and/or orexin synthesis in the hypothalamus.

  7. Gastroesophageal reflux disease management according to contemporary international guidelines: a translational study.

    Science.gov (United States)

    Pace, Fabio; Riegler, Gabriele; de Leone, Annalisa; Dominici, Patrizia; Grossi, Enzo

    2011-03-07

    To test the Genval recommendations and the usefulness of a short trial of proton pump inhibitor (PPI) in the initial management and maintenance treatment of gastroesophageal reflux disease (GERD) patients. Five hundred and seventy seven patients with heartburn were recruited. After completing a psychometric tool to assess quality of life (PGWBI) and a previously validated GERD symptom questionnaire (QUID), patients were grouped into those with esophagitis (EE, n = 306) or without mucosal damage (NERD, n = 271) according to endoscopy results. The study started with a 2-wk period of high dose omeprazole (omeprazole test); patients responding to this PPI test entered an acute phase (3 mo) of treatment with any PPI at the standard dose. Finally, those patients with a favorable response to the standard PPI dose were maintained on a half PPI dose for a further 3-mo period. The test was positive in 519 (89.9%) patients, with a greater response in EE patients (96.4%) compared with NERD patients (82.6%) (P = 0.011). Both the percentage of completely asymptomatic patients, at 3 and 6 mo, and the reduction in heartburn intensity were significantly higher in the EE compared with NERD patients (P management of GERD patients. In addition, we observed that the overall response to PPI therapy is lower in NERD compared to EE patients.

  8. Epidemiologic aspects in esophageal pathology focusing on gastroesophageal reflux disease and Barrett’s esophagus

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    George Săraci

    2011-11-01

    Full Text Available Objective: To determine the main epidemiologic characteristics of esophageal pathology,insisting on gastroesophageal reflux disease (GERD, Barrett’s esophagus (BE and to evaluate therelationship between these conditions and some widely spread risk factors. Material and methods: Datawere collected from clinical file records archive, endoscopy reports and histopatologic reports and slidesfor 8225 patients (01.01.2005-31.07.2007 who presented esophageal changes during upper digestiveendoscopy. We used Kolmogorov-Smirnov test to assess the normality of variables distribution and thenwe used parametric or non-parametric tests along with multivariate analysis. Results: BE is associatedwith male sex (r=0.039; pHelicobacter pylori (Hp infection(r=0.024; p=0.02. Age is not an important factor (OR=0.99; p=0.03. Presence of sliding hiatal hernia(SHH is influenced by body mass index (r=0.533; p<0.001 and female sex (p=0.001. SHH sizeinfluences the severity of esophagitis (r=0.04; p<0.01. The most frequent type of metaplasia is theincomplete intestinal one and the most frequent form of esophageal cancer is adenocarcinoma.Conclusion: BE is associated positively with GERD, esophagitis, male sex and negatively with Hp andesophageal varices. SHH influences severity of esophagitis and is more frequent in female patients.Adenocarcinoma is more frequent that squamous esophageal cancer.

  9. Gastroesophageal reflux disease and atrial fibrillation: a nationwide population-based study.

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    Chin-Chou Huang

    Full Text Available OBJECTIVES: Precise mechanisms of atrial fibrillation (AF are uncertain, but their association with esophageal disorders has been recently proposed. The association between gastroesophageal reflux disease (GERD, the most common gastroesophageal disorder, and AF remains undetermined. We therefore aimed to investigate the association between GERD and later development of AF. METHODS AND RESULTS: Patients with GERD were identified from the 1,000,000-person cohort dataset sampled from the Taiwan National Health Insurance database. The study cohort comprised 29,688 newly diagnosed adult GERD patients; 29,597 randomly selected age-, gender-, comobidity-matched subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the AF-free survival rate for the two cohorts. During a maximum three years of follow-up, a total of 351 patients experienced AF, including 184 (0.62% patients in the GERD cohort and 167 (0.56% in the control group. The log-rank test showed that patients with GERD had significantly higher incidence of AF than those without GERD (p = 0.024. After Cox proportional hazard regression model analysis, GERD was independently associated with the increased risk of AF (hazard ratio, 1.31; 95% confidence interval, 1.06-1.61, p = 0.013. CONCLUSION: GERD was independently associated with an increased risk of future AF in a nationwide population-based cohort.

  10. Influence of age on outcome of total laparoscopic fundoplication for gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    F Pizza; M Di Martino; A Del Genio; G Rossetti; P Limongelli; G Del Genio; V Maffettone; V Napolitano; L Brusciano; G Ruyso; S Tolone

    2007-01-01

    AIM: To demonstrate that age does not influence the choice of treatment for gastroesophageal reflux disease (GERD). We hypothesized that the outcome of total fundoplication in patients > 65 years is similar to that of patients aged ≤ 65 years.METHODS: Four hundred and twenty consecutive patients underwent total laparoscopic fundoplication for GERD. Three hundred and fifty-five patients were younger than 65 years (group Y),and 65 patients were 65 years or older (group E).The following elements were considered: presence, duration, and severity of GERD symptoms;presence of a hiatal hernia; manometric evaluation, 24 h pH-monitoring data, duration of operation;incidence of complications; and length of hospital stay.RESULTS: Elderly patients more often had atypical symptoms of GERD and at manometric evaluation had a higher rate of impaired esophageal peristalsis in comparison with younger patients. A mild intensity of heartburn often leads physicians to underestimate the severity of erosive esophagitis. The duration of the operation was similar between the two groups. The incidence of intraoperative and postoperative complications was low and the difference was not statistically significant between the two groups. An excellent outcome was observed in 92.9% young patients and 91.9% elderly patients.CONCLUSION: Laparoscopic antirefiux surgery is a safe and effective treatment for GERD even in elderly patients, warranting low morbidity and mortality rates and a significant improvement of symptoms comparable to younger patients.

  11. Association of medications for lifestyle-related diseases with reflux esophagitis

    Directory of Open Access Journals (Sweden)

    Asaoka D

    2016-10-01

    Full Text Available Daisuke Asaoka,1 Akihito Nagahara,2 Mariko Hojo,1 Kenshi Matsumoto,1 Hiroya Ueyama,1 Kohei Matsumoto,1 Kentaro Izumi,1 Tsutomu Takeda,1 Hiroyuki Komori,1 Yoichi Akazawa,1 Yuji Shimada,2 Taro Osada,1 Sumio Watanabe1 1Department of Gastroenterology, University of Juntendo, School of Medicine, Tokyo, 2Department of Gastroenterology, Juntendo University Shizuoka Hospital, Shizuoka, Japan Background: Because of a change in lifestyle, especially adoption of westernized eating habits, lifestyle-related diseases have become increasingly prevalent. The aim of this study was to investigate the association of medications for lifestyle-related diseases with reflux esophagitis (RE.Methods: We conducted a hospital-based, cross-sectional retrospective study of consecutive outpatients who received an upper gastrointestinal endoscopy in our department from February 2008 to November 2014, which was performed by one specialist who was a member of the Japan Gastroenterological Endoscopy Society. We investigated the patient profile, Helicobacter pylori (H. pylori infection status, medications for lifestyle-related diseases (including calcium channel blockers, statins, and bisphosphonates, and upper gastrointestinal endoscopic findings (RE, hiatal hernia, Barrett’s mucosa, and endoscopic gastric mucosal atrophy [EGA]. Patients with gastrectomy, peptic ulcer disease, gastric or esophageal malignant disease, and those who used proton pump inhibitors or histamine-2 receptor antagonists were excluded. We divided the subjects into a group without RE (RE(– and a RE (RE(+ group as judged by endoscopy, and investigated the risk factors for RE.Results: Of 1,744 consecutive cases, 590 cases (300 males and 290 females; mean age 60.5±13.2 years were eligible. RE(– and RE(+ cases numbered 507 and 83, respectively. Bivariate analysis showed significant positive associations of RE with male sex, body mass index (BMI, calcium channel blockers, Barrett’s mucosa, hiatal

  12. Improvement of clinical parameters in patients with gastroesophageal reflux disease after radiofrequency energy delivery

    Institute of Scientific and Technical Information of China (English)

    Hai-Feng Liu; Jian-Guo Zhang; Jun Li; Xiao-Guang Chen; Wei-An Wang

    2011-01-01

    AIM: To evaluate the efficacy of Stretta procedure with gastroesophageal reflux disease (GERD) based on symptom control, medication changes and oesophagitis grade.METHODS: Ninety patients with a history of GERD underwent Stretta procedure from June 2007 to March 2010. All patients with GERD diagnosed by the presence of endoscopically evidenced oesophagitis or abnormal esophageal pH testing. We evaluated GERD-health-related quality of life, satisfaction, medication use and endoscopy at baseline, 6, 12 mo after treatment. Complications of the procedure were analyzed. RESULTS: We found that patients experienced significant changes in symptoms of GERD after Stretta procedure. The onset of GERD symptom relief was less than 2 mo (70.0%) or 2 to 6 mo (16.7%). The mean GERD-HRQL score was 25.6 (baseline), 7.3 (6 mo, P< 0.01), and 8.1 (12 mo, P< 0.01).The mean heartburn score was 3.3 (baseline), and 1.2 (12 mo, P< 0.05). The percentage of patients with satisfactory GERD control improved from 31.1% at baseline to 86.7% after treatment, and patient satisfaction improved from 1.4 at baseline to 4.0 at 12 mo (P< 0.01). Medication usage decreased significantly from 100% of patients on proton pump inhibitors therapy at baseline to 76.7% of patients showing elimination of medications or only as needed use of antacids/H2-RA at 12 mo. An improvement in endoscopic grade of oesophagitis was seen in 33 of the 41 patients. All patients had either no erosions or only mild erosive disease (grade A) at 6 mo. CONCLUSION: The experience with Stretta procedure confirms that it is well tolerated, safe, effective and durable in the treatment of GERD. The Stretta procedure provides the drug-refractory patients with a new minimally invasive method.

  13. Relationship between reflux and laryngeal cancer

    NARCIS (Netherlands)

    Coca-Pelaz, A.; Rodrigo, J.P.; Takes, R.P.; Silver, C.E.; Paccagnella, D.; Rinaldo, A.; Hinni, M.L.; Ferlito, A.

    2013-01-01

    Gastroesophageal reflux disease (GERD), or its variation known as laryngopharyngeal reflux (LPR), has been recognized as a potential cause of several laryngeal disorders. Patients with laryngeal cancer have lifestyle risk factors, especially tobacco and alcohol consumption, that play an etiological

  14. Association of medications for lifestyle-related diseases with reflux esophagitis

    Science.gov (United States)

    Asaoka, Daisuke; Nagahara, Akihito; Hojo, Mariko; Matsumoto, Kenshi; Ueyama, Hiroya; Matsumoto, Kohei; Izumi, Kentaro; Takeda, Tsutomu; Komori, Hiroyuki; Akazawa, Yoichi; Shimada, Yuji; Osada, Taro; Watanabe, Sumio

    2016-01-01

    Background Because of a change in lifestyle, especially adoption of westernized eating habits, lifestyle-related diseases have become increasingly prevalent. The aim of this study was to investigate the association of medications for lifestyle-related diseases with reflux esophagitis (RE). Methods We conducted a hospital-based, cross-sectional retrospective study of consecutive outpatients who received an upper gastrointestinal endoscopy in our department from February 2008 to November 2014, which was performed by one specialist who was a member of the Japan Gastroenterological Endoscopy Society. We investigated the patient profile, Helicobacter pylori (H. pylori) infection status, medications for lifestyle-related diseases (including calcium channel blockers, statins, and bisphosphonates), and upper gastrointestinal endoscopic findings (RE, hiatal hernia, Barrett’s mucosa, and endoscopic gastric mucosal atrophy [EGA]). Patients with gastrectomy, peptic ulcer disease, gastric or esophageal malignant disease, and those who used proton pump inhibitors or histamine-2 receptor antagonists were excluded. We divided the subjects into a group without RE (RE(−)) and a RE (RE(+)) group as judged by endoscopy, and investigated the risk factors for RE. Results Of 1,744 consecutive cases, 590 cases (300 males and 290 females; mean age 60.5±13.2 years) were eligible. RE(−) and RE(+) cases numbered 507 and 83, respectively. Bivariate analysis showed significant positive associations of RE with male sex, body mass index (BMI), calcium channel blockers, Barrett’s mucosa, hiatal hernia and negative associations of RE with H. pylori positivity, EGA. Multivariate analysis showed significant positive associations of RE with BMI (odds ratio [OR]: 1.20, 95% confidence interval [95% CI]: 1.10–1.29), use of calcium channel blockers (OR: 2.12, 95% CI: 1.16–3.87), Barrett’s mucosa (OR: 2.97, 95% CI: 01.64–5.38), hiatal hernia (OR: 3.13, 95% CI: 1.79–5.47) and negative

  15. Treating gastro-oesophageal reflux disease during pregnancy and lactation: what are the safest therapy options?

    Science.gov (United States)

    Broussard, C N; Richter, J E

    1998-10-01

    Gastro-oesophageal reflux and heartburn are reported by 45 to 85% of women during pregnancy. Typically, the heartburn of pregnancy is new onset and is precipitated by the hormonal effects of estrogen and progesterone on lower oesophageal sphincter function. In mild cases, the patient should be reassured that reflux is commonly encountered during a normal pregnancy: lifestyle and dietary modifications may be all that are required. In a pregnant woman with moderate to severe reflux symptoms, the physician must discuss with the patient the benefits versus the risks of using drug therapy. Medications used for treating gastro-oesophageal reflux are not routinely or vigorously tested in randomised, controlled trials in women who are pregnant because of ethical and medico-legal concerns. Safety data are based on animal studies, human case reports and cohort studies as offered by physicians, pharmaceutical companies and regulatory authorities. If drug therapy is required, first-line therapy should consist of nonsystemically absorbed medications, including antacids or sucralfate, which offer little, if any, risk to the fetus. Systemic therapy with histamine H2 receptor antagonists (avoiding nizatidine) or prokinetic drugs (metoclopramide, cisapride) should be reserved for patients with more severe symptoms. Proton pump inhibitors are not recommended during pregnancy except for severe intractable cases of gastrooesophageal reflux or possibly prior to anaesthesia during labour and delivery. In these rare situations, animal teratogenicity studies suggests that lansoprazole may be the best choice. Use of the least possible amount of systemic drug needed to ameliorate the patient's symptoms is clearly the best for therapy. If reflux symptoms are intractable or atypical, endoscopy can safely be performed with conscious sedation and careful monitoring the mother and fetus.

  16. Current perspectives on reflux laryngitis.

    Science.gov (United States)

    Asaoka, Daisuke; Nagahara, Akihito; Matsumoto, Kenshi; Hojo, Mariko; Watanabe, Sumio

    2014-12-01

    Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease (GERD). With the increase of GERD patients, the importance of LPR is acknowledged widely. However, the pathophysiology of LPR is not understood completely and the diagnostic criteria for LPR remain controversial. Unfortunately, a gold standard diagnostic test for reflux laryngitis is not available. Recently, an experimental animal model for reflux laryngitis was developed to investigate the pathophysiology of reflux laryngitis. An empirical trial of lifestyle modification and proton pump inhibitor therapy is a reasonable approach for LPR symptoms. Alternatives after failure with aggressive medical treatment are limited and multichannel intraluminal impedance and pH monitoring is currently the best alternative to detect nonacid reflux. Additional prospective and evidence-based research is anticipated.

  17. Pharmacokinetics and safety of dexlansoprazole MR in pediatric patients with symptomatic gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Kukulka M

    2014-12-01

    Full Text Available Michael Kukulka,1 Sai Nudurupati,2 Maria Claudia Perez3 1Department of Clinical Pharmacology, 2Department of Analytical Sciences, 3Department of Clinical Science, Takeda Development Center Americas, Inc., Deerfield, IL, USA Objective: To evaluate the safety and pharmacokinetic profile of dexlansoprazole modified-release (MR capsules in pediatric patients with symptomatic gastroesophageal reflux disease (GERD. Methods: This Phase I, open-label study enrolled male and female patients (1 to 11 years of age with GERD. Patients received dexlansoprazole MR 15 mg, 30 mg, or 60 mg (according to weight once daily for 7 days. Blood samples for the measurement of plasma dexlansoprazole concentrations were collected for 24 hours after the day 7 dose. Dexlansoprazole plasma concentrations and pharmacokinetic parameters were summarized by dose group. Safety assessments included adverse events (AEs, clinical laboratory evaluations, fasting gastrin concentrations, physical examinations, electrocardiograms, and vital signs. Results: Thirty-six patients received study drug (12 per dose group, and 31 had evaluable pharmacokinetic data. There was a significant effect of weight on dose-normalized area under the curve (AUC, P=0.003 and dose-normalized maximum plasma concentration (Cmax (P=0.013, indicating that for a given dose, dexlansoprazole exposure decreases as body weight increases. After adjusting for body weight, both dexlansoprazole Cmax and AUC increased in an approximately dose-proportional manner with increasing dexlansoprazole dose. A total of ten of 36 patients reported at least one treatment-emergent AE, with most events considered mild in intensity. The most common AEs were vomiting, abdominal pain, diarrhea, and nausea. Conclusion: In 1- to 11-year-old patients with symptomatic GERD, weight-adjusted dexlansoprazole AUC and Cmax increased approximately dose-proportionally. However, for a given dose, dexlansoprazole exposure decreased with increasing

  18. The gastro-esophageal reflux disease questionnaire using Indonesian language: A language validation survey

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    Marcellus Simadibrata

    2011-05-01

    Full Text Available Background: The aims of this study were to test the usefulness of the Gastro-esophageal Reflux Disease Questionnaire (GERDQ in the diagnosis of GERD, to validate the GERDQ written in Indonesian language, and to evaluate the reliability of the GERDQ for use in Indonesian-speaking GERD patients (Virginia study.Methods: This was a prospective survey of 40 patients diagnosed with GERD, based on an endoscopic examination, in 3 cities in Indonesia (Jakarta, Bandung, and Surabaya from 15 January to 15 May 2009. Patients were asked to complete the GERDQ, and the validity and reliability of the questionnaire were assessed.Results: The percentages of respondents who reported symptoms lasting 4–7 days were as follows: 68% had a burning sensation behind the breastbone (heartburn; 65% had stomach content (fluid move upwards to the throat or mouth (regurgitation; 70% had a pain in the centre of the upper abdomen; 58% had nausea; 63% had difficulty sleeping because of the heartburn and/or regurgitation; and 63% took additional medication for heartburn and/or regurgitation. Cronbach’s alpha was 0.83, indicating that all of the questions in the Indonesian-language GERDQ are valid and reliable for Indonesian GERD patients.Conclusions: This study achieved the primary objectives and showed that the GERDQ is valid and reliable for use with Indonesian-speaking GERD patients. The results were consistent with those of the DIAMOND study, which showed that the GERDQ can be used to diagnose GERD on the basis of the reported symptoms. (Med J Indones 2011; 20:125-30Keyword: GERD, GERDQ, Reliability test, Validity test, Virginia study

  19. Fewer acute respiratory infection episodes among patients receiving treatment for gastroesophageal reflux disease

    Science.gov (United States)

    Xirasagar, Sudha; Chung, Shiu-Dong; Tsai, Ming-Chieh; Chen, Chao-Hung

    2017-01-01

    Patients with gastroesophageal reflux disease (GERD) present with comorbid complications with implications for healthcare utilization. To date, little is known about the effects of GERD treatment with a proton-pump inhibitor (PPI) on patients’ subsequent healthcare utilization for acute respiratory infections (ARIs). This population-based study compared ARI episodes captured through outpatient visits, one year before and one year after GERD patients received PPI treatment. We used retrospective data from the Longitudinal Health Insurance Database 2005 in Taiwan, comparing 21,486 patients diagnosed with GERD from 2010 to 2012 with 21,486 age-sex matched comparison patients without GERD. Annual ARI episodes represented by ambulatory care visits for ARI (visits during a 7-day period bundled into one episode), were compared between the patient groups during the 1-year period before and after the index date (date of GERD diagnosis for study patients, first ambulatory visit in the same year for their matched comparison counterpart). Multiple regression analysis using a difference-in-difference approach was performed to estimate the adjusted association between GERD treatment and the subsequent annual ARI rate. We found that the mean annual ARI episode rate among GERD patients reduced by 11.4%, from 4.39 before PPI treatment, to 3.89 following treatment (mean change = -0.5 visit, 95% confidence interval (CI) = (-0.64, -0.36)). In Poisson regression analysis, GERD treatment showed an independent association with the annual ARI rate, showing a negative estimate (with p<0.001). The study suggests that GERD treatment with PPIs may help reduce healthcare visits for ARIs, highlighting the importance of treatment-seeking by GERD patients and compliance with treatment. PMID:28222168

  20. Update on novel endoscopic therapies to treat gastroesophageal reflux disease: A review

    Institute of Scientific and Technical Information of China (English)

    Jessica; Hopkins; Noah; J; Switzer; Shahzeer; Karmali

    2015-01-01

    Endoscopic treatments for gastroesophageal reflux disease(GERD) have become increasingly popular in recent years. While surgical intervention with the Laparoscopic Nissen Fundoplication remains the gold standard, two endoscopic interventions, specifically, are gaining traction in clinical use(Esophy X and Stretta). The Esophy X(Endo Gastric Solutions, Inc., Redmond, WA, United States) was developed as a method of restoring the valve at the GE junction through an endoluminal fundoplication(ELF) technique. Long-term data suggests that transoral incisional fundoplication(TIF) with Esophy X may be effective for symptom control and proton pump inhibitor reduction or cessation for up to 2-6 years. There is no evidence that Esophy X is more effective than surgical intervention. TIF may be most effective for patients with HH < 2 cm and Hill Grade I/II valves. Stretta(Mederi Therapeutics, Greenwich, CT, United States) was approved by the Food and Drug Administration in 2000. It delivers radiofrequency energy to the lower esophageal sphincter and gastric cardia. Published reviews of the literature are conflicted in their recommendations of Stretta in the management of GERD. The literature suggests that the Stretta procedure has an acceptable safety profile and may be effective in reducing symptom burden and quality of life scores up to 8 years post-intervention. However, there does not appear to be any sustained improvement in objective outcomes and there is no evidence that Stretta results in improved outcomes as compared to surgical intervention. Treatment modalities for GERD, as a field, suffer from a lack of standardization in primary and secondary outcomes. Although many studies have looked at health related quality of life, the tools used to do so are markedly heterogeneous. Future directions for the endoscopic treatment of GERD include novel techniques like endoscopic submucosal dissection.

  1. Transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes

    Institute of Scientific and Technical Information of China (English)

    Pier Alberto Testoni; Giorgia Mazzoleni; Sabrina Gloria Giulia Testoni

    2016-01-01

    Gastro-esophageal reflux disease(GERD)is a verycommon disorder that results primarily from the loss of an effective antireflux barrier,which forms a mechanical obstacle to the retrograde movement of gastric content.GERD can be currently treated by medical therapy,surgical or endoscopic transoral intervention.Medical therapy is the most common approach,though concerns have been increasingly raised in recent years about the potential side effects of continuous longterm medication,drug intolerance or unresponsiveness,and the need for high dosages for long periods to treat symptoms or prevent recurrences.Surgery too may in some cases have consequences such as longlasting dysphagia,flatulence,inability to belch or vomit,diarrhea,or functional dyspepsia related to delayed gastric emptying.In the last few years,transoral incisionless fundoplication(TIF)has proved an effective and promising therapeutic option as an alternative to medical and surgical therapy.This review describes the steps of the TIF technique,using the Esophy X?device and the MUSETM system.Complications and their management are described in detail,and the recent literature regarding the outcomes is reviewed.TIF reconfigures the tissue to obtain a full-thickness gastroesophageal valve from inside the stomach,by serosato-serosa plications which include the muscle layers.To date the procedure has achieved lasting improvement of GERD symptoms(up to six years),cessation or reduction of proton pump inhibitor medication in about 75%of patients,and improvement of functional findings,measured by either p H or impedance monitoring.

  2. PRISM, a Patient-Reported Outcome Instrument, Accurately Measures Symptom Change in Refractory Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Fuller, Garth; Bolus, Roger; Whitman, Cynthia; Talley, Jennifer; Erder, M Haim; Joseph, Alain; Silberg, Debra G; Spiegel, Brennan

    2017-03-01

    Most patients with gastroesophageal reflux disease (GERD) experience relief following treatment with proton pump inhibitors (PPIs) (Vakil et al. in Am J Gastroenterol 101:1900-1920, 2006; Everhart and Ruhl in Gastroenterology 136:376-386, 2009). As many as 17-44% of patients, however, exhibit only partial response to therapy. Most extant GERD patient-reported outcome (PRO) instruments fail to meet development best practices as described by the FDA (Talley and Wiklund in Qual Life Res 14:21-33, 2005; Van Pinxteren et al. in Cochrane Database Syst Rev 18:CD002095, 2004; El-Serag et al. in Aliment Pharmacol Ther 32:720-737, 2010). To develop and validate a PRO instrument for clinical trials involving patients with GERD who are PPI partial responders. We prepared a systematic literature review, held patient focus groups, convened an expert panel, and conducted cognitive interviews to establish content validity. Eligible participants took PPI therapy for at least 8 weeks, had undergone an upper endoscopy, and scored at least 8 points on the GerdQ [6]. Qualitative data guided development of 26 draft items. Items were reviewed by expert panels and debriefed with patients. The resulting 21-item instrument underwent psychometric evaluation during a Phase IIB trial. During the trial, confirmatory factor analysis (n = 220) resulted in a four-factor model displaying the highest goodness of fit. All domains had a high inter-item correlation (Cronbach's α > 0.8). Test-retest reliability and convergent validity were strong, with highly significant (p PRISM scores and severity anchors and significant (p PRISM. Developed in line with FDA guidance on PROs, PRISM represents an important new outcome measure for patients with GERD with a partial response to PPI therapy.

  3. Gastro esophageal reflux disease is associated with absence from work: Results from a prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    Andreas Leodolter; Marc Nocon; Michael Kulig; Stefan N Willich; Peter Malfertheiner; Joachim Labenz

    2005-01-01

    AIM: To study the association of gastro-esophageal reflux disease (GERD) with the absence from work and to estimate the extent of loss in gross domestic product due to inability to work.METHODS: Analysis was based on the prospectively gathered data of a large European cohort study involving 6 215 symptomatic GERD patients (ProGERD). Among these patients, 2 871 were initially employed. The calculation of the loss of gross domestic product was based on the assumption that the prevalence of GERD was about 15% in Germany. According to the German Federal Statistical Office, the mean gross wage of employees was 150 ∈/d in 2002.RESULTS: The data of 2 078 employed patients who were prospectively followed up for over 2 years were analyzed. At study entry, the patients reported a mean of 1.8 d per year of inability to work. During the prospective follow-up under routine clinical care, the proportion of patients reporting days with inability to work decreased from 14% to 6% and the mean number of days per year with inability to work decreased to 0.9 d. Assuming a prevalence of troublesome GERD of 15% in the employed German population, the loss of gross domestic product amounted to 668 million ∈/year in Germany.CONCLUSION: GERD causes a relevant impairment on the national economics by absence from work. The presented data demonstrate the importance of GERD,not only for patients and health insurance companies,but also for the community at large.

  4. Transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes.

    Science.gov (United States)

    Testoni, Pier Alberto; Mazzoleni, Giorgia; Testoni, Sabrina Gloria Giulia

    2016-05-01

    Gastro-esophageal reflux disease (GERD) is a very common disorder that results primarily from the loss of an effective antireflux barrier, which forms a mechanical obstacle to the retrograde movement of gastric content. GERD can be currently treated by medical therapy, surgical or endoscopic transoral intervention. Medical therapy is the most common approach, though concerns have been increasingly raised in recent years about the potential side effects of continuous long-term medication, drug intolerance or unresponsiveness, and the need for high dosages for long periods to treat symptoms or prevent recurrences. Surgery too may in some cases have consequences such as long-lasting dysphagia, flatulence, inability to belch or vomit, diarrhea, or functional dyspepsia related to delayed gastric emptying. In the last few years, transoral incisionless fundoplication (TIF) has proved an effective and promising therapeutic option as an alternative to medical and surgical therapy. This review describes the steps of the TIF technique, using the EsophyX(®) device and the MUSE(TM) system. Complications and their management are described in detail, and the recent literature regarding the outcomes is reviewed. TIF reconfigures the tissue to obtain a full-thickness gastro-esophageal valve from inside the stomach, by serosa-to-serosa plications which include the muscle layers. To date the procedure has achieved lasting improvement of GERD symptoms (up to six years), cessation or reduction of proton pump inhibitor medication in about 75% of patients, and improvement of functional findings, measured by either pH or impedance monitoring.

  5. EFFECTS OF PROTON PUMP INHIBITORS ON DENTAL EROSIONS CAUSED BY GASTROESOPHAGEAL REFLUX DISEASE

    Directory of Open Access Journals (Sweden)

    Andrei Vasile OLTEANU

    2015-12-01

    Full Text Available Background: Numerous studies worldwide have assessed the association between dental erosions or other related oral manifestations, and the gastroesophageal reflux disease (GERD. Nowadays, one of the main therapeutic resources of GERD is represented by proton pump inhibitors (PPIs. Adequate salivary secretions and flow are considered mandatory for the protection of both teeth and esophageal mucosa. The aim of the present study was to evaluate the possible correlation between GERD treatment options and subsequent control of oral manifestation, taking as premises that either PPIs or dietary and lifestyle changes may control oral patterns of GERD by acting on salivary secretions. Methods: 48 clinically diagnosed GERD adult patients with oral manifestations, mainly erosions, were included in the study, none of which showing alarming symptoms that would require further gastroenterologic examination. Oral examination evaluated the DMF (decayed, missing, filled and OHI-S (Simplified Oral Hygiene indices. Salivary flow was evaluated by the Saxon test. 25 patients were prescribed dietary and lifestyle measures and PPIs (omeprazole – 20 mg, whereas 23 patients were managed only through dietary and lifestyle modifications. General assessment was performed at the time of diagnosis and 4 weeks afterwards. Results: No significant differences as to the DMF index, OHI-S index or Saxon test were found over the 4 weeks management between the groups. Conclusions: Oral manifestation of GERD may be caused by impaired salivary secretions and flow, otherwise no - positive or negative - effect could be secondary to PPI therapy. Accordingly, complex oral rehabilitation of GERD patients and collaboration between gastroenterologists and dentists should be promoted.

  6. Prevalence of dental erosion among people with gastroesophageal reflux disease in China.

    Science.gov (United States)

    Li, Wenhao; Liu, Jingming; Chen, Su; Wang, Yao; Zhang, Zhenting

    2017-01-01

    Gastroesophageal reflux disease (GERD) is typically diagnosed based on symptoms of regurgitation and heartburn, although it may also manifest as asthma-like symptoms, laryngitis, or dental erosion. The purpose of this prospective, cross-sectional study was to assess the prevalence of dental erosion in people with GERD and to evaluate the association between GERD and dental erosion. The presence, severity, and pattern of dental erosion was assessed in 51 participants with GERD and 50 participants without GERD using the Smith and Knight tooth wear index. Medical, dietary, and dental histories were collected by questionnaire. Factors potentially related to dental erosion, including GERD, were evaluated by logistic regression. Dental erosion was observed in 31 (60.8%) participants with GERD and 14 (28%) participants without GERD. Bivariate analysis revealed that participants with GERD were more likely to experience dental erosion (crude odds ratio [cOR]: 2.74; 95% CI: 1.19, 6.32) than participants without GERD. Multivariate analysis also revealed that participants with GERD had a higher risk of dental erosion (adjusted odds ratio [aOR]: 3.97; 95% CI: 1.45, 10.89). Consumption of grains and legumes, the most frequently consumed foods in China, did not correlate with dental erosion. However, carbonated beverage consumption was significantly associated with GERD and dental erosion (aOR: 3.34; 95% CI: 1.01, 11.04; P=.04). GERD was positively correlated with dental erosion. Carbonated beverage consumption can increase the risk of both GERD and dental erosion. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Gastroesophageal reflux disease management according to contemporary international guidelines: A translational study

    Institute of Scientific and Technical Information of China (English)

    Fabio Pace; Gabriele Riegler; Annalisa de Leone; Patrizia Dominici; Enzo Grossi; the EMERGE Study Group

    2011-01-01

    AIM: To test the Genval recommendations and the usefulness of a short trial of proton pump inhibitor (PPI) in the initial management and maintenance treatment of gastroesophageal reflux disease (GERD) patients.METHODS: Five hundred and seventy seven patients with heartburn were recruited. After completing a psychometric tool to assess quality of life (PGWBI) and a previously validated GERD symptom questionnaire (QUID), patients were grouped into those with esophagitis (EE, n = 306) or without mucosal damage (NERD, n = 271) according to endoscopy results. The study started with a 2-wk period of high dose omeprazole (omeprazole test); patients responding to this PPI test entered an acute phase (3 mo) of treatment with any PPI at the standard dose. Finally, those patients with a favorable response to the standard PPI dose were maintained on a half PPI dose for a further 3-mo period.RESULTS: The test was positive in 519 (89.9%) patients, with a greater response in EE patients (96.4%) compared with NERD patients (82.6%) (P = 0.011). Both the percentage of completely asymptomatic patients, at 3 and 6 mo, and the reduction in heartburn intensity were significantly higher in the EE compared with NERD patients (P < 0.01). Finally, the mean PGWBI score was significantly decreased before and increased after therapy in both subgroups when compared with the mean value in a reference Italian population.CONCLUSION: Our study confirms the validity of the Genval guidelines in the management of GERD patients. In addition, we observed that the overall response to PPI therapy is lower in NERD compared to EE patients.

  8. Total diet, individual meals, and their association with gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Mehranghiz Ebrahimi-Mameghani

    2017-06-01

    Full Text Available Background: To identify the association of total diet and individual meals with gastroesophageal reflux disease (GERD. Methods: This age- and sex-matched case-control study was carried out among 217 subjects (106 cases and 111 controls. Data were collected using a demographic questionnaire and a GERD checklist and a 3-day food record. Results: Cases consumed more fat (median: 26.3 [3.2-71.5] g vs. 21.8 [4.3-58.1] g; P=0.04and more energy percent form carbohydrates (median: 72.5 [0-100] vs. 69.0 [0-100]; P=0.02at lunch, and less energy (median: 129.5 kcal [0-617.6] vs. 170.5 kcal [0-615.7]; P=0.01 and protein (2.4 [0-19.4] g vs. 3.1 [0-21.8] g; P=0.01 at evening snack, compared to controls.The volume of food was significantly different between the two group only at lunch (median:516 [161-1292] g vs. 468 [198-1060] g; P=0.02. The percentage of energy from total dietary protein showed a significant association with GERD after adjusting for confounders (odds ratio[OR]=0.89; 95% CI: 0.81-0.98. Regarding the individual meals, amount of fat consumed at lunch (OR=1.02; 95% CI: 1.00-1.05, and amount of protein intake at evening snack (OR=0.92;95% CI: 0.85-1.00 were significantly associated with GERD. Meanwhile, caloric density and meal frequency did not differ significantly between the two groups. Conclusion: Amount of fat consumed at lunch is positively associated with GERD, whereas the percentage of energy from total protein and amount of protein intake at evening snack are more likely to be inversely associated with GERD.

  9. Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    PENG Sui; XIONG Li-shou; XIAO Ying-lian; WANG An-jiang; LIN Jin-kun; HU Pin-jin; CHEN Min-hu

    2010-01-01

    Background The relationship between symptom elimination and normalization of esophageal acid level of gastroesophageal reflux disease (GERD) on proton-pump inhibitor (PPI) therapy has been questioned. This study aimed to evaluate the relationship between symptom response and gastro-esophageal acidity control in Chinese patients with GERD on esomeprazole therapy, and to assess the role of 24-hour esophageal pH-metry after therapy in GERD patients.Methods GERD patients with typical reflux symptoms were enrolled and received esomeprazole 40 mg once daily for 4 weeks. Patients with positive baseline 24-hour esophageal pH-metry were divided into two groups depending on an additional dual-channel 24-hour pH-metry after treatment. The pH- group achieved normalization of esophageal pH level whereas the pH+ group did not.Results Of the 80 patients studied, 76 had abnormal baseline esophageal pH levels. Of these, 90% (52/58) of symptom-free patients and 67% (12/18) of symptom-persistent patients achieved esophageal pH normalization after therapy (P=0.030). The mean post-therapy gastric nocturnal percent time of pH <4.0 was significantly higher in pH+group than that in pH- group (P <0.001) after therapy. The multivariate regression analysis identified hiatus hernia (P<0.001) and persistent reflux symptom (P=0.004) were two independent factors predicting the low post-therapy esophageal pH level.Conclusions Symptom elimination is not always accompanied by esophageal pH normalization, and vice verse.Esophageal pH-metry is recommended for GERD patients with hiatus hernia or with persistent reflux symptoms after PPI therapy.

  10. Vesicoureteral Reflux

    Science.gov (United States)

    ... causing the reflux. References [1] Pohl HG, Joyce GM, Wise M, Cilento BG. Pediatric urologic disorders. In: ... for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888- ...

  11. Typical and atypical symptoms of gastro esophageal reflux disease: Does Helicobacter pylori infection matter?

    Institute of Scientific and Technical Information of China (English)

    Laurino; Grossi; Antonio; Francesco; Ciccaglione; Leonardo; Marzio

    2015-01-01

    AIM: To analyze whether the presence of Helicobacter pylori(H. pylori) infection could affect the quality of symptoms in gastro-esophageal reflux disease(GERD) patients. METHODS: one hundred and forty-four consecutive patients referred to our Unit for suspected GERD were recruited for the study. All patients underwent esophageal p H-metric recording. For those with a positive test, C13 urea breath test was then performed to assess the H. pylori status. GERD patients were stratified according to the quality of their symptoms and classified as typical, if affected by heartburn and regurgitation, and atypical if complaining of chest pain, respiratory and ears, nose, and throat features. H. pylori-negative patients were also asked whether they had a previous diagnosis of H. pylori infection. If a positive response was given, on the basis of the time period after successful eradication, patients were considered as "eradicated"(E) if H. pylori eradication occurred more than six months earlier or "recently eradicated" if the therapy had been administered within the last six months. Patients without history of infection were identified as "negative"(N). χ2 test was performed by combining the clinical aspects with the H. pylori status.RESULTS: one hundred and twenty-nine of the 144 patients, including 44 H. pylori-positive and 85 H. pylori-negative(41 negative, 21 recently eradicated, 23 eradicated more than 6 mo before), were eligible for the analysis. No difference has been found between H. pylori status and either the number of reflux episodes(138 ± 23 vs 146 ± 36, respectively, P = 0.2, not significant) or the percentage of time with pH values < 4(6.8 ± 1.2 vs 7.4 ± 2.1, respectively, P = 0.3, not significant). The distribution of symptoms was as follows: 13 typical(30%) and 31 atypical(70%) among the 44 H. pylori-positive cases; 44 typical(52%) and 41 atypical(48%) among the 85 H. pylori-negative cases,(P = 0.017 vs H. pylori +; OR = 2.55, 95%CI: 1

  12. Time esophageal pH < 4 overestimates the prevalence of pathologic esophageal reflux in subjects with gastroesophageal reflux disease treated with proton pump inhibitors

    Directory of Open Access Journals (Sweden)

    Sloan Sheldon

    2008-05-01

    Full Text Available Abstract Background A Stanford University study reported that in asymptomatic GERD patients who were being treated with a proton pump inhibitor (PPI, 50% had pathologic esophageal acid exposure. Aim We considered the possibility that the high prevalence of pathologic esophageal reflux might simply have resulted from calculating acidity as time pH Methods We calculated integrated acidity and time pH Results The prevalence of pathologic 24-hour esophageal reflux in both studies was significantly higher when measured as time pH Conclusion In GERD subjects treated with a PPI, measuring time esophageal pH

  13. Clinical usefulness of adherence to gastro-esophageal reflux disease guideline by Spanish gastroenterologists

    Institute of Scientific and Technical Information of China (English)

    Fermín Mearin; Julio Ponce; Marta Ponce; Agustín Balboa; Miguel A González; Javier Zapardiel

    2012-01-01

    AIM:To investigate usefulness of adherence to gastroesophageal reflux disease (GERD) guideline established by the Spanish Association of Gastroenterology.METHODS:Prospective,observational and multicentre study of 301 patients with typical symptoms of GERD who should be managed in accordance with guidelines and were attended by gastroenterologists in daily practice.Patients (aged > 18 years) were eligible for inclusion if they had typical symptoms of GERD (heartburn and/or acid regurgitation) as the major complaint in the presence or absence of accompanying atypical symptoms,such as dyspeptic symptoms and/or supraesophageal symptoms.Diagnostic and therapeutic decisions should be made based on specific recommendations of the Spanish clinical practice guideline for GERD which is a widely disseminated and well known instrument among Spanish in digestive disease specialists.RESULTS:Endoscopy was indicated in 123 (41%)patients:50 with alarm symptoms,32 with age > 50years without alarm symptom.Seventy-two patients (58.5%) had esophagitis (grade A,23,grade B,28,grade C,18,grade D,3).In the presence of alarm symptoms,endoscopy was indicated consistently with recommendations in 98% of cases.However,in the absence of alarm symptoms,endoscopy was indicated in 33% of patients > 50 years (not recommended by the guideline).Adherence for proton pump inhibitors (PPIs) therapy was 80%,but doses prescribed were lower (half) in 5% of cases and higher (double) in 15%.Adherence regarding duration of PPI therapy was 69%; duration was shorter than recommended in 1% (4 wk in esophagitis grades C-D) or longer in 30%(8 wk in esophagitis grades A-B or in patients without endoscopy).Treatment response was higher when PPI doses were consistent with guidelines,although differences were not significant (95% vs 85%).CONCLUSION:GERD guideline compliance was quite good although endoscopy was over indicated in patients > 50 years without alarm symptoms; PPIs were

  14. Efficacy of adding sodium alginate to omeprazole in patients with nonerosive reflux disease: a randomized clinical trial.

    Science.gov (United States)

    Manabe, N; Haruma, K; Ito, M; Takahashi, N; Takasugi, H; Wada, Y; Nakata, H; Katoh, T; Miyamoto, M; Tanaka, S

    2012-07-01

    Nonerosive reflux disease (NERD) is the most common form of gastroesophageal reflux disease. Patients with NERD have a lower response rate to proton pump inhibitors (PPIs) than patients with erosive esophagitis when gauged from relief of heartburn. Sodium alginate decreases the acidity of refluxate and protects the esophageal mucosa. However, whether the addition of sodium alginate to PPI therapy can improve NERD symptoms remains unknown. Accordingly, the aim of this study was to evaluate the efficacy of adding sodium alginate to basal PPI therapy for NERD. Patients who had experienced heartburn on at least 2 days per week during the 1-month period before entering the study and had no endoscopic mucosal breaks (grade M or N according to Hoshihara's modification of the Los Angeles classification) were randomized to one of two treatments for 4 weeks: omeprazole (20 mg once daily) plus sodium alginate (30 mL four times a day) (group A) or omeprazole (20 mg once daily) alone (group B). Eighty-seven patients were enrolled, and 76 patients were randomly assigned to group A (n = 36) or group B (n = 40). Complete resolution of heartburn for at least 7 consecutive days by the end of treatment was significantly more common in group A (56.7%) than in group B (25.7%). One patient from group A had mild drug-related diarrhea that was not clinically serious. In conclusion, omeprazole combined with sodium alginate was better than omeprazole alone in Japanese patients with NERD. © 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  15. Reflux symptoms and side effects among patients with gastroesophageal reflux disease at baseline, during treatment with PPIs, and after Nissen fundoplication.

    Science.gov (United States)

    Rantanen, Tuomo; Kiljander, Toni; Salminen, Paulina; Ranta, Arto; Oksala, Niku; Kellokumpu, Ilmo

    2013-06-01

    There are no prospective studies available on the behavior of extraesophageal and esophageal symptoms and treatment-related side effects in patients without effective antireflux medication, receiving the most effective antireflux medication, and after laparoscopic fundoplication. Extraesophageal and esophageal reflux symptoms and treatment-related side effects were assessed in 60 patients while they were on no effective antireflux medication (three-week washout period), after three month of treatment with double-dose esomeprazole, and 3 months after laparoscopic Nissen fundoplication. Esophageal and extraesophageal reflux symptoms, rectal flatulence, and bloating were analyzed with the visual analog scale. In addition, dysphagia, rectal flatulence, and bloating were recorded as none, mild, moderate, or severe. Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were further reduced after fundoplication. Dysphagia and flatulence did not increase from baseline after surgery. Bloating decreased both after treatment with esomeprazole and after fundoplication. In contrast, dysphagia and increased flatus were found more often after surgery than during treatment with esomeprazole. Dysphagia and rectal flatulence were less common during treatment with esomeprazole than at baseline or after surgery. Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were reduced further after fundoplication. Any treatment-related side effect was not increased after surgery when compared to baseline. However, compared to esomeprazole there was more dysphagia and flatulence after fundoplication.

  16. Enfermedad por reflujo gastroesofágico en niños Disease due to gastroesophageal reflux in children

    OpenAIRE

    Leonor Adriana Castiblanco Galvis; Etty Paola Cortés Ramírez; Claudia Paola Acevedo Villafañe; Carlos Alberto Velasco Benítez

    1997-01-01

    En niños normales el reflujo gastroesofágico (RGE) es usualmente autolimitado. La enfermedad por RGE (ERGE) causa severos problemas respiratorios, gastrointestinales y de alimentación. La ERGE es causa frecuente de morbilidad en niños. El propósito del presente artículo es describir la fisiopatología, las manifestaciones clínicas, el diagnóstico, el manejo y las complicaciones de la ERGE en niños. In normal infants gastroesophageal reflux (GER) is usually self-limited but GER disease (GERD) i...

  17. Increased prevalence of symptoms of gastroesophageal reflux diseases in type 2 diabetics with neuropathy

    Institute of Scientific and Technical Information of China (English)

    Xiangbing Wang; CS Pitchumoni; Khushbu Chandrarana; Neha Shah

    2008-01-01

    AIM:To analyze the prevalence of gastroesophageal reflux disease (GERD) related symptoms in patients with diabetes mellitus (DM) and to find out the relationship between diabetic neuropathy and the prevalence of GERD symptoms.METHODS:In this prospective questionnaire study,150 consecutive type 2 diabetic patients attending the endocrine clinic were enrolled.A junior physician helped the patients to understand the questions.Patients were asked about the presence of five most frequent symptoms of GERD that included heartburn (at least 1/wk),regurgitation,chest pain,hoarseness of voice and chronic cough.Patients with past medical history of angina,COPD,asthma,cough due to ACEI or preexisting GERD prior to onset of diabetes and apparent psychiatric disorders were excluded from the survey.We further divided the patients into two groups based on presence or absence of peripheral neuropathy.Out of 150 patients,46 had neuropathy,whereas 104 patients did not have neuropathy.Data are expressed as mean±SD,and number of patients in each category and percentage of total patients in that group.Normal distributions between groups were compared with Student t test and the prevalence rates between groups were compared with Chi-square tests for significance.RESULTS:The average duration of diabetes were 12±9.2 years and the average HbAlc level of this group was 7.7% + 2.0%.The mean weight and BMI were 198 + 54 Ibs.and 32±7.2 kg/m2.Forty percent (61/150) patients reported having at least one of the symptoms of GERD and thirty percent (45/150) reported having heartburn at least once a week.The prevalence of GERD symptoms is higher in patients with neuropathy than patients without neuropathy (58.7% vs 32.7%,P<0.01).The prevalence of heartburn,chest pain and chronic cough are also higher in patients with neuropathy than in patients without neuropathy (43.5% vs 24%;10.9% vs 4.8%and 17.8% vs 6.7% respectively,P<0.05).CONCLUSION:The prevalence of GERD symptoms in type 2 DM is higher

  18. 针药并用治疗胃食管反流病%Treating gastro esophageal reflux disease by acupuncture and herbs

    Institute of Scientific and Technical Information of China (English)

    吴栩; 陈盛烨

    2012-01-01

      胃食管反流病是较为常见的食管与食管外的疾病,主要是由于胃内容物反流入食管而引起的,用针药并用的方法治疗胃食管反流病,疗效显著。%  Gastro esophageal reflux disease is more common in the esophagus and esophageal disease, mainly because of stomach contents into the esophagus and cause. Treating gastro esophageal reflux disease by acupuncture and herbs, the efficacy was significantly.

  19. Lack of differential pattern in central adiposity and metabolic syndrome in Barrett's esophagus and gastroesophageal reflux disease.

    LENUS (Irish Health Repository)

    Healy, L A

    2012-02-01

    Obesity is an established risk factor for esophageal adenocarcinoma, although the mechanism is unclear. A pathway from reflux to inflammation through metaplasia is the dominant hypothesis, and an added role relating to visceral adiposity and the metabolic syndrome has been mooted in Barrett\\'s esophagus (BE) patients. Whether BE differs from gastroesophageal reflux disease (GERD) in obesity and metabolic syndrome profiles is unclear, and this was the focus of this study. Patients with proven BE or GERD were randomly selected from the unit data registry and invited to attend for metabolic syndrome screening, anthropometry studies including segmental body composition analysis, and laboratory tests including fasting lipids, insulin, and C-reactive protein. Metabolic syndrome was defined using the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) criteria. One hundred and eighteen BE patients and 113 age- and sex-matched GERD controls were studied. The incidence of obesity (body mass index >30 kg\\/m(2)) was 36% and 38%, respectively, with the pattern of fat deposition predominantly central and an estimated trunk fat mass of 13 and 14 kg, respectively. Using the NCEP criteria, metabolic syndrome was significantly more common in the BE cohort (30% vs 20%, P < 0.05), but there was no significant difference using IDF criteria (42% vs 37%, P= 0.340). Central obesity and the metabolic syndrome are common in both Barrett\\'s and GERD cohorts, but not significantly different, suggesting that central obesity and the metabolic syndrome does not per se impact on the development of BE in a reflux population. In BE, the importance of obesity and the metabolic syndrome in disease progression merits further study.

  20. Risk factors for renal scarring in children with primary vesicoureteral reflux disease

    Directory of Open Access Journals (Sweden)

    Sevgi Mir

    2013-01-01

    Full Text Available To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR and the possible risk factor(s, we studied 90 children (60 girls and 30 boys with VUR followed in the Pediatric Nephrology Unit at the Ege University Hospital from 1998 to 2003. All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m technetium dimercapto-succinic acid scintigraphy. All infants with VUR were given low-dose prophylactic antibiotics and followed-up until resolution of the reflux. Grade of reflux and number of urinary tract infection (UTI episodes (≥3 were found to be statistically significant risk factors for renal scarring (P 0.05. Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05. We conclude that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

  1. Gastroesophageal reflux.

    Directory of Open Access Journals (Sweden)

    Yanet Hidalgo Marrero

    2005-12-01

    Full Text Available Although many infants has smaller degrees of gastroesophageal reflux, it is recognized that 1:3,000 at 1:10,000 of they have a pathological or symptomatic reflux. Near 90% of children vomits during the first 6 weeks of life, due primarily to the physiologic immaturity of antireflux mechanism. However, in 60% of cases, reflux disappears before 18 months, even without treatment. 30% maintains the symptoms, becoming in pathological, and of them, 10% develops serious problems, around 5% esophagitis with stenosis and between the 1 to 5% the death related with aspiration. We presented the Good Clinical Practices Guideline for Portal hypertension, approved by consensus in the 4th National Good Clinical Practices Workshop in Pediatric Surgery (Las Tunas, Cuba, March, 2005

  2. [Implementation and evaluation of a blended learning course on gastroesophageal reflux disease for physicians in Latin America].

    Science.gov (United States)

    Cohen, Henry; Margolis, Alvaro; González, Nicolás; Martínez, Elisa; Sanguinetti, Alberto; García, Sofía; López, Antonio

    2014-01-01

    Integrating evidence-based clinical practice guidelines on gastroesophageal reflux disease into medical practice is of prime importance in Latin America, given its high prevalence in this region. The aim of this project was to implement and assess an educational intervention on gastroesophageal reflux disease, aimed at primary care physicians in Latin America, with contents based on current clinical guidelines. The course included initial activities, whether face-to-face or through distance learning, and a 2-month period of Internet study and interaction. A pilot test was carried out in Uruguay, which was then repeated in 5 countries (Mexico, Colombia, Venezuela, Argentina and again in Uruguay). A global template was designed, which was then adapted to each of the countries: this was done with the participation of local institutions and leaders. Local credits were given for recertification. Participation was free. Of 3,110 physicians invited to participate, 1,143 (36.8%) started the course. Of these, 587 (51.4%) accessed at least half the contents of the course and 785 (68.7%) took part in the clinical discussions. A total of 338 (29.6%) completed all the requirements of the course and received a certificate. Among physicians who took both the pre- and post-intervention knowledge tests, scores improved from 60 to 80% (PLatin America, with an overall design that was adapted to each country. Determination of specific needs and the participation of national experts were fundamental to the success of the course.

  3. Physical activity, obesity and gastroesophageal reflux disease in the general population

    Institute of Scientific and Technical Information of China (English)

    Therese Dj(a)rv; Anna Wikman; Helena Nordenstedt; Asif Johar; Jesper Lagergren; Pernilla Lagergren

    2012-01-01

    AIM:To clarify the association between physical activity and gastroesophageal reflux disease (GERD) in nonobese and obese people.METHODS:A Swedish population-based cross-sectional survey was conducted.Participants aged 40-79 years were randomly selected from the Swedish Registry of the Total Population.Data on physical activity,GERD,body mass index (BMI) and the covariates age,gender,comorbidity,education,sleeping problems,and tobacco smoking were obtained using validated questionnaires.GERD was self-reported and defined as heartburn or regurgitation at least once weekly,and having at least moderate problems from such symptoms.Frequency of physical activity was categorized into three groups:(1)"high" (several times/week); (2) "intermediate" (approximately once weekly); and (3) "low" (1-3 times/mo or less).Analyses were stratified for participants with "normal weight" (BMI < 25 kg/m2),"overweight" (BMI 25 to ≤ 30 kg/m2) and "obese" (BMI > 30 kg/m2).Multivariate logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs),adjusted for potential confounding by covariates.RESULTS:Of 6969 eligible and randomly selected individuals,4910 (70.5%) participated.High frequency of physical activity was reported by 2463 (50%) participants,GERD was identified in 472 (10%) participants,and obesity was found in 680 (14%).There were 226 (5%) individuals with missing information about BMI.Normal weight,overweight and obese participants were similar regarding distribution of gender and tobacco smoking status,while obese participants were on average slightly older,had fewer years of education,more comorbidity,slightly more sleeping problems,lower frequency of physical activity,and higher occurrence of GERD.Among the 2146 normal-weight participants,crude point estimates indicated a decreased risk of GERD among individuals with high frequency of physical activity (OR:0.59,95% CI:0.39-0.89),compared to low frequency of physical

  4. Colonic fermentation influences lower esophageal sphincter function in gastroesophageal reflux disease

    DEFF Research Database (Denmark)

    Piche, Thierry; des Varannes, Stanislas Bruley; Sacher-Huvelin, Sylvie

    2003-01-01

    3 weeks. On day 7, esophageal motility and pH were recorded in fasting conditions and after a test meal containing 6.6 g of FOS or placebo. Breath hydrogen concentrations (reflecting colonic fermentation) and plasma concentrations of glucagon-like peptide 1 (GLP-1), peptide YY, and cholecystokinin...... were monitored. RESULTS: Compared with placebo, FOS led to a significant increase in the number of transient lower esophageal sphincter relaxations (TLESRs) and reflux episodes, esophageal acid exposure, and the symptom score for GERD. The integrated plasma response of GLP-1 was significantly higher...

  5. Long-Term Benefits of Smoking Cessation on Gastroesophageal Reflux Disease and Health-Related Quality of Life.

    Directory of Open Access Journals (Sweden)

    Yukie Kohata

    Full Text Available Smoking is associated with gastroesophageal reflux disease (GERD. Varenicline, a nicotinic receptor partial agonist, is used to aid smoking cessation. The purpose of this study was to prospectively examine the long-term benefits of smoking cessation on GERD and health-related quality of life (HR-QOL.Patients treated with varenicline were asked to fill out a self-report questionnaire about their smoking habits, gastrointestinal symptoms, and HR-QOL before and 1 year after smoking cessation. The prevalence of GERD, frequency of symptoms, and HR-QOL scores were compared. We also investigated associations between clinical factors and newly-developed GERD.A total of 141 patients achieved smoking cessation (success group and 50 did not (failure group at 1 year after the treatment. The GERD improvement in the success group (43.9% was significantly higher than that in the failure group (18.2%. The frequency of reflux symptoms significantly decreased only in the success group. There were no significant associations between newly developed GERD and clinical factors including increased body mass index and successful smoking cessation. HR-QOL significantly improved only in the success group.Smoking cessation improved both GERD and HR-QOL. Smoking cessation should be recommended for GERD patients.

  6. Is there a role for dynamic swallowing MRI in the assessment of gastroesophageal reflux disease and oesophageal motility disorders?

    Energy Technology Data Exchange (ETDEWEB)

    Kulinna-Cosentini, Christiane; Koelblinger, C.; Ba-Ssalamah, A.; Weber, M.; Kleinhansl, P. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Schima, W. [Abteilung fuer Radiologie und bildgebende Diagnostik, KH Goettlicher Heiland, Vienna (Austria); Lenglinger, J.; Riegler, M.; Cosentini, E.P. [Medical University of Vienna, Department of Surgery, Vienna (Austria); Bischof, G. [Hospital St. Josef, Department of Surgery, Vienna (Austria)

    2012-02-15

    To evaluate the diagnostic value of dynamic MRI swallowing in patients with symptoms of Gastroesophageal Reflux Disease (GERD). Thirty-seven patients (17 m/20f) with typical signs of GERD underwent MR swallowing in the supine position at 1.5 T with a phased-array body coil. Using dynamic, gradient echo sequences (B-FFE) in the coronal, sagittal and axial planes, the bolus passages of buttermilk spiked with gadolinium chelate were tracked. MRI, pH-metry and manometry were performed within 31 days and results were compared. MRI results were concordant with pH-metry in 82% (23/28) of patients diagnosed with abnormal oesophageal acid exposure by pH-metry. Five patients demonstrated typical symptoms of GERD and had positive findings with pH monitoring, but false negative results with MRI. In four of six patients (67%), there was a correct diagnosis of oesophageal motility disorder, according to manometric criteria, on dynamic MRI. The overall accuracy of MRI diagnoses was 79% (27/34). A statistically significant difference was found between the size of hiatal hernia, grade of reflux in MRI, and abnormal acid exposure on pH-monitoring. MR fluoroscopy may be a promising radiation-free tool in assessing the functionality and morphology of the GE junction. (orig.)

  7. Radiologic diagnosis of gastro-oesophageal reflux

    Energy Technology Data Exchange (ETDEWEB)

    Fransson, S.G.; Soekjer, H.; Johansson, K.E.; Tibbling, L.

    In 149 patients, a standardized radiologic method for the detection of gastro-oesophageal reflux was applied and compared with the results obtained at endoscopy and by a manometric reflux test. Radiologic reflux was recorded in 53 patients, of whom 25 had reflux without abdominal compression and 51 with compression. At least one of the other two types of examination disclosed pathologic conditions in all but 2 of 53 patients. Oesophagitis was significantly more severe among the patients with reflux observed at radiography. The presence of hiatal incompetence with reflux only to the hiatal hernia but not to the oesophagus was not a strong indicator of gastro-oesophageal reflux disease. Hiatal hernia was present in a significantly larger number of the patients with reflux at radiography than in those without reflux. Increased width of the hiatus gave stronger evidence for reflux disease than in patients with a normal hiatus. Thus, the width of the hiatus also had a bearing on the diagnosis of gastro-oesophageal reflux disease.

  8. Effect of pantoprazole in patients with chronic laryngitis and pharyngitis related to gastroesophageal reflux disease: clinical, proximal, and distal pH monitoring results.

    Science.gov (United States)

    Karoui, S; Bibani, N; Sahtout, S; Zouiten, L; Kallel, L; Matri, S; Serghini, M; Ben Mustapha, N; Boubaker, J; Besbes, G; Filali, A

    2010-05-01

    Few studies had evaluated the results of proton pump inhibitors on distal and proximal pH recording using a dual-channel probe. The aim of this study was to determine the clinical and pH-metric effect of treatment with pantoprazole 80 mg for 8 weeks in patients with ear, nose, and throat (ENT) manifestations of gastroesophageal reflux disease associated with pathological proximal acid exposure. We conducted a prospective open study. Patients included had to have chronic pharyngitis or laryngitis, and a pathological gastroesophagopharyngeal reflux. All patients received treatment with pantoprazole 80 mg daily for 8 weeks. One week after the end treatment, patients had a second ENT examination and a 24-hour pH monitoring using dual-channel probe. We included 33 patients (11 men, 22 women). A pathological distal acid reflux was found in 30 patients (91%). After treatment, the improvement of ENT symptoms was found in 51.5% of patients. Normalization of 24-hour proximal esophageal pH monitoring was observed in 22 patients (66%). After treatment, the overall distal acid exposure, the number of distal reflux events, and the number of reflux during more than 5 minutes were significantly decreased (respectively: 19.4% vs 7.2% [P laryngitis.

  9. Treatment of gastro-oesophageal reflux disease with rabeprazole in primary and secondary care : does Helicobacter pylori infection affect proton pump inhibitor effectiveness?

    NARCIS (Netherlands)

    de Wit, NJ; de Boer, WA; Geldof, H; Hazelhoff, B; Bergmans, P; Tytgat, GNJ; Smout, AJPM

    2004-01-01

    Background: The presence of the gastric pathogen, Helicobacter pylori influences acid suppression by proton pump inhibitors and treatment outcome in patients with gastro-oesophageal reflux disease. Aim: To determine the influence of H. pylori infection on effectiveness of rabeprazole in primary and

  10. Adherence to a predominantly Mediterranean diet decreases the risk of gastroesophageal reflux disease: a cross-sectional study in a South Eastern European population

    NARCIS (Netherlands)

    Mone, I.; Kraja, B.; Bregu, A.; Duraj, V.; Sadiku, E.; Hyska, J.; Burazeri, G.

    2015-01-01

    W1-publicatie Our aim was to assess the association of a Mediterranean diet and gastroesophageal reflux disease among adult men and women in Albania, a former communist country in South Eastern Europe with a predominantly Muslim population. A cross-sectional study was conducted in 2012, which includ

  11. Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy-responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

    OpenAIRE

    Smeets, Fabiënne G M; Keszthelyi, Daniel; Bouvy, Nicole D; Masclee, Ad A M; Conchillo, José M

    2015-01-01

    Background/Aims In patients with gastroesophageal reflux disease (GERD), an increased esophagogastric junction (EGJ) distensibility has been described. Assessment of EGJ distensibility with the endoscopic functional luminal imaging probe (EndoFLIP) technique might identify patients responsive to transoral incisionless fundoplication (TIF), whereas postoperative measurement of EGJ distensibility might provide insight into the antireflux mechanism of TIF. Therefore, we investigated the value of...

  12. Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease.

    NARCIS (Netherlands)

    Broeders, J.A.; Mauritz, F.A.; Ahmed Ali, U.; Draaisma, W.A.; Ruurda, J.P.; Gooszen, H.G.; Smout, A.J.P.M.; Broeders, I.A.M.J.; Hazebroek, E.J.

    2010-01-01

    BACKGROUND: Laparoscopic Nissen fundoplication (LNF) is currently considered the surgical approach of choice for gastro-oesophageal reflux disease (GORD). Laparoscopic Toupet fundoplication (LTF) has been said to reduce troublesome dysphagia and gas-related symptoms. A systematic review and meta-ana

  13. Adherence to a predominantly Mediterranean diet decreases the risk of gastroesophageal reflux disease: a cross-sectional study in a South Eastern European population.

    Science.gov (United States)

    Mone, I; Kraja, B; Bregu, A; Duraj, V; Sadiku, E; Hyska, J; Burazeri, G

    2016-10-01

    Our aim was to assess the association of a Mediterranean diet and gastroesophageal reflux disease among adult men and women in Albania, a former communist country in South Eastern Europe with a predominantly Muslim population. A cross-sectional study was conducted in 2012, which included a population-based sample of 817 individuals (≥18 years) residing in Tirana, the Albanian capital (333 men; overall mean age: 50.2 ± 18.7 years; overall response rate: 82%). Assessment of gastroesophageal reflux disease was based on Montreal definition. Participants were interviewed about their dietary patterns, which in the analysis was dichotomized into: predominantly Mediterranean (frequent consumption of composite/traditional dishes, fresh fruit and vegetables, olive oil, and fish) versus largely non-Mediterranean (frequent consumption of red meat, fried food, sweets, and junk/fast food). Logistic regression was used to assess the association of gastroesophageal reflux disease with the dietary patterns. Irrespective of demographic and socioeconomic characteristics and lifestyle factors including eating habits (meal regularity, eating rate, and meal-to-sleep interval), employment of a non-Mediterranean diet was positively related to gastroesophageal reflux disease risk (fully adjusted odds ratio = 2.3, 95% confidence interval = 1.2-4.5). Our findings point to a beneficial effect of a Mediterranean diet in the occurrence of gastroesophageal reflux disease in transitional Albania. Findings from this study should be confirmed and expanded further in prospective studies in Albania and in other Mediterranean countries. © 2015 International Society for Diseases of the Esophagus.

  14. Diagnosis and treatment of gastroesophageal reflux disease: recommendations of the Asociación Mexicana de Gastroenterología.

    Science.gov (United States)

    Huerta-Iga, F; Bielsa-Fernández, M V; Remes-Troche, J M; Valdovinos-Díaz, M A; Tamayo-de la Cuesta, J L

    Emerging concepts in the pathophysiology of gastroesophageal reflux disease (GERD) and the constant technologic advances in the diagnosis and treatment of this clinical condition make it necessary to frequently review and update the clinical guidelines, recommendations, and official statements from the leading academic groups worldwide. The Asociación Mexicana de Gastroenterología (AMG), aware of this responsibility, brought together national experts in this field to analyze the most recent scientific evidence and formulate a series of practical recommendations to guide and facilitate the diagnostic process and efficacious treatment of these patients. The document includes algorithms, figures, and tables for convenient consultation, along with opinions on GERD management in sensitive populations, such as pregnant women and older adults.

  15. The effect of ranitidine on symptom relief and quality of life of patients with gastro-oesophageal reflux disease.

    Science.gov (United States)

    Chal, K L; Stacey, J H; Sacks, G E

    1995-01-01

    A 4-week study involving 354 patients with the symptoms of gastro-oesophageal reflux disease was conducted to assess the effect of ranitidine (as effervescent tablets) on their relief and quality of life. All patients received 150 mg bd for 2 weeks, with those responding to treatment continuing on the same dosage for a further 2-week period and 'non-responders' having the dosage increased to 150 mg qds for a further 2 weeks. Quality of life and symptom assessments were carried out at 0, 2 and 4 weeks. Two weeks' treatment with ranitidine 150 mg bd was effective at controlling the GORD symptoms in 78% of patients. A 4-week treatment with either 150 mg bd or qds controlled the symptoms in 85% of patients. All patients had significant improvements in all dimensions of their quality of life over the study period.

  16. Disease due to gastroesophageal reflux in children Enfermedad por reflujo gastroesofágico en niños

    Directory of Open Access Journals (Sweden)

    Leonor Adriana Castiblanco Galvis

    1997-03-01

    Full Text Available In normal infants gastroesophageal reflux (GER is usually self-limited but GER disease (GERD is a frequent cause of morbidity in childhood, causing severe respiratory, gastrointestinal and feeding problems. This review describes the pathophysiology, clinical aspects,diagnosis, treatment and complications of GERD in children. En niños normales el reflujo gastroesofágico (RGE es usualmente autolimitado. La enfermedad por RGE (ERGE causa severos problemas respiratorios, gastrointestinales y de alimentación. La ERGE es causa frecuente de morbilidad en niños. El propósito del presente artículo es describir la fisiopatología, las manifestaciones clínicas, el diagnóstico, el manejo y las complicaciones de la ERGE en niños.

  17. Study on gastroesophageal reflux and morbidity of gastroesophageul reflux disease among the shipboard personnel%海勤人员胃食管反流发生与发病探讨

    Institute of Scientific and Technical Information of China (English)

    吕礁; 方长华; 周国中; 施云星; 刘长云; 余理红; 曾晓虹; 覃林花; 季兴英; 李琳

    2009-01-01

    目的 探讨海勤人员胃食管反流(gastroesophageal reflux,GER)发生与胃食管反流病(gastreesophageal reflux disease,GERD)发病情况.方法 (1)航行前任意2 h、航行开始2 h后,对63名在舰艇工作的健康志愿者,连续2 h实时监测食管下端pH值;同时计算烧心感、胸骨后疼痛、反酸、反食等4种症状的程度和频度积分(symptomatic core,Sc).(2)对某部177名海勤人员和139名陆勤人员进行反流症状问卷调查(reflux diagnostic questionnaire,RDQ),按烧心感、胸骨后疼痛、反酸、反食等4种症状统计、计算RDQ积分.RDQ≥20分者为GERD组,≤15分者为非GERD组,剔除16~19分者(海勤人员39例,陆勤人员31例).(3)对2004年1月至2007年12月我科门诊患者作胃镜检查,Sc积分≥8分者入选为研究对象,胃镜检查排除食管狭窄、消化性溃疡、胃食管肿瘤等疾病后,最终入选的海勤人员187人,陆勤人员251人.结果 (1)航行前Sc积分、pH5 min次数及pH3年者,反流发生率明显增加;(3)Sc症状积分≥8分者,海勤人员反流性食管炎(reflux esophagitis,RE)发病率显著高于陆勤人员组;舰龄>1年者,RE发生率明显增加.结论 (1)航行时较非航行时胃食管酸反流明显增加,症状也明显加重;(2)经常航海的海勤人员反流症状发生率显著高于陆勤人员;(3)海勤人员RE发生率显著高于陆勤人员.%Objective To investigate gastroesophageal reflux (GER) and morbidity of gastroesophageal reflux disease (GERD) among the shipboard personnel.Methods Real-time esophalgus monitoring of pH was made on 63 healthy subjects of shipboard personnel,two hours before and after deployment at sea.Symptomatic scores (Sc) were analyzed in accordance with heartburn,restrosternal chest pain,acid regurgitation and food regurgitation.177 shipboard personnel and 139 shore-based personnel participated in the reflux diagnostic questionnaire (RDQ) and RDQ scores were analyzed based on the above four symptoms

  18. Vesicoureteral reflux and reflux nephropathy

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, H.S.

    Vesicoureteral reflux (VUR) is mainly a primary phenomenon due to incontinence of the ureterovesical junction, mostly affecting a pediatric population. During micturition cystourethrography (MCU) reflux into the kidney - intrarenal reflux (IRR) - is occasionally seen. In areas with IRR the kidney surface may subsequently be depressed and the papillae retracted (reflux nephropathy (RN)). VUR may lead to hypertension and/or end-stage renal failure. Most commonly, VUR is discovered during evaluation for urinary tract infection, but it may also be present in patients with hypertension, toxemia of pregnancy, chronic renal failure and proteinuria, and it may be found in siblings of patients with VUR. For the time being VUR is demonstrated at radiographic MCU, whereas RN is diagnosed by demonstration of focal scars and of abnormal parenchymal thickness at urography. In children with VUR and no abnormalities of calyces or parenchymal defects standardized measurement of the parenchymal thickness at three sites may identify kidneys which are likely to develop focal scars. Quantitation of focal scarring should be performed in connection with a measure of the overall kidney size. The occurrence of IRR is dependent of the papillary morphology, intrapelvic pressure and urine flow. There may be an important relationship between renal ischemia and IRR in producing a 'vicious circle of deleterious effects' which, combined with parenchymal extravasation, may lead to RN. Treatment of VUR includes medical and surgical management. Since renal scarring may occur in infancy, prevention should focus on infants and young children. Infants and young children with severe VUR may have normal urograms. Therefore a MCU should also be performed, preferably with the recommended standardized technique. (orig.).

  19. Management of gastroesophageal reflux disease and erosive esophagitis in pediatric patients: Focus on delayed-release esomeprazole

    Directory of Open Access Journals (Sweden)

    Elizabet V Guimarães

    2010-10-01

    Full Text Available Elizabet V Guimarães, Paula VP Guerra, Francisco J PennaDepartment of Pediatrics, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, BrazilObjective: To review the literature on the treatment of gastroesophageal reflux disease (GERD with emphasis on proton pump inhibitors (PPIs, particularly on delayed-release esomeprazole, and to identify properties and adverse effects of PPIs observed in the treatment of GERD in children and adolescents.Sources: Electronic search of PubMed/Medline and Cochrane Collaboration databases, and of abstracts on DDW, NASPGHAN, and ESPGHAN. We focused on controlled and randomized studies published since 2000 and identified reviews that presented a consensual position, and directives published within the last 10 years.Main results: PPIs are considered better antisecretory agents than H2-receptor antagonists. Although all PPIs are similar, they are not identical in their pharmacologic properties. For example, the acid-suppressive effect of esomeprazole, the S-isomer of omeprazole, persists for more than 16 hours after administration of the morning dose. Therefore, it can control acidity after night meals better than a single dose of omeprazole. Moreover, the onset of the suppressive effect of esomeprazole is faster. It achieves acid inhibition faster than other PPIs.Conclusion: Currently, the mainstream treatment for GERD in children is a PPI. Although PPIs are safe drugs, effective in healing erosive esophagitis, and in relieving symptoms, studies with esomeprazole have shown that this drug has as powerful an ability to inhibit acid secretion as omeprazole. It also seems that some pharmacologic properties of esomeprazole are actually better for the treatment of GERD.Keywords: gastroesophageal reflux, therapy, child, adolescent.

  20. Perioperative and late outcomes of laparoscopic fundoplication for neurologically impaired children with gastro-esophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    WONG Kenneth KY; LIU Xue-lai

    2012-01-01

    Background Persistent gastro-esophageal reflux (GER) due to various pathological factors often results in overt clinical symptoms and signs,which is termed as gastro-esophageal reflux disease (GERD).Affected children usually present with failure to thrive,recurrent pneumonia or apnea.Many neurologically impaired children have symptoms related to GERD.Although laparoscopic fundoplication has been established to be an effective treatment modality for children with GERD,data on its role and long-term efficacy for neurologically impaired patients remain sparse.The aim of this study was to review the results of such patients who underwent laparoscopic fundoplication.Methods A retrospective review was performed from 1998 to 2009.All children with neurological impairment who had laparoscopic fundoplication were included.Results Fifty-nine GERD patients (male=32,female=27; mean age 6 years) were identified.All subjects showed symptoms of frequent emesis; 32 of them had history of hematemesis (54.2%); 54 had feeding difficulty; 35 (59.3%) had associated respiratory symptoms,including recurrent pneumonia.Gastrostomy was performed concurrently in 39 cases.There was no conversion to open procedure nor was there intra-operative complications and operative mortality.Emesis or hematemesis was controlled adequately in all.However,respiratory symptoms were not controlled in 10 patients (16.9%),and five of them required further respiratory assistance including nasal airway tube and tracheostomy.Clinical recurrence of GERD was not observed in any subject.Twelve patients died during follow-up (range from 3 months to 9 years) due to severe respiratory complications,cardiac arrest,and brain tumor.Conclusions Laparoscopic fundoplication is an excellent procedure for controlling clinically significant symptoms in neurological impaired patients with GERD.Further studies are required to assess the improvement of the quality of life in such patients.

  1. Myrtus communis L. Freeze-Dried Aqueous Extract Versus Omeprazol in Gastrointestinal Reflux Disease: A Double-Blind Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Zohalinezhad, Mohammad E; Hosseini-Asl, Mohammad Kazem; Akrami, Rahimeh; Nimrouzi, Majid; Salehi, Alireza; Zarshenas, Mohammad M

    2016-01-01

    The current work assessed a pharmaceutical dosage form of Myrtus communis L. (myrtle) in reflux disease compared with omeprazol via a 6-week double-blind randomized controlled clinical trial. Forty-five participants were assigned randomly to 3 groups as A (myrtle berries freeze-dried aqueous extract, 1000 mg/d), B (omeprazol capsules, 20 mg/d), and C (A and B). The assessment at the beginning and the end of the study was done by using a standardized questionnaire of frequency scale for the symptoms of gastroesophageal reflux disease (FSSG). In all groups, both reflux and dyspeptic scores significantly decreased in comparison with the respective baselines. Concerning each group, significant changes were found in FSSG, dysmotility-like symptoms and acid reflux related scores. No significant differences were observed between all groups in final FSSG total scores (FSSG2). Further studies with more precise design and larger sample size may lead to a better outcome to suggest the preparation as an alternative intervention.

  2. Relationship between Helicobacter pylori infection and gastroesophageal reflux disease%幽门螺杆菌感染与胃食管反流的关系

    Institute of Scientific and Technical Information of China (English)

    周政; 刘有理; 王光明; 黄志刚

    2013-01-01

    目的 探讨胃食管反流病(GRED)与幽门螺杆菌(Hp)的关系.方法 确诊的胃食管反流病患者60例及浅表糜烂性胃炎患者63例(对照组),均行幽门螺杆菌检测,再将60例GERD患者分为2组,25例常规三联抗HP治疗,为HP根除组,另外35例作为Hp持续感染组.随访1年.结果 60例GERD患者Hp感染率为58.3%,对照组Hp感染率82.5%,GERD患者Hp感染率低于对照组,差异有统计学意义(P<0.05).Hp根除组GERD复发率高于Hp持续感染组,差异有统计学意义(P<0.05).对照组Hp根除后GERD的发病率为25.5%.结论 Hp感染可能在GERD的发病过程中起保护作用.%Objective To explore the relationship between gastroesophageal reflux disease( GRED )and Helicobacter pylori( Hp ). Methods Helicobacter pylori was checked among the patients ,60 cases of Gastroesophageal reflux disease( GRED )and 63 cases of the superficial erosive gastritis. The 60 cases of Gastroesophageal reflux disease were divided into two groups. Helicobacter pylori eradicate group ( 25 cases )had routine trigeminy resist treatment of Helicobacter pylori,the other 35cases as persistent infection of Helicobacter pylori group. Follow up was conducted of one year. Results The Helicobacter pylori infection rate of 60 cases of Gastroesophageal reflux dis-ease( GRED )was 58. 3 percent. The Helicobacter pylori infection rate of 63 cases of control group was 82. 5 percent. The Helicobacter pylori infection rate of Gastroesophageal reflux disease group was lower than that of control group. The difference between two groups had statistical significance( P < 0.05 ). The GRED relapse rate of Helicobacter pylori eradication group was higher than that of persistent Helicobacter pylori infection group. The difference between two groups had statistical significance( P <0. 05 ). The GERD morbidity of control group after Helicobacter pylori eradication was 25. 5 percent. Conclusion Helicobacter pylori infection may play the protective effect in

  3. Esofagite por refluxo e laringite por refluxo: Estágios clínicos diferentes da mesma doença? Reflux esophagitys and reflux laryngitis: Different stages of the same disease?

    Directory of Open Access Journals (Sweden)

    Fabiano B. Gavazzoni

    Full Text Available Introdução: O refluxo gastro-esofágico (RGE é uma entidade decorrente de falha anatômica e/ou funcional dos mecanismos de contenção do conteúdo gástrico. As manifestações otorrinolaringológicas do RGE são globus em orofaringe, regurgitação, disfonia, pirose orofaríngea, disfagia e tosse crônica. Objetivo: Pretende-se avaliar os sintomas otorrinolaringológicos do refluxo em pacientes com indicação cirúrgica de hérnia hiatal e comparar com pacientes apenas com queixas laríngeas do RGE. Forma de Estudo: prospectivo clínico randomizado. Material e método: Foram avaliados dois grupos. O grupo A, com 18 pacientes admitidos nos Serviços de Cirurgia do Aparelho Digestivo e Cirurgia Geral que necessitavam de tratamento cirúrgico de esofagite graus III e IV, quanto aos sintomas otorrinolaringológicos do RGE. O grupo B, com 44 pacientes do Serviço de Otorrinolaringologia com queixas laríngeas de RGE. Os pacientes foram submetidos a um protocolo, videolaringoscopia e endoscopia digestiva alta (EDA. Os dados obtidos foram tabulados e comparados com a literatura. Resultados: Os sintomas referidos pelos pacientes do grupo B foram os mesmos do grupo A, porém, disfonia, tosse, regurgitação e pirose em orofaringe foram mais prevalentes no grupo B. As alterações laringoscópicas dos pacientes do grupo B foram mais significativas. As alterações de EDA foram mais prevalentes nos pacientes do grupo A. A partir destes dados nota-se que não existe correlação entre a doença esofageana e os sintomas laríngeos. Conclusão: O trabalho demonstrou a correlação entre sintomas otorrinolaringológicos e o refluxo gastro-esofágico, porém a comparação entre os dois grupos permitiu concluir que, apesar dos quadros apresentarem fisiopatologia semelhante, não se tratam de estágios evolutivos da mesma doença.Introduction: Gastroesophageal reflux disease (GRD is an entity due to anatomical or functional failure of contention

  4. Refractory gastroesophageal reflux disease Doença do refluxo gastroesofágico refratária

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    Joaquim Prado P. Moraes-Filho

    2012-12-01

    Full Text Available CONTEXT: Gastroesophageal reflux disease (GERD is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Its pathophysiology, diagnosis and treatment have frequently been analyzed but it is interesting to review some aspects of the GERD refractory patients to the proton pump inhibitors treatment. The treatment encompasses behavioral measures and pharmacological therapy. The majority of the patients respond well to proton pump inhibitors treatment but 20%-42% of them may not do so well. Patients who are unresponsible to 4-8 weeks' treatment with proton pump inhibitors (omeprazole, pantoprazole, rabeprazole, lansoprazole, esomeprazole, pantoprazole-Mg might have so-called refractory GERD. RESULTS: In some cases the patients are not real refractory because either they do not have GERD or the disease was not correctly treated, but the term refractory is still employed. Although debatable, the Brazilian GERD Consensus based upon evidences recommends as first step in the diagnosis, the upper digestive endoscopy to exclude the diagnosis of peptic ulcer and cancer and in some cases identify the presence of esophageal mucosa erosions. CONCLUSIONS: The main causes of the so-called refractory GERD are: (1 functional heartburn; (2 low levels of adherence to proton pump inhibitors treatment; (3 inadequate proton pump inhibitors dosage; (4 wrong diagnosis; (5 co-morbidities and pill-induced esophagitis; (6 genotypic differences; (7 nonacid gastroesophageal reflux; (8 autoimmune skin diseases; (9 eosinophilic esophagitis.CONTEXTO: A doença do refluxo gastroesofágico (DRGE é a condição que se desenvolve quando o refluxo do conteúdo gástrico provoca sintomas incômodos e/ou complicações. A fisiopatologia, o diagnóstico e o tratamento da enfermidade têm sido convenientemente estudados, mas é interessante revisar alguns aspectos dos pacientes que são aparentemente refratários, ou seja, n

  5. Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

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    Chi-Kuei Hsu

    2016-12-01

    Full Text Available This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05. A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]. The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012. In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians.

  6. Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

    Science.gov (United States)

    Hsu, Chi-Kuei; Lai, Chih-Cheng

    2016-01-01

    This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD) in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05). A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]). The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012). In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians. PMID:28028458

  7. Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole

    Directory of Open Access Journals (Sweden)

    Mermelstein J

    2016-07-01

    Full Text Available Joseph Mermelstein,1 Alanna Chait Mermelstein,2 Maxwell M Chait,3 1Department of Medicine, Mount Sinai Beth Israel/Icahn School of Medicine, 2Department of Psychiatry, New York Presbyterian Hospital/Weill Cornell Medicine, 3Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA Abstract: Gastroesophageal reflux disease is the most common upper gastroenterology disorder in the US. It is associated with a variety of complications and significantly impacts quality of life. Proton pump inhibitors are the most effective treatment. Dexlansoprazole modified release (MR is a proton pump inhibitor that employs a novel release formulation that prolongs its absorption and allows for more flexibility in dosing. Dexlansoprazole MR can be dosed without regard to food intake or time of day, and once-daily dosing may replace twice-daily dosing of other agents. Dexlansoprazole MR is effective for healing and maintenance of erosive esophagitis, and for the treatment of nonerosive disease, including nocturnal gastroesophageal reflux disease. Dexlansoprazole MR is safe and well tolerated, and can improve quality of life. Keywords: dexlansoprazole, proton pump inhibitors, gastroesophageal reflux disease, erosive esophagitis

  8. Gastric greater curvature plication combined with Nissen fundoplication in the treatment of gastroesophageal reflux disease and obesity

    Directory of Open Access Journals (Sweden)

    Oral Ospanov

    2016-01-01

    Conclusions: LNFGP took significantly longer time to perform, but resulted in significantly higher weight reduction and remission/improvement of comorbidities. Both procedures produced similar anti-reflux effect.

  9. [Feeding disorders, ALTE syndrome, Sandifer syndrome and gastroesophageal reflux disease in the course of food hypersensitivity in 8-month old infant].

    Science.gov (United States)

    Iwańczak, Barbara; Mowszet, Krystyna; Iwańczak, Franciszek

    2010-07-01

    This paper describes the occurrence of feeding disorders, atopic dermatitis, life-threatening symptoms, Sandifer syndrome, and gastroesophageal reflux disease in 8-month old infant in the course of food hypersensitivity. Used in the treatment of cow's milk protein hydrolysates with a considerable degree of hydrolysis, omeprazole, Cisapride. It was not until the introduction of elemental diet based on free amino acids resulted in the withdrawal of life-threatening child's symptoms.

  10. Spatiotemporal characteristics of acid refluxate and relationship to symptoms in premature and term infants with chronic lung disease.

    Science.gov (United States)

    Jadcherla, Sudarshan R; Gupta, Alankar; Fernandez, Soledad; Nelin, Leif D; Castile, Robert; Gest, Alfred L; Welty, Stephen

    2008-03-01

    The prevalence of gastroesophageal reflux (GER) is high among infants with chronic lung disease (CLD), and the associated pathogenic mechanisms are not clear. The relationship of symptoms to the extent or duration of acid reflux events (AREs) is not well known in preterm or term infants. Our aim was to evaluate the relationship between spatial (height) and temporal (duration) characteristics of AREs (pH <4.0) with symptoms in CLD. We tested the hypothesis that in infants with CLD, AREs into the pharynx are associated with increased symptom occurrence and delayed clearance. Nine infants born at 29.8 +/- 5.5 wk gestation (mean +/- SD, range 24.7-39.0 wk) with CLD were evaluated for GER at 49.7 +/- 8.0 wk postmenstrual age (mean +/- SD, range 39.9-67.4 wk). Esophageal manometry was first performed to determine the nares-lower esophageal sphincter (LES) distance. A pH-impedance probe was placed at 87% of the nares-LES distance, and a recording was performed for about 24 h at cribside. Symptoms (respiratory, sensory, and movement) were documented by nurses that were blinded to the pH-impedance recordings. A symptom was considered associated with an ARE if it occurred 2 min before, during, or 2 min after the ARE. The proximal extent and associated clearance mechanisms were correlated with symptom sensitivity index (SSI = number of AREs with symptoms/total AREs *100). Multiple logistic regression methods, analysis of variance (ANOVA) models, and chi(2) tests were performed. Data are described as median, mean +/- SD, or %. A total of 511 AREs, based on pH-Impedance methods, were analyzed from 203 h of recordings in the nine infants. The distal esophagus was the maximal height reached in 80% of AREs (P < 0.001, compared to other esophageal segments). Overall 33% of the AREs were associated with symptoms, and an SSI of 77% was noted with high AREs into the pharynx. The average acid clearance time was prolonged with symptomatic AREs versus nonsymptomatic AREs by 3.5-fold (P

  11. Study of Knowledge attitude and Practice of Non-pharmacological measures in patients with Gastro-esophageal Reflux Disease

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    Kaushal Suthar

    2013-07-01

    Full Text Available Background: Gastroesophageal reflux disease (GERD and its complications are very common all over the world as well as in India. Although pharmacological measures are very useful, nonpharmacological measures can give promising results in its management. Objective of this study was to assess knowledge, attitude and practice of nonpharmacological measures to control symptoms in patients with GERD. Materials and Methods: An interview of total 100 patients suffering from GERD not on pharmacological management was conducted. Their demographic details and responses to the questions were noted in the questionnaire.Results: Knowledge and practice about avoidance of large meals before lying down, avoidance of smoking, alcohol and tobacco chewing, weight loss and avoiding constricting cloths were very much compromised while knowledge and practice about avoidance of caffeine, carbonated beverages, spicy and citrus foods and fatty meals were at acceptable stage. About 20% of the study population said that GERD can be treated by drugs alone i.e. they were not aware of non-pharmacological measures. Conclusion: In patients with GERD, knowledge and practice regarding avoidance of fatty foods, spicy foods, citrus foods, caffeine and carbonated beverages is good but that of avoidance of smoking and tobacco chewing, alcohol, weight reduction, avoiding constricting cloths and avoidance of large meals before lying down is lacking. So, when we treat patients with GERD, areas of lacking knowledge and practice as mentioned above must be focused while motivating for the life style modification

  12. Epidemiology and risk factors of uninvestigated dyspepsia, irritable bowel syndrome, and gastroesophageal reflux disease among students of Damascus University, Syria.

    Science.gov (United States)

    Al Saadi, Tareq; Idris, Amr; Turk, Tarek; Alkhatib, Mahmoud

    2016-12-01

    Uninvestigated dyspepsia (UD), irritable bowel syndrome (IBS), and gastroesophageal reflux disease (GERD) are common disorders universally. Many studies have assessed their epidemiological characteristics around the world. However, such information is not known for Syria. We aim to estimate the epidemiologic characteristics and possible risk factors for UD, IBS, and GERD among students at Damascus University, Damascus, Syria. A cross-sectional study was conducted in July-September 2015 at a campus of Damascus University. A total of 320 students were randomly asked to complete the survey. We used ROME III criteria to define UD and IBS, and Montreal definition for GERD. In total, 302 valid participants were included in the analysis. Prevalence for UD, IBS, and GERD was 25%, 17%, and 16%, respectively. Symptom overlap was present in 46 students (15%), with UD+IBS in 28 (9.3%), UD+GERD in 26 (8.6%), and IBS+GERD in 14 (4.6%) students. Eleven (3.6%) students had symptoms of UD+IBS+GERD. Each of these overlaps occurred more frequently than expected by chance. Significant risk factors included cigarettes smoking, waterpipe consumption, and body mass index coffee/d for IBS; and two cups of tea and one to five cigarettes/d for GERD. Risk factors for these disorders remain poorly characterized and need further investigations. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  13. Effects of antireflux treatment on bronchial hyper-responsiveness and lung function in asthmatic patients with gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Shan-Ping Jiang; Rui-Yun Liang; Zhi-Yong Zeng; Qi-Liang Liu; Yong-Kang Liang; Jian-Guo Li

    2003-01-01

    AIM: To investigate the effects of antireflux treatment on bronchial hyper-responsiveness and lung function in asthmatic patients with gastroesophageal reflux disease (GERD).MF THODS: Thirty asthmatic patients with GERD were randomly divided into two groups (group A and group B).Patients in group A (n=15) only received asthma medication including inhaled salbutamol 200 pg four times a day and budesonide 400 μg twice a day for 6 weeks. Patients in Group B (n=15) received the same medication as group A,and also antireflux therapy including oral omeprazole 20mg once a day and domperidone 10 mg three times a day for 6 weeks. Pulmonary function tests and histamine bronchoprovocation test were performed before and after the study.RESULTS: There was no significant difference in the baseline values of pulmonary function and histamine PC20-FEV1 between the two groups. At the end of the study, the mean values for VC, VC%, FVC, FVC%, FEV1, FEV1%, PEF, PEF%, PC20-FEV1were all significantly improved in group B, compared with group A.CONCLUSION: Antireflux therapy may improve pulmonary function and inhibit bronchial hyper-responsiveness in asthmatic patients with GERD.

  14. "The missing LINX" for gastroesophageal reflux disease: Operative techniques video for the Linx magnetic sphincter augmentation procedure.

    Science.gov (United States)

    Kuckelman, John P; Barron, Morgan R; Martin, Matthew J

    2017-05-01

    In 2012 the FDA approved a magnetic sphincter augmentation (MSA) device (LINX, Torax Medical, Inc) for placement around the lower esophageal sphincter as an alternative approach to fundoplication for gastroesophageal reflux disease (GERD). This is a relatively new procedure and there is not widespread familiarization with the standard indications and techniques of device placement. We present two operative videos to highlight the standard surgical technique and technical points needed for successful LINX placement. First will be placement in a standard indications setting of uncomplicated GERD with no hiatal hernia. Second will be placement with complicated anatomy due to alterations from prior gastric surgery and a hiatal hernia. Our experience has revealed that the LINX device can be placed safely in patients with normal or significantly altered anatomy but requires adherence to several key principles and technical points. This procedure offers a new option that is anatomically and physiologically unique compared to standard fundoplication, and that offers highly effective control of GERD with a less invasive approach. Published by Elsevier Inc.

  15. [Therapeutic principles in gastroesophageal reflux].

    Science.gov (United States)

    Chassany, O; Elkharrat, D; Bergmann, J F; Segrestaa, J M

    1995-01-01

    Gastroesophageal reflux is a common disease. Its chronic course, even if mild, is sometimes complicated by erosive oesophagitis. Drug therapy acts against gastric acidity and motility disorders. Treatment of gastroesophageal reflux disease has three aims: improvement of symptoms and quality of life, healing erosive lesions and prevention of symptomatic and endoscopic relapses. Non-drug measures are always useful, even if their efficacy is not well established. Initial therapy of a symptomatic reflux or mild oesophagitis is most of the time effective (antacids, prokinetics, H2 receptor antagonists). Proton-pump inhibitors are also effective in healing and preventing severe oesophagitis. Questions about long-term treatment adverse events with powerful acid inhibitors, such as hypergastrinemia and the risk of gastric carcinoid tumours seem to be resolved. Studies are requested to define the optimal long-term maintenance treatment with cisapride, H2 receptor antagonists or proton-pump inhibitors at low doses in prevention of symptomatic and mild oesophagitis relapses.

  16. The University of Chicago contribution to the treatment of gastroesophageal reflux disease and its complications: a tribute to David B. Skinner 1935-2003.

    Science.gov (United States)

    Greene, Christina L; Worrell, Stephanie G; Patti, Marco G; DeMeester, Tom R

    2015-03-01

    To highlight the contributions from the University of Chicago under the leadership of Dr David B. Skinner to the understanding of gastroesophageal reflux disease (GERD) and its complications. The invention of the esophagoscope confirmed that GERD was a premorbid condition. The medical world was divided between those who believed in a morphological lower esophageal sphincter (LES) and those who did not. Those who did not believe attempted to rearrange the anatomy of the foregut organs to stop reflux with minimal success. The discovery of the LES focused attention on the sphincter as the main deterrent to reflux and the hope that measurement of a low LES pressure would mark the presence of GERD. This turned out not to be so. In July 1973, with this history of confusion, Dr Skinner at the age of 36 assumed the chair of surgery at the University of Chicago. The publications of the University of Chicago's esophageal group were collected from private and public (PubMed) databases, reviewed, and seminal contributions selected. Twenty-four-hour esophageal pH monitoring led to the understanding of the LES, its contribution to GERD, and the complication of Barrett's esophagus. The relationship of Barrett's to adenocarcinoma was clarified. The rising incidence of esophageal adenocarcinoma led to contributions in the staging of esophageal cancer and its treatment with an en bloc resection. Ten years after the death of Dr Skinner, we can appreciate the monumental contributions to benign and malignant esophageal disease under his leadership.

  17. Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2013-03-01

    Full Text Available Francesco Di Pierro,1 Mario Gatti,2 Giuliana Rapacioli,3 Leandro Ivaldi4 1Velleja Research, Milan, 2Gastroenterology Department, Giussano Hospital, Monza-Brianza, 3AIOR, Piacenza, 4Digestive Endoscopic Department, Ceva Hospital, Ceva, Cuneo, Italy Background: The purpose of this study was to compare the efficacy of alginic acid alone versus alginic acid combined with low doses of pure glycyrrhetinic acid and bilberry anthocyanosides as an addon to conventional proton pump inhibitor therapy in relieving symptoms associated with nonerosive reflux disease. Methods: This prospective, randomized, 8-week, open-label trial was conducted at two centers. Sixty-three patients with persistent symptoms of gastroesophageal reflux disease and normal upper gastrointestinal endoscopy were eligible for the study. Patients in group A (n = 31 were treated with pantoprazole and a formula (Mirgeal® containing alginic acid and low doses of pure glycyrrhetinic acid + standardized Vaccinium myrtillus extract for 4 weeks, then crossed over to the multi-ingredient formula for a further 4 weeks. Patients in group B (n = 32 were treated pantoprazole and alginic acid alone twice daily, then crossed over to alginic acid twice daily for a further 4 weeks. Efficacy was assessed by medical evaluation of a symptom relief score, estimated using a visual analog scale (0–10. Side effects, tolerability, and compliance were also assessed. Results: Of the 63 patients enrolled in the study, 58 (29 in group A and 29 in group B completed the 8-week trial. The baseline characteristics were comparable between the two groups. During the study, significant differences were recorded in symptom scores for both groups. In group A, symptoms of chest pain, heartburn, and abdominal swelling were less serious than in group B. Treatment A was better tolerated, did not induce hypertension, and had fewer side effects than treatment B. No significant differences in compliance were found between the

  18. Epidemiology of gastroesophageal reflux disease:A general population-based study in Xi'an of Northwest China

    Institute of Scientific and Technical Information of China (English)

    Jin-Hai Wang; Jin-Yan Luo; Lei Dong; Jun Gong; Ming Tong

    2004-01-01

    AIM: Gastroesophageal reflux disease (GERD) is a common disorder in the Western population, but detailed populationbased data in China are limited. The aim of this study was to understand the epidemiology of symptomatic gastroesophageal reflux (SGER) in adults of Xi′an, a northwestern city of China,and to explore the potential risk factors of GERD.METHODS: Symptoms suggestive of GERD, functional dyspepsia (FD), irritable bowel syndrome (IBS), upper respiratory diseases and some potential risk factors were investigated in a face-to-face manner in a region-stratified random samples of 2 789 residents aged 18-70 years in Xi′an by using a standardized questionnaire.METHODS: With a response rate of 91.8%, the prevalence of SGER was 16.98% (95% CI, 14.2-18.92) in Xi′an adults,and no gender-related difference was observed (P<0.05).SGER was more common among subjects aged 30-70 years than in those aged 18-29 years (P<0.01). The prevalence of SGER in rural, urban and suburban subjects was 21.07%,17.44% and 12.12%, respectively, and there was a significant difference between rural, urban and suburban regions (P<0.05). Compared with subjects without SGER,the prevalence of symptoms suggestive of FD and IBS,pneumonia, asthma, bronchitis, laryngitis, pharyngitis,chronic cough, wheeze, globus sensation, oral ulcer and snore was significantly increased in subjects with SGER (P<0.01). Heavy smoking (OR=5.76; CI, 3.70-6.67), heavy alcohol use (OR=2.85; CI, 1.67-4.49), peptic ulcer (OR=5.76;CI, 3.99-8.32), cerebral palsy (OR=3.97; CI, 1.97-8.00),abdominal operation (OR=2.69; CI, 1.75-4.13), obesity (OR=2.16; CI, 1.47-3.16), excessive food intake (OR=1.43;CI, 1.17-1.15), sweet food (OR=1.23; CI, 0.89-1.54),and consumption of coffee (OR=1.23; CI, 0.17-2.00) were independently associated with SGER. The episodes of GERD were commonly precipitated by dietary factors (66.05%),followed by body posture (26.54%), iii temper (23.72%),fatigue (22.32%) and stress (10

  19. Reflux in Children

    Science.gov (United States)

    ... could be GERD. What causes reflux and GERD in children? There is a muscle (the lower esophageal ... contents don't flow back into the esophagus. In children who have reflux and GERD, this muscle ...

  20. Reflux in Infants

    Science.gov (United States)

    ... to 14 months. What causes reflux and GERD in infants? There is a muscle (the lower esophageal ... contents don't flow back into the esophagus. In babies who have reflux, the lower esophageal sphincter ...

  1. Manifestações extra-esofágicas da doença do refluxo gastroesofágico Extraesophageal manifestations of gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Richard Ricachenevski Gurski

    2006-04-01

    Full Text Available A doença do refluxo gastroesofágico freqüentemente se apresenta com pirose e regurgitação, os chamados sintomas típicos. Porém, um subgrupo de pacientes apresenta um conjunto de sinais e sintomas que não estão relacionados diretamente ao dano esofágico. A esse conjunto dá-se o nome de manifestações extra-esofágicas da doença do refluxo gastroesofágico. Compreendem, principalmente, broncoespasmo, tosse crônica e alterações inflamatórias na laringe (chamados manifestações atípicas. Apesar de essas manifestações formarem um grupo heterogêneo, algumas considerações gerais englobam todos os subgrupos: embora a associação entre a doença do refluxo gastroesofágico e as manifestações extra-esofágicas esteja bem estabelecida, uma relação entre causa e efeito definitiva ainda não está elucidada; em relação à patogênese das manifestações extra-esofágicas, os principais mecanismos propostos são a injúria direta do tecido extra-esofágico pelo conteúdo ácido gástrico refluído e o reflexo esôfago-brônquico mediado pelo nervo vago; a doença do refluxo gastroesofágico pode não ser incluída no diagnóstico diferencial do grupo de pacientes que apresenta somente os sintomas atípicos. Este artigo revisa as manifestações extra-esofágicas da doença do refluxo gastroesofágico encontradas na literatura, discutindo a epidemiologia, patogênese, diagnóstico e tratamento, com foco nas apresentações mais estudadas e estabelecidas.Gastroesophageal reflux disease often presents as heartburn and acid reflux, the so-called "typical" symptoms. However, a subgroup of patients presents a collection of signs and symptoms that are not directly related to esophageal damage. These are known collectively as the extraesophageal manifestations of gastroesophageal reflux disease. Principal among such manifestations are bronchospasm, chronic cough and laryngitis, which are classified as atypical symptoms. These

  2. Delayed-release oral suspension of omeprazole for the treatment of erosive esophagitis and gastroesophageal reflux disease in pediatric patients: a review

    Directory of Open Access Journals (Sweden)

    Alice Monzani

    2010-03-01

    Full Text Available Alice Monzani, Giuseppina Oderda1Department of Pediatrics, Università del Piemonte Orientale, Novara, ItalyAbstract: Omeprazole is a proton-pump inhibitor indicated for gastroesophageal reflux disease and erosive esophagitis treatment in children. The aim of this review was to evaluate the efficacy of delayed-release oral suspension of omeprazole in childhood esophagitis, in terms of symptom relief, reduction in reflux index and/or intragastric acidity, and endoscopic and/or histological healing. We systematically searched PubMed, Cochrane and EMBASE (1990 to 2009 and identified 59 potentially relevant articles, but only 12 articles were suitable to be included in our analysis. All the studies evaluated symptom relief and reported a median relief rate of 80.4% (range 35%–100%. Five studies reported a significant reduction of the esophageal reflux index within normal limits (<7% in all children, and 4 studies a significant reduction of intra-gastric acidity. The endoscopic healing rate, reported by 9 studies, was 84% after 8-week treatment and 95% after 12-week treatment, the latter being significantly higher than the histological healing rate (49%. In conclusion, omeprazole given at a dose ranging from 0.3 to 3.5 mg/kg once daily (median 1 mg/kg once daily for at least 12 weeks is highly effective in childhood esophagitis.Keywords: proton pump inhibitors, children, ranitidine, H2-blockers

  3. Rabeprazole 10 mg versus 20 mg in preventing relapse of gastroesophageal reflux disease: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    ZHU Hai-di; WANG Heng; XIA Xian-ming; XU Shu-man; LAN Yao

    2013-01-01

    Background Several randomized controlled trials (RCTs) have compared endoscopic and symptomatic relapses in patients with erosive gastroesophageal reflux disease (GERD).We have summarized current evidence for rabeprazole 10 or 20 mg once daily for GERD maintenance treatment over 1 or 5 years.Methods MEDLINE,EMBASE,and the Cochrane Central Register of Controlled Trials were searched,through August 2012,for eligible RCTs of adults with erosive GERD.The efficacies of rabeprazole 10 and 20 mg/d were compared.Results The search identified 288 citations,and five RCTs containing 1480 patients were considered eligible.Heartburn relapse rates did not differ significantly between patients treated with rabeprazole 10 and 20 mg/d for 1 year (relative risk (RR)=1.29; 95% confidence interval (CI):0.97-1.72),but differed in patients treated for 5 years (RR=1.274; 95% CI:1.005-1.615).Endoscopic relapse rates differed significantly between rabeprazole 10 and 20 mg/d for 1 year (RR=1.92;95% CI:1.21-3.06),for 5 years (RR=1.667; 95% CI:1.073-2.589),and in combined 1-and 5-year maintenance trials (RR=1.785; 95% CI:1.298-2.456).Conclusion Rabeprazole 20 mg/d was superior to rabeprazole 10 mg/d in preventing endoscopic relapse of erosive GERD,but that the two dosages were equivalent in symptomatic relief over 1 year.

  4. Prevalence of uninvestigated dyspepsia and gastroesophageal reflux disease in Korea: a population-based study using the Rome III criteria.

    Science.gov (United States)

    Min, Byung-Hoon; Huh, Kyu Chan; Jung, Hye-Kyung; Yoon, Young Hoon; Choi, Kee Don; Song, Kyung Ho; Keum, Bora; Kim, Jung Won

    2014-11-01

    There have been few population-based studies on the prevalences of gastroesophageal reflux disease (GERD) and dyspepsia using Rome III criteria in Asian countries. A population-based, cross-sectional study was conducted by telephone interviews of 5,000 Koreans between the ages of 20-69 years. Gastrointestinal symptoms were assessed by a translated Korean version of Rome III criteria. Uninvestigated dyspepsia (UID) was defined by symptom criteria of Rome III. GERD was defined by troublesome heartburn and/or acid regurgitation occurring at least once a week. The EQ5D assessment tool was used for the evaluation of quality of life. The prevalences of UID, postprandial distress syndrome (PDS), and epigastric pain syndrome (EPS) were 7.7, 5.6, and 4.2 %, respectively. Overlap between PDS and EPS was found in 27.1 % (104/384) of subjects with UID. There were no significant differences in demographic variables between patients with PDS and EPS. The prevalence of GERD was 7.1 %. Overlap between GERD and UID was found in 50.0 % of GERD patients. The EQ5D index of patients without either UID or GERD was 0.92 ± 0.07, and those of patients with only UID, with only GERD, and with both UID and GERD were 0.88 ± 0.09, 0.88 ± 0.11, and 0.84 ± 0.15, respectively. GERD and UID based on Rome III criteria were prevalent and significantly affected the quality of life in Korea. In Korean patients with UID, there was considerable overlap and there were no significant differences in demographic variables between PDS and EPS.

  5. Patient-Provider Interactions Affect Symptoms in Gastroesophageal Reflux Disease: A Pilot Randomized, Double-Blind, Placebo-Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Michelle L Dossett

    Full Text Available It is unclear whether the benefits that some patients derive from complementary and integrative medicine (CIM are related to the therapies recommended or to the consultation process as some CIM provider visits are more involved than conventional medical visits. Many patients with gastrointestinal conditions seek out CIM therapies, and prior work has demonstrated that the quality of the patient-provider interaction can improve health outcomes in irritable bowel syndrome, however, the impact of this interaction on gastroesophageal reflux disease (GERD is unknown. We aimed to assess the safety and feasibility of conducting a 2 x 2 factorial design study preliminarily exploring the impact of the patient-provider interaction, and the effect of an over-the-counter homeopathic product, Acidil, on symptoms and health-related quality of life in subjects with GERD.24 subjects with GERD-related symptoms were randomized in a 2 x 2 factorial design to receive 1 either a standard visit based on an empathic conventional primary care evaluation or an expanded visit with questions modeled after a CIM consultation and 2 either Acidil or placebo for two weeks. Subjects completed a daily GERD symptom diary and additional measures of symptom severity and health-related quality of life.There was no significant difference in GERD symptom severity between the Acidil and placebo groups from baseline to follow-up (p = 0.41, however, subjects who received the expanded visit were significantly more likely to report a 50% or greater improvement in symptom severity compared to subjects who received the standard visit (p = 0.01. Total consultation length, perceived empathy, and baseline beliefs in CIM were not associated with treatment outcomes.An expanded patient-provider visit resulted in greater GERD symptom improvement than a standard empathic medical visit. CIM consultations may have enhanced placebo effects, and further studies to assess the active components of this

  6. A study of the symptoms of gastro-esophageal reflux disease and associated risk factors among the rural school children of Veleru India

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    Gunda Jahnavi

    2013-10-01

    Full Text Available Background: Prevalence of gastro-esophageal reflux disease (GERD in all ages has shown an upward trend over the past decades. The reasons for this increase are ill-understood. The data in the pediatric population is limited. Recent studies have linked childhood GERD to adult GERD. This study was conducted to assess the symptoms, risk factors of GERD among the schoolchildren residing in a rural area. Aims: The aim of this study was to find out the prevalence of GERD risk factors among the school children aged 8-17 years and to find any association between body mass indexes , meal pattern and sleep disturbances related to GERD. Materials and Methods: We did a cross-sectional study on 380 school children of 4 th -10 th standard from 4 schools of Veleru, the Rural Health Center attached to Dr. Pinnamaneni Siddhartha Institute of Medical Sciences. The questionnaire consisted of questions for reflux symptoms, meal pattern and sleep disturbances. Results: The symptoms of reflux like abdominal pain was reported in 7%, heartburn in 1.3%, regurgitation in 2.4%, vomiting in 2.9%, difficulty in swallowing in 2.1%, sore taste in mouth in 0.8% of the children. The risk-factors for reflux like caffeinated drinks were found in 45.3%, very spicy food in 12.1%, heavy meals in 2.4% of the children. Sleep disturbance was seen in 33.4% of the children. Obesity was present in 0.6% of the children. Conclusion: School children should be informed about the symptoms and risk factors of GERD so that healthy dietary habits can be developed at a young age and GERD can be prevented.

  7. Laparoscopic Nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease: A meta-analysis and systematic review.

    Science.gov (United States)

    Du, Xing; Wu, Ji-Min; Hu, Zhi-Wei; Wang, Feng; Wang, Zhong-Gao; Zhang, Chao; Yan, Chao; Chen, Mei-Ping

    2017-09-01

    Laparoscopic Nissen fundoplication (LNF) has been the gold standard for the surgical management of Gastro-esophageal reflux disease (GERD). Laparoscopic anterior 180° fundoplication (180° LAF) is reported to reduce the incidence of postoperative complications while obtaining similar control of reflux. The present meta-analysis was conducted to confirm the value of the 2 techniques. PubMed, Medline, Embase, Cochrane Library, Springerlink, and China National Knowledge Infrastructure Platform databases were searched for randomized controlled trials (RCTs) comparing LNF and 180° LAF. Data regarding the benefits and adverse results of 2 techniques were extracted and compared using a meta-analysis. Six eligible RCTs comparing LNF (n = 266) and 180° LAF (n = 265) were identified. There were no significant differences between LNF and 180° LAF with regard to operating time, perioperative complications, length of hospital stay, patient satisfaction, willingness to undergo surgery again, quality of life, postoperative heartburn, proton pump inhibitor (PPI) use, postoperative DeMeester scores, postoperative lower esophageal sphincter (LES) pressure, postoperative gas-bloating, unable to belch, diarrhea, or overall reoperation. LNF was associated with a higher prevalence of postoperative dysphagia compared with 180° LAF, while 180° LAF was followed by more reoperation for recurrent reflux symptoms. LNF and 180° LAF are equally effective in controlling reflux symptoms and obtain a comparable prevalence of patient satisfaction. 180° LAF can reduce the incidence of postoperative dysphagia while this is offset by a higher risk of reoperation for recurrent symptoms. The risk of recurrent symptoms should need to be balanced against the risk of dysphagia when surgeons choose surgical procedures for each individual with GERD.

  8. What makes individuals with gastroesophageal reflux disease dissatisfied with their treatment?

    DEFF Research Database (Denmark)

    Bytzer, Peter

    2009-01-01

    . CONCLUSIONS: Patient satisfaction is a complex issue that depends on many factors. Patient satisfaction can be influenced by treatment regimen, general level of well-being, the bedside manner of the physician, and the quality of patient-physician communication. Improvements in recognition of GERD can improve...... management of the disease as well as patient satisfaction with their care and treatment....... in health-related quality of life is associated with greater dissatisfaction. Patients are more likely to be satisfied if they are taken seriously by their physician and if their symptoms are investigated. They are also more likely to be satisfied if the patient-physician consultation is interactive...

  9. Acid Reflux

    Science.gov (United States)

    ... Patient Education & Resource Center GI Health and Disease Recursos en Español What is a Gastroenterologist Video and ... Education & Resource Center Home GI Health and Disease Recursos en Español What is a Gastroenterologist? Podcasts and ...

  10. Reflux nephropathy

    Science.gov (United States)

    ... Chronic kidney disease End-stage kidney disease High blood pressure Kidney transplant Nephrotic syndrome Neurogenic bladder Renal Urinary tract infection - adults Urinary tract infection - children Review Date 9/22/2015 Updated by: Charles Silberberg, ...

  11. Review article: the clinical relevance of transient lower oesophageal sphincter relaxations in gastro-oesophageal reflux disease

    NARCIS (Netherlands)

    B.F. Kessing; J.M. Conchillo; A.J. Bredenoord; A.J.P.M. Smout; A.A.M. Masclee

    2011-01-01

    P>Background Transient lower oesophageal sphincter relaxations (TLOSR) are considered the physiological mechanism that enables venting of gas from the stomach and appear as sphincter relaxations that are not induced by swallowing. It has become increasingly clear that most reflux episodes occur duri

  12. Preoperative workup to assess indication for laparoscopic treatment in gastroesophageal reflux disease Aseguramiento preoperatorio en la indicación de tratamiento laparoscópico en la enfermedad por reflujo gastroesofágico

    Directory of Open Access Journals (Sweden)

    S. Pérez-Holanda

    2008-07-01

    Full Text Available Introduction and objectives: antireflux surgery performed by an experienced surgeon is a maintenance option for patients with well-documented gastroesophageal reflux disease (GERD. Well-documented GERD is difficult to find, as GERD is a multifactorial disease in which the gastroesophageal junction, with its special anatomical and functional components, is important. In order to examine patient preoperative workups, and their indication for surgical treatment in GERD, we retrospectively studied patients who underwent a laparoscopic antireflux procedure. Methods: preoperative workups in patients from our health care area who underwent a laparoscopic antireflux procedure from December 1997 to February 2007 were retrospectively analyzed. Data related to epidemiological findings, symptoms, morphologic and functional evaluation, medical therapy, and indication for surgical treatment were recorded and statistically analyzed by means of a bivariate test. Differences were significant when the p value was equal to or less than 0.05. Results: 100 patients (50 % female, 51.31 ± 13.53 years of age underwent a laparoscopic antireflux surgery after 56.47 ± 61.33 months with symptoms. Ninety-five percent of patients had an anatomical abnormality. The pH monitoring test diagnosed three quarters of cases. The most frequent indication for GERD treatment was persistent or recurrent esophagitis despite adequate medical treatment (52 cases. Conclusions: based on our preoperative workup, as described, 100 percent of subjects were well documented and diagnosed with GERD (both non-erosive reflux disease and erosive reflux disease, and their indication for laparoscopic treatment was retrospectively assessed in 94% of cases.Introducción y objetivos: la cirugía antirreflujo realizada por un cirujano experto es una opción para el tratamiento de mantenimiento para el paciente con enfermedad por reflujo gastroesofágico (ERGE bien documentada. La "buena documentaci

  13. Estudo da hiper-responsividade brônquica em pacientes portadores de refluxo gastroesofágico Bronchial hyperreactivity in patients with gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Mônica Silveira Lapa

    2005-08-01

    Full Text Available OBJETIVO: O intuito deste trabalho foi evidenciar a existência desse reflexo vagal, através de uma broncoprovocação, em pacientes portadores de refluxo gastroesofágico. MÉTODOS: Onze pacientes com endoscopia sem evidências de refluxo gastroesofágico ou hérnia hiatal (grupo controle e dez pacientes com hérnia hiatal ou refluxo gastroesofágico foram submetidos à broncoprovocação com carbacol. RESULTADOS: O teste foi positivo em 5 dos pacientes com hérnia hiatal ou refluxo gastroesofágico (50%, e em 3 do grupo controle (27% (p = 0,64. CONCLUSÃO: A hipótese de que as vias aéreas de pacientes com refluxo gastroesofágico sem sintomas asmatiformes anteriores possam ser mais responsivas do que as de pacientes sem refluxo gastroesofágico permanece não comprovada.OBJECTIVE: To identify this vagal reflex using bronchial provocation tests in patients with gastroesophageal reflux disease. METHODS: The study group was composed of 10 patients presenting endoscopic evidence of hiatal hernia or gastroesophageal reflux disease, and the control group consisted of 11 patients presenting no evidence of either condition. All subjects were submitted to bronchial provocation with carbachol. RESULTS: The provocation test was positive in 5 (50% of the study group patients and 3 (27% of the control group patients (p = 0.64. CONCLUSION: The hypothesis that the airways of patients with gastroesophageal reflux disease (and no history of asthma-like respiratory symptoms might be more responsive than those of individuals without the disease remains unproven.

  14. Reflux Revisited: Advancing the Role of Pepsin

    Directory of Open Access Journals (Sweden)

    Karna Dev Bardhan

    2012-01-01

    Full Text Available Gastroesophageal reflux disease is mediated principally by acid. Today, we recognise reflux reaches beyond the esophagus, where pepsin, not acid, causes damage. Extraesophageal reflux occurs both as liquid and probably aerosol, the latter with a further reach. Pepsin is stable up to pH 7 and regains activity after reacidification. The enzyme adheres to laryngeal cells, depletes its defences, and causes further damage internally after its endocytosis. Extraesophageal reflux can today be detected by recognising pharyngeal acidification using a miniaturised pH probe and by the identification of pepsin in saliva and in exhaled breath condensate by a rapid, sensitive, and specific immunoassay. Proton pump inhibitors do not help the majority with extraesophageal reflux but specifically formulated alginates, which sieve pepsin, give benefit. These new insights may lead to the development of novel drugs that dramatically reduce pepsinogen secretion, block the effects of adherent pepsin, and give corresponding clinical benefit.

  15. Gastro-oesophageal reflux disease and obesity: pathogenesis and response to treatment.

    Science.gov (United States)

    Mion, François; Dargent, Jérôme

    2014-08-01

    The link between obesity and GERD is clear on all measures of the disease: clinical symptoms, erosive oesophagitis, acid esophageal exposure, and complications. The pathogenesis of this link may be due to general factors such as visceral adiposity, oestrogen levels, or decrease of Helicobacter pylori infection with increased gastric acid secretion. Increased abdominal pressure leads to disruption of the esophago-gastric junction and hiatal hernia, and esophageal motility may be modified by obesity. Weight loss does improve GERD, but lifestyle modifications and diet are usually insufficient in the long-term for morbid obesity. GERD and hiatal hernia are key issues in bariatric surgery, and are widely discussed because of important implications. It is not currently certain which procedure should be favoured in case of GERD; yet gastric bypass offers the best guarantee of success. Hiatal hernia repair is also deemed necessary by some authors at the same time of the bariatric surgery. Minimally invasive techniques pose a new challenge to this issue, both technically and theoretically. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Laryngopharyngeal reflux in patients with reflux esophagitis

    Institute of Scientific and Technical Information of China (English)

    Yung-Chih Lai; Pa-Chun Wang; Jun-Chen Lin

    2008-01-01

    AIM: To assess the prevalence of laryngopharyngeal reflux (LPR) in patients with reflux esophagitis and dis-close factors contributing to the development of LPR.METHODS: A total of 167 patients who proved to have reflux esophagitis by endoscopy were enrolled.ings for the diagnosis of LPR. We used validated ques-tionnaires to identify the presence of laryngopharyn-geal symptoms, and stringent criteria of inclusion to increase the specificity of laryngoscopic findings. The data of patients were analyzed statistically to find out factors related to LPR.RESULTS: The prevalence rate of LPR in studied sub-jects with reflux esophagitis was 23.9%. Age, hoarse-ness and hiatus hernia were factors significantly as-sociated with LPR. In 23 patients with a hiatus hernia,the group with LPR was found to have a lower trend of esophagitis grading.CONCLUSION: Laryngopharyngeal reflux is present in patients with reflux esophagitis, and three predicting factors were identified. However, the development of LPR might be different from that of reflux esophagi-tis. The importance of hiatus hernia deserves further study.

  17. Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides

    Science.gov (United States)

    Di Pierro, Francesco; Gatti, Mario; Rapacioli, Giuliana; Ivaldi, Leandro

    2013-01-01

    Background The purpose of this study was to compare the efficacy of alginic acid alone versus alginic acid combined with low doses of pure glycyrrhetinic acid and bilberry anthocyanosides as an addon to conventional proton pump inhibitor therapy in relieving symptoms associated with nonerosive reflux disease. Methods This prospective, randomized, 8-week, open-label trial was conducted at two centers. Sixty-three patients with persistent symptoms of gastroesophageal reflux disease and normal upper gastrointestinal endoscopy were eligible for the study. Patients in group A (n = 31) were treated with pantoprazole and a formula (Mirgeal®) containing alginic acid and low doses of pure glycyrrhetinic acid + standardized Vaccinium myrtillus extract for 4 weeks, then crossed over to the multi-ingredient formula for a further 4 weeks. Patients in group B (n = 32) were treated pantoprazole and alginic acid alone twice daily, then crossed over to alginic acid twice daily for a further 4 weeks. Efficacy was assessed by medical evaluation of a symptom relief score, estimated using a visual analog scale (0–10). Side effects, tolerability, and compliance were also assessed. Results Of the 63 patients enrolled in the study, 58 (29 in group A and 29 in group B) completed the 8-week trial. The baseline characteristics were comparable between the two groups. During the study, significant differences were recorded in symptom scores for both groups. In group A, symptoms of chest pain, heartburn, and abdominal swelling were less serious than in group B. Treatment A was better tolerated, did not induce hypertension, and had fewer side effects than treatment B. No significant differences in compliance were found between the two groups. Conclusion Use of low doses of pure glycyrrhetinic acid + bilberry anthocyanosides, together with alginic acid as addon therapy, substantially improves symptoms in patients with nonerosive reflux disease without increasing side effects or worsening

  18. Рrediction risk factors of gastroesophageal reflux disease in children and adolescents with chronic gastroduodenal pathology

    Directory of Open Access Journals (Sweden)

    L. M. Boiarskа

    2013-12-01

    Full Text Available Introduction. According to the modern literature gastroesophageal reflux disease (GERD is multifactorial illness. The main risk factors of its development are acid-peptic factor, Н.pylori, the autonomic nervous system dysfunction, rapid growth, heredity, burdened perinatal history, dysplasia of connective tissue structures (DCTS, environmental factors and lifestyle. Among the contradictory questions is intercurrent factors influence on the development and course of the disease. Aim of the work. To determine the risk factors for GERD in children and adolescents with chronic gastroduodenal pathology with the creation of mathematical forecasting model of the disease development and course. Materials and methods. The study involved 138 children with chronic gastroduodenal pathology who were treated inZaporozhyeCityPediatricHospital #5, aged 9 to 17 years. The main group consisted of 97 children with GERD (Group 1 - 46 children with GERD with esophagitis, Group 2 - GERD without esophagitis, comparison group comprised 41 children without clinical and endoscopic manifestations of the esophagus pathology. The following methods were conducted: clinical and medical history, instrumental - fibroesophagogastroduodenoscopy, intragastric pH-metry, ambulatory around-the clock pH monitoring in the esophagus, functional - Holter cardiac monitoring, respiratory HELIK urease test, mathematics and statistics - variational statistics, correlation analysis, binary logistic regression and multivariate regression analysis. Study results. According to the clinical and anamnestic analysis identified risk factors for GERD in children with chronic gastroduodenal pathology: hereditary predisposition (RR=1,79(1,27-2,66, р<0,05, abnormal pregnancy (ВР=1,62(1,31-1,81, р<0,05, early artificial feeding (RR = 1.31 (1,03-1,6, р<0,05, the presence of neurological symptoms during the first year life (RR = 1,32 (1,01-1,51, p <0.05, impaired diet (RR = 1,92 (1,24-2,82, p <0

  19. Influence on consumer behavior: the impact of direct-to-consumer advertising on medication requests for gastroesophageal reflux disease and social anxiety disorder.

    Science.gov (United States)

    Khanfar, Nile M; Polen, Hyla H; Clauson, Kevin A

    2009-01-01

    A 68-question Internet survey was used to determine the impact of televised direct-to-consumer advertising (DTCA) on consumer-initiated medication changes for the treatment of gastroesophageal reflux disease (GERD) and social anxiety disorder (SAD). Of the 427 respondents, 10% that viewed DTCA for GERD and 6% that viewed DTCA for SAD reported that they subsequently initiated a conversation with their physician. Nearly half of respondents, 47.4% for GERD and 40% for SAD, reported that a change in therapy occurred as a direct result of these discussions. Televised DTCA for these two drug classes can have a significant impact on patient-initiated prescription requests.

  20. Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy.

    Science.gov (United States)

    Silva, Carlos Eduardo Dilen da; Niedermeier, Bruno Taccola; Portinho, Fernando

    2015-07-01

    Introduction The indirect laryngoscopy has an important role in the characterization of reflux laryngitis. Although many findings are nonspecific, some strongly suggest that the inflammation is the cause of reflux. Objective The aim of this study was to evaluate the correlation between reflux symptoms and the findings of indirect laryngoscopy. Methods We evaluated 27 patients with symptoms of pharyngolaryngeal reflux disease. Results Laryngoscopy demonstrated in all patients the presence of hypertrophy of the posterior commissure and laryngeal edema. The most frequent symptoms were the presence of dry cough and foreign body sensation. Conclusion There was a correlation between the findings at laryngoscopy and symptoms of reflux.

  1. Gastroesophageal pressure gradients in gastroesophageal reflux disease: relations with hiatal hernia, body mass index, and esophageal acid exposure.

    Science.gov (United States)

    de Vries, Durk R; van Herwaarden, Margot A; Smout, André J P M; Samsom, Melvin

    2008-06-01

    The roles of intragastric pressure (IGP), intraesophageal pressure (IEP), gastroesophageal pressure gradient (GEPG), and body mass index (BMI) in the pathophysiology of gastroesophageal reflux disease (GERD) and hiatal hernia (HH) are only partly understood. In total, 149 GERD patients underwent stationary esophageal manometry, 24-h pH-metry, and endoscopy. One hundred three patients had HH. Linear regression analysis showed that each kilogram per square meter of BMI caused a 0.047-kPa increase in inspiratory IGP (95% confidence interval [CI] 0.026-0.067) and a 0.031-kPa increase in inspiratory GEPG (95% CI 0.007-0.055). Each kilogram per square meter of BMI caused expiratory IGP to increase with 0.043 kPa (95% CI 0.025-0.060) and expiratory IEP with 0.052 kPa (95% CI 0.027-0.077). Each added year of age caused inspiratory IEP to decrease by 0.008 kPa (95% CI -0.015-0.001) and inspiratory GEPG to increase by 0.008 kPa (95% CI 0.000-0.015). In binary logistic regression analysis, HH was predicted by inspiratory and expiratory IGP (odds ratio [OR] 2.93 and 2.62, respectively), inspiratory and expiratory GEPG (OR 3.19 and 2.68, respectively), and BMI (OR 1.72/5 kg/m(2)). In linear regression analysis, HH caused an average 5.09% increase in supine acid exposure (95% CI 0.96-9.22) and an average 3.46% increase in total acid exposure (95% CI 0.82-6.09). Each added year of age caused an average 0.10% increase in upright acid exposure and a 0.09% increase in total acid exposure (95% CI 0.00-0.20 and 0.00-0.18). BMI predicts IGP, inspiratory GEPG, and expiratory IEP. Age predicts inspiratory IEP and GEPG. Presence of HH is predicted by IGP, GEPG, and BMI. GEPG is not associated with acid exposure.

  2. Comparative clinical trial of S-pantoprazole versus racemic pantoprazole in the treatment of gastro-esophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Vikas G Pai; Nitin V Pai; Hemant P Thacker; Jaisingh K Shinde; Vijay P Mandora; Subhash S Erram

    2006-01-01

    AIM: To compare the efficacy and tolerability of S-pantoprazole (20 mg once a day) versus racemic Pantoprazole (40 mg once a day) in the treatment of gastroesophageal reflux disease (GERD).METHODS: This multi-centre, randomized, double-blind clinical trial consisted of 369 patients of either sex suffering from GERD. Patients were randomly assigned to receive either one tablet (20 mg) of S-pantoprazole once a day (test group) or 40 mg racemic pantoprazole once a day (reference group) for 28 d. Patients were evaluated for reduction in baseline on d 0, GERD symptom score on d 14 and 28, occurrence of any adverse effect during the course of therapy. Gastrointestinal (GI) endoscopy was performed in 54 patients enrolled at one of the study centers at baseline and on d 28.RESULTS: Significant reduction in the scores (mean and median) for heart burn (P < 0.0001), acid regurgitation (P < 0.0001), bloating (P < 0.0001), nausea (P < 0.0001)and dysphagia (P < 0.001) was achieved in both groups on d 14 with further reduction on continuing the therapy till 28 d. There was a statistically significant difference in the proportion of patients showing improvement in acid regurgitation and bloating on d 14 and 28 (P = 0.004for acid regurgitation; P = 0.03 for bloating) and heart burn on d 28 (P = 0.01) between the two groups, with a higher proportion in the test group than in the reference group. Absolute risk reductions for heartburn/acid regurgitation/bloating were approximately 15% on d 14 and 10% on d 28. The relative risk reductions were 26%-33% on d 14 and 15% on d 28. GI endoscopy showed no significant difference in healing of esophagitis (P= 1) and gastric erosions (P = 0.27) between the two groups. None of the patients in either group reported any adverse effect during the course of therapy.CONCLUSION: In GERD, S-pantoprazole (20 mg) is more effective than racemic pantoprazole (40 mg) in improving symptoms of heartburn, acid regurgitation,bloating and equally

  3. Comparison of Omeprazole with Ranitidine for Treatment of Symptoms Associated with Gastroesophageal Reflux Disease and Uncomplicated Duodenal Ulcer

    Directory of Open Access Journals (Sweden)

    Andre P Archambault

    1996-01-01

    Full Text Available This randomized, single-blind, parallel group study was conducted to compare omeprazole with ranitidine for the treatment of symptoms associated with gastroesophageal reflux disease (GERD, uncomplicated duodenal ulcer (DU or both. After baseline assessments, patients were randomized to receive daily treatment with either 20 mg omeprazole or 300 mg ranitidine for four weeks. In total, 1481 patients (1001 omeprazole, 480 ranitidine with a diagnosis of GERD (n=904 and/or DU (n=577, confirmed by endoscopy or barium meal and reporting moderate to severe symptoms, were included in the analyses. The seventy of overall daytime symptoms reported by the omeprazole group at clinic visits was lower than that reported by the ranitidine group at week 2 for the entire patient group (P=0.0002 and at both weeks 2 and 4 for the subgroup of patients with GERD (P=0.0001 and P=0.001, respectively. The severity of overall night-time symptoms reported by the omeprazole group was lower than that reported by the ranitidine group at week 4 for all patients as a whole (P=0.042 and at both weeks 2 and 4 for the subgroup of patients with GERD (P=0.035 and P=0.010, respectively. There were no significant differences in reports of adverse events. In the omeprazole group, 19% of patients at week 2 and 15% of patients at week 4 reported adverse events, while the corresponding results from the ranitidine group were 21% and 11%. In conclusion, patients with GERD, DU or both treated with omeprazole 20 mg daily for four weeks showed statistically significant reductions in symptoms compared with patients treated with ranitidine 300 mg daily for the same period of time. The percentage of patients with any remaining daytime symptoms was 12% lower in the omeprazole group compared with the ranitidine group at week 2, and 7% lower at week 4. Five per cent fewer patients in the omeprazole group experienced night-time symptoms at either week 2 or week 4.

  4. Proton pump inhibitors in gastroesophageal reflux disease: a custom-tailored therapeutic regimen Diseñando un traje a la medida: los inhibidores de la bomba de protones en la enfermedad por reflujo gastroesofágico

    Directory of Open Access Journals (Sweden)

    Sergio Sobrino-Cossío

    2012-07-01

    Full Text Available The Montreal Definition and Classification divides Gastroesophageal Reflux Disease (GERD into esophageal symptomatic syndromes (and with mucosal damage and extraesophageal syndromes (with acid established association and proposed association. In typical GERD symptoms, an 8-week treatment with PPIs is satisfactory in most cases (> 90%. Response rates to PPIs in GERD are highly variable, as they also rely on an appropriate clinical diagnosis of the disease; endoscopy differentiates the macroscopic GERD phenotype. The non-erosive variety (50-70% prevalence has a different symptomatic response rate, as gastric acid is not the sole etiology of symptoms. The possible explanations of treatment failure include treatment adherence, PPI metabolism alterations and characteristics, and inadequate diagnosis. Refractory symptoms are related to gastric content neutralization by the chronic use of PPIs. Extraesophageal manifestations are associated with other pathophysiological mechanisms where an autonomic nervous system disturbance gives rise to symptoms. In these clinical entities, the relationship between symptoms and acid needs to be established in order to determine the use of PPIs, or consider other drugs. In other words, so as to "custom-tailor the best-fitting therapy" we need to answer the questions for whom, for what, how and for how long. Finally, PPI safety and tolerability are factors to be considered in elderly patients requiring chronic PPI use, who usually have chronic concomitant illnesses.La Clasificación de Montreal divide la enfermedad por reflujo gastro-esofágico (ERGE en síndromes esofágicos sintomáticos y con daño a la mucosa y en síndromes extraesofágicos con asociación establecida al ácido y asociación propuesta. En síntomas ERGE típicos el tratamiento con inhibidores de la bomba de protones (IBP es satisfactorio (> 90% a 8 semanas en la mayoría de los casos. Las tasas de respuesta a los IBP en la ERGE son muy variables

  5. Gastroesophageal Reflux Disease (GERD)

    Science.gov (United States)

    ... foods affect some people with GERD: citrus fruits chocolate drinks or foods with caffeine fatty and fried ... and by prescription and help by blocking the production of stomach acid. If your doctor thinks you ...

  6. Reflux and Lung Disease

    Science.gov (United States)

    ... including fatty foods, citrus and tomato-containing products, chocolate, mint, spicy foods, carbonated beverages, caffeine, and alcohol. ... Eating 10 Quick and Healthy Lunch Ideas 10 Benefits of Staying Hydrated Healthy ... Health Taking Multivitamins Shortness of Breath and Eating Steroids ...

  7. Gastroesophageal reflux disease

    Science.gov (United States)

    ... 2015;81(6):1305-1310. PMID: 25863867 www.ncbi.nlm.nih.gov/pubmed/25863867 . Falk GW, Katzka ... JAMA . 2011;305:1969-1977. PMID: 21586712 www.ncbi.nlm.nih.gov/pubmed/21586712 . Katz PO, Gerson ...

  8. Gastro-oesophageal reflux disease and chronic cough%胃食管反流与慢性咳嗽

    Institute of Scientific and Technical Information of China (English)

    王长征

    2006-01-01

    胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)也有人称为“胃食管反流相关性咳嗽”,是慢性咳嗽常见的原因之一。不同作者报道,GERC约占慢性咳嗽病因的10%-40%。

  9. Reactive oxygen species and chemokines:Are they elevated in the esophageal mucosa of children with gastroesophageal reflux disease?

    Institute of Scientific and Technical Information of China (English)

    Engin Tutar; Deniz Ertem; Goksenin Unluguzel; Sevda Tanrikulu; Goncagul Haklar; Cigdem Celikel; Evin Ademoglu; Ender Pehlivanoglu

    2008-01-01

    AIM:To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood reflux esophagitis.METHODS:A total of 59 subjects who had complaints suggesting GERD underwent esophagogastroduoden oscopy.Endoscopic and histopathologic diagnosis of reflux esophagitis was established by Savary-Miller and Vandenplas grading systems,respectively.Esophageal biopsy specimens were taken from the esophagus 20% proximal above the esophagogastric junction for conventional histopathological examination and the measurements of ROS and cytokine levels.ROS were measured by chemiluminescence,whereas IL-8 and MCP-1 levels were determined with quantitative immunometric ELISA on esophageal tissue.Esophageal tissue ROS,IL-8 and MCP-1 levels were compared among groups with and without endoscopic/histopathologic esophagitis.RESULTS:Of 59 patients 28 (47.5%) had normal esophagus whereas 31 (52.5%) had endoscopic esophagitis.In histopathological evaluation,almost 73% of the cases had mild and 6.8% had moderate degree of esophagitis.When ROS and chemokine levels were compared among groups with and without endoscopic esophagitis,statistical difference could not be found between patients with and without esophagitis.Although the levels of ROS,IL-8 and ICP-1 were found to be higher in the group with histopathological reflux esophagitis,this difference was not statistically significant.CONCLUSION:These results suggest that the grade of esophagitis is usually mild or moderate during childhood and factors apart from ROS,IL-8 and MCP-1 may be involved in the pathogenesis of reflux esophagitis in children.

  10. Esomeprazole regimens for reflux symptoms in Chinese patients with chronic gastritis.

    Science.gov (United States)

    Sun, Jing; Yuan, Yao-Zong; Hou, Xiao-Hua; Zou, Duo-Wu; Lu, Bin; Chen, Min-Hu; Liu, Fei; Wu, Kai-Chun; Zou, Xiao-Ping; Li, Yan-Qing; Zhou, Li-Ya

    2015-06-14

    To compare symptom control with esomeprazole regimens for non-erosive reflux disease and chronic gastritis in patients with a negative endoscopy. This randomized, open-label study was designed in line with clinical practice in China. Patients with typical reflux symptoms for ≥ 3 mo and a negative endoscopy who had a Gastroesophageal Reflux Disease Questionnaire score ≥ 8 were randomized to initial treatment with esomeprazole 20 mg once daily either for 8 wk or for 2 wk. Patients with symptom relief could enter another 24 wk of maintenance/on-demand treatment, where further courses of esomeprazole 20 mg once daily were given if symptoms recurred. The primary endpoint was the symptom control rate at week 24 of the maintenance/on-demand treatment period. Secondary endpoints were symptom relief rate, success rate (defined as patients who had symptom relief after initial treatment and after 24 wk of maintenance treatment), time-to-first-relapse and satisfaction rate. Based on the data collected in the modified intention-to-treat population (MITT; patients in the ITT population with symptom relief after initial esomeprazole treatment, n = 262), the symptom control rate showed a small but statistically significant difference in favor of the 8-wk regimen (94.9% vs 87.3%, P = 0.0473). Among the secondary endpoints, based on the data collected in the ITT population (n = 305), the 8-wk group presented marginally better results in symptom relief after initial esomeprazole treatment (88.3% vs 83.4%, P = 0.2513) and success rate over the whole study (83.8% vs 72.8%, P = 0.0258). The 8-wk regimen was found to provide a 46% reduction in risk of relapse vs the 2-wk regimen (HR = 0.543; 95%CI: 0.388-0.761). In addition, fewer unscheduled visits and higher patient satisfaction supported the therapeutic benefits of the 8-wk regimen over the 2-wk regimen. Safety was comparable between the two groups, with both regimens being well tolerated. Chinese patients diagnosed with chronic

  11. Digestive Diseases

    Science.gov (United States)

    ... Celiac Disease Bowel Control Problems (Fecal Incontinence) Gas Lactose Intolerance Diarrhea Diverticulosis & Diverticulitis Acid Reflux (GER & GERD) More Digestive Disease Topics Children and Teens Acid Reflux (GER & GERD) in Infants Acid Reflux (GER & GERD) in Children & Teens Chronic ...

  12. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1995-06-15

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  13. High-definition endoscopy with iScan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group.

    Science.gov (United States)

    Rey, J W; Deris, N; Marquardt, J U; Thomaidis, T; Moehler, M; Kittner, J M; Nguyen-Tat, M; Dümcke, S; Tresch, A; Biesterfeld, S; Goetz, M; Mudter, J; Neurath, M F; Galle, P R; Kiesslich, R; Hoffman, A

    2016-01-01

    Nonerosive reflux disease (NERD) is commonly diagnosed in patients with symptoms of reflux. The aim of the present study was to determine whether high-definition endoscopy (HD) plus equipped with the iScan function or chromoendoscopy with Lugol's solution might permit the differentiation of NERD patients from those without reflux symptoms, proven by targeted biopsies of endoscopic lesions. A total of 100 patients without regular intake of proton pump inhibitors and with a normal conventional upper endoscopy were prospectively divided into NERD patients and controls. A second upper endoscopy was performed using HD+ with additional iScan function and then Lugol's solution was applied. Biopsy specimens were taken from the gastroesophageal junction in all patients. A total of 65 patients with reflux symptoms and 27 controls were included. HD(+) endoscopy with iScan revealed subtle mucosal breaks in 52 patients; the subsequent biopsies confirmed esophagitis in all cases. After Lugol's solution, 58 patients showed mucosal breaks. Sensitivity for the iScan procedure was 82.5%, whereas that for Lugol's solution was 92.06%. Excellent positive predictive values of 100% and 98.3%, respectively, were noted. The present study suggests that the majority of patients with NERD and typical symptoms of reflux disease can be identified by iScan or Lugol's chromoendoscopy as minimal erosive reflux disease (ERD) patients.

  14. Relationship between Gastro-esophageal Reflux Disease and the Stagnation Theory%从郁论治胃食管反流病探析

    Institute of Scientific and Technical Information of China (English)

    刘仁昌; 王光铭; 李春婷

    2012-01-01

    从气结为郁、痰积为郁、湿蕴为郁、瘀留为郁四方面阐述了郁之理论在胃食管反流病中形成的机理,以疏肝行气法、化痰降浊法、清热除湿法、祛瘀通络法作为开郁以治疗胃食管反流病的具体治法,并为其治法在临床治疗中提供了佐证.%To explain the importance of stagnation theory in treating gastro-esophageal reflux disease by four parts which is stagnation of Qi, stagnation of Phlegm, stagnation of dampness and blood stasis. With the evidence in how to treat gastro-esophageal reflux disease in clinic, the main treatment is smoothing the liver Qi, eliminating the phlegm, clearing away dampness-heat, removing the blood stasis to free collaterals.

  15. Familial vesicoureteral reflux

    OpenAIRE

    朴, 勺; 新井, 豊; 友吉, 唯夫; 吉田, 修

    1983-01-01

    Primary vesicoureteral reflux was seen in 2 siblings in a family of 5 (1 daughter and 2 sons). Voiding cystogram of elder sister, who complained of fever and backache, showed bilateral reflux at the age of 6. Left reflux disappeared soon but right reflux persisted. Right antireflux operation was performed at the age of 9, but right renal function deteriorated gradually. Right nephrectomy was done at the age of 12 because of persistent pyuria and renal stones. The second case was her younger b...

  16. [Reflux nephropathy in absence of obvious vesicoureteral reflux].

    Science.gov (United States)

    Vino, L; Pedrolli, A; Portuese, A; Dal Cerè, M; Pizzini, C; Sinaguglia, G; Fanos, V

    2000-01-01

    Although the majority of patients with vesicoureteric reflux presents DMSA scan alterations, parenchimal renal scars are found also in children without vesicoureteric reflux. Two clinical cases of reflux nephropathy without evidence of reflux are presented. Several explanations could be advocated to justify this picture, including haematogenous source of infection, inadequate timing and/or procedure of cystouretrography, intermittency of reflux, ascending bacteria, previous presence of reflux, and appearance of controlateral reflux during the natural history of a monolateral documented reflux. Tailored diagnostic and therapeutic strategy should discussed for each patient.

  17. [Severe laryngitis associated to gastroesophageal reflux].

    Science.gov (United States)

    Botto, Hugo; Antonioli, Cintia; Nieto, Mary; Cocciaglia, Alejandro; Cuestas, Giselle; Roques Revol, Magdalena; López Marti, Jessica; Rodríguez, Hugo

    2014-02-01

    There is a strong association between gastroesophageal reflux and pharyngolaryngeal reflux as factors leading to respiratory disease, manifested as dysphonia, wheezing, coughing, recurrent laryngitis, bronchial obstruction, laryngospasm and apparent life-threatening events (ALTEs). These manifestations can be mild or severe and may sometimes put the patient's life at risk. We present two cases of patients with severe laryngitis who required endotracheal intubation, one of which underwent tracheostomy. The diagnostic methods and their limitations and the patients outcomes are described.

  18. Gastro-esophageal reflux disease symptoms and demographic factors as a pre-screening tool for Barrett's esophagus.

    Directory of Open Access Journals (Sweden)

    Xinxue Liu

    Full Text Available BACKGROUND: Barrett's esophagus (BE occurs as consequence of reflux and is a risk factor for esophageal adenocarcinoma. The current "gold-standard" for diagnosing BE is endoscopy which remains prohibitively expensive and impractical as a population screening tool. We aimed to develop a pre-screening tool to aid decision making for diagnostic referrals. METHODOLOGY/PRINCIPAL FINDINGS: A prospective (training cohort of 1603 patients attending for endoscopy was used for identification of risk factors to develop a risk prediction model. Factors associated with BE in the univariate analysis were selected to develop prediction models that were validated in an independent, external cohort of 477 non-BE patients referred for endoscopy with symptoms of reflux or dyspepsia. Two prediction models were developed separately for columnar lined epithelium (CLE of any length and using a stricter definition of intestinal metaplasia (IM with segments ≥ 2 cm with areas under the ROC curves (AUC of 0.72 (95%CI: 0.67-0.77 and 0.81 (95%CI: 0.76-0.86, respectively. The two prediction models included demographics (age, sex, symptoms (heartburn, acid reflux, chest pain, abdominal pain and medication for "stomach" symptoms. These two models were validated in the independent cohort with AUCs of 0.61 (95%CI: 0.54-0.68 and 0.64 (95%CI: 0.52-0.77 for CLE and IM ≥ 2 cm, respectively. CONCLUSIONS: We have identified and validated two prediction models for CLE and IM ≥ 2 cm. Both models have fair prediction accuracies and can select out around 20% of individuals unlikely to benefit from investigation for Barrett's esophagus. Such prediction models have the potential to generate useful cost-savings for BE screening among the symptomatic population.

  19. Novel ion exchange resin-based combination drug-delivery system for treatment of gastro esophageal reflux diseases

    Directory of Open Access Journals (Sweden)

    Mangesh Ramesh Bhalekar

    2010-06-01

    Full Text Available The present study involves preparation and characterization of a combination tablet of ranitidine in immediate release form and domperidone in sustained release form, using ion exchange resins. Ranitidine lowers acid secretion, while domperidone release over a prolonged period improves gastric motility thus justifying this combination in gastro esophageal reflux diseases (GERD and ensuring patient compliance. Drug loading was carried out by batch method & resinates were characterized using FTIR, XRPD. Resinates were formulated as a combination tablet and evaluated for tablet properties & in vitro drug release. Resinates provided sustained release of domperidone and immediate release of ranitidine. IR and X-ray studies indicate complexation of drug and resin along with monomolecular distribution of drugs in amorphous form in the resin matrix. The tablets of resinate combination showed good tablet properties. In-vitro drug release gave desired release profiles and ex-vivo drug absorption studies carried out by placing everted rat intestine in dissolution medium indicated statistically significant similarity in absorption from test and marketed formulation. The novelty of this study is that the retardation in release of domperidone from resinates is achieved by presence of weak resin in the formulation.O presente estudo envolve a preparação e a caracterização de associação do comprimido de ranitidina de liberação imediata e domperidona de liberação prolongada, utilizando resinas de troca iônica. A ranitidina diminui a secreção ácida, enquanto a liberação prolongada de domperidona melhora a motilidade gástica, justificando, dessa forma, a associação em doenças de refluxo gastroesofágico (DRGE e garantindo a adesão do paciente. A carga de fármaco foi efetuada pelo método em batelada e os resinatos, caracterizados utilizando-se FTIR e XRPD. Os resinatos foram formulados como comprimido da associação e avaliados com rela

  20. Effect of electrical stimulation of the lower esophageal sphincter in gastroesophageal reflux disease patients refractory to proton pump inhibitors

    Institute of Scientific and Technical Information of China (English)

    Edy Soffer; Leonardo Rodríguez; Patricia Rodriguez; Beatriz Gómez; Manoel G Neto; Michael D Crowell

    2016-01-01

    AIM: To evaluate the efficacy of lower esophageal sphincter(LES)-electrical stimulation therapy(EST) in a subgroup of patients that reported only partial response to proton pump inhibitors(PPIs) therapy, compared to a group of patient with complete response.METHODS: Bipolar stitch electrodes were laparoscopically placed in the LES and connected to an implantable pulse generator(EndoS tim BV, the Hague, the Netherlands), placed subcutaneously in the anterior abdominal wall. Stimulation at 20 Hz, 215 μsec, 3-8 m Amp in 30 min sessions was delivered starting on day 1 post-implant. Patients were evaluated using gastroesophageal reflux disease(GERD)-HRQL, symptom diaries; esophageal p H and esophageal manometry before and up to 24 mo after therapy and results were compared between partial and complete responders.RESULTS: Twenty-three patients with GERD on LESEST were enrolled and received continuous per-protocol stimulation through 12 mo and 21 patients completed 24 mo of therapy. Of the 23 patients, 16(8 male, mean age 52.1 ± 12 years) had incomplete response to PPIs prior to LES-EST, while 7 patients(5 male, mean age 52.7 ± 4.7) had complete response to PPIs. In the sub-group with incomplete response to PPIs, median(IQR) composite GERD-HRQL score improved significantly from 9.5(9.0-10.0) at baseline on-PPI and 24.0(20.8-26.3) at baseline off-PPI to 2.5(0.0-4.0) at 12-mo and 0.0(0.0-2.5) at 24-mo follow-up(P < 0.05 compared to on-and off-PPI at baseline). Median(IQR) % 24-h esophageal pH < 4.0 at baseline in this sub-group improved significantly from 9.8%(7.8-11.5) at baseline to 3.0%(1.9-6.3) at 12 mo(P < 0.001) and 4.6%(2.0-5.8) at 24 mo follow-up(P < 0.01). At their 24-mo follow-up, 9/11 patients in this sub-group were completely free of PPI use. These results were comparable to the sub-group that reported complete response to PPI therapy at baseline. No unanticipated implantation or stimulation-related adverse events, or any untoward sensation due to stimulation

  1. Multilayered epithelium at the gastroesophageal junction is a marker of gastroesophageal reflux disease: data from a prospective Central European multicenter study (histoGERD trial).

    Science.gov (United States)

    Langner, Cord; Wolf, Eva-Maria; Plieschnegger, Wolfgang; Geppert, Michael; Wigginghaus, Bernd; Höss, Gabriele M; Eherer, Andreas; Schneider, Nora I; Rehak, Peter; Vieth, Michael

    2014-04-01

    Multilayered epithelium is defined as hybrid epithelium with characteristics of both squamous and columnar epithelia. Our aim was to evaluate the clinicopathological significance of the lesion by relating its presence to various histological and clinical and/or endoscopic features indicating gastroesophageal reflux disease (GERD). A total of 1,071 individuals participated in a prospective cross-sectional study (576 females and 495 males; median age 53 years). Biopsy material was systematically sampled from the gastroesophageal junction. The histological diagnosis of esophagitis was made according to the Esohisto consensus guidelines. The endoscopic diagnosis of esophagitis was made according to the modified Los Angeles classification and the diagnosis of Barrett's esophagus according to Prague's C & M criteria, respectively. Multilayered epithelium was identified in 103 (9.6 %) individuals, frequently within or adjacent to the ducts of esophageal glands. Its presence was associated with increasing age (p epithelium was associated with features of the squamous epithelium indicating GERD, particularly intercellular space dilation (p = 0.005), and presence of cardiac mucosa (epithelium was observed in about every tenth individual undergoing upper gastrointestinal endoscopy. The association with histological and clinical features indicating GERD advocates the lesion as a promising new marker for reflux esophagitis. The association with cardiac mucosa and Barrett's esophagus suggests multilayered epithelium to be an intermediate step in the development of columnar metaplasia and, ultimately, Barrett's esophagus.

  2. 胃食管反流病诊断方法的临床价值%Clinical Value of Diagnostic Methods for Gastroesophageal Reflux Disease

    Institute of Scientific and Technical Information of China (English)

    宋菁婧

    2011-01-01

    Although gastroesophageal reflux disease (GERD) can be diagnosed based on reflux symptoms, upper gastrointestinal endoscopy, 24-hour esophageal pH-monitoring and proton pump inhibitor (PPI) therapeutic test etc, there is no standardized diagnosis flowchart and criteria at the moment, and debate on the diagnosis of GERD is still going on.This article reviewed the clinical value of relevant diagnostic methods for GERD.%胃食管反流病(GERD)虽可根据反流症状群、上消化道内镜检查、24 h食管pH监测、质子泵抑制剂(PPI)诊断性治疗等综合分析而作出诊断,但目前尚缺乏统一、明确的诊断流程和标准,因此GERD的诊断仍存在诸多争议.本文就GERD相关诊断方法的临床价值作一综述.

  3. Diagnosing gastro-oesophageal reflux disease or lactose intolerance in babies who cry a lot in the first few months overlooks feeding problems.

    Science.gov (United States)

    Douglas, Pamela Sylvia

    2013-04-01

    This paper explores two areas in which the translation of research into practice may be improved in the management of cry-fuss behaviours in the first few months of life. Firstly, babies who cry excessively are often prescribed proton pump inhibitors, despite evidence that gastro-oesophageal reflux disease is very rarely a cause. The inaccuracy of commonly used explanatory mechanisms, the side-effects of acid-suppressive medications, and the failure to identify treatable problems, including feeding difficulty when the diagnosis of 'reflux' is applied, are discussed. Secondly, crying breastfed babies are still prescribed lactase or lactose-free formula, despite evidence that the problem of functional lactose overload is one of breastfeeding management. The mechanisms and management of functional lactose overload are discussed. These two problems of research translation need to be addressed because failure to identify and manage other causes of cry-fuss problems, including feeding difficulty, may have adverse outcomes for a small but significant minority of families.

  4. The influence of demographic factors and health-related quality of life on treatment satisfaction in patients with gastroesophageal reflux disease treated with esomeprazole

    Directory of Open Access Journals (Sweden)

    El-Dika Samer

    2005-01-01

    Full Text Available Abstract Background The correlation between treatment satisfaction and demographic characteristics, symptoms, or health-related quality of life (HRQL in patients with gastroesophageal reflux disease (GERD is unknown. The objective of this study was to assess correlates of treatment satisfaction in patients with GERD receiving a proton pump inhibitor, esomeprazole. Methods Adult GERD patients (n = 217 completed demography, symptom, HRQL, and treatment satisfaction questionnaires at baseline and/or after treatment with esomeprazole 40 mg once daily for 4 weeks. We used multiple linear regressions with treatment satisfaction as the dependent variable and demographic characteristics, baseline symptoms, baseline HRQL, and change scores in HRQL as independent variables. Results Among the demographic variables only Caucasian ethnicity was positively associated with treatment satisfaction. Greater vitality assessed by the Quality of Life in Reflux and Dyspepsia (QOLRAD and worse heartburn assessed by a four-symptom scale at baseline, were associated with greater treatment satisfaction. The greater the improvement on the QOLRAD vitality (change score, the more likely the patient is to be satisfied with the treatment. Conclusions Ethnicity, baseline vitality, baseline heartburn severity, and change in QOLRAD vitality correlate with treatment satisfaction in patients with GERD.

  5. Dental erosion, an extraesophageal manifestation of gastroesophageal reflux disease: the experience of a center for digestive physiology in Southeastern Mexico

    Directory of Open Access Journals (Sweden)

    Laura Roesch-Ramos

    2014-02-01

    Full Text Available Background: Dental erosion (DE is the loss of the hard tissues of the tooth produced by the action of gastric juice, pepsin and acid on the dental enamel, its frequency ranges from 5to 53.41%. In Mexico there are no reports on the frequency and possible association. Objective: To establish the prevalence of dental erosion and its relationship to GERD. Patients and methods: Prospective, observational, descriptive and comparative study was conducted in 60patients diagnosed with GERD and 60healthy patients at the Institute of Medical and Biological Research of the Universidad Veracruzana in Veracruz city. Anthropometric characteristics, dietary habits, oral hygiene, alcohol consumption, smoking, ED index and Index of decayed/missing dental pieces/sealed and correlation between severity of ED and GERD were analyzed. Results: 78.67% of patients with GERD had ED, 23.33% corresponded to grade 0, 41.67% to N1, N2and 23.33% to 11.67% to N3. Predominance of females (2.3:1. The mean age was 50.92± 13.52years. The severity of dental erosion was significantly related to the severity of reflux, halitosis, CPO index and poor eating habits. There was no statistically significant difference in the other variables analyzed. Conclusions: Dental erosion has a high frequency in patients with GERD and reflux characteristics are directly related to their severity and therefore should be considered as a manifestation of GERD extraesophageal.

  6. Effect of omeprazole on symptoms and ultrastructural esophageal damage in acid bile reflux

    Institute of Scientific and Technical Information of China (English)

    Carlo Calabrese; Anna Fabbri; Mauro Bortolotti; Giovanna Cenacchi; Scialpi Carlo; Desiree Zahlane; Mario Miglioli; Giulio Di Febo

    2005-01-01

    AIM: To value whether omeprazole could induce the healing of DIS and regression of symptoms in patients with DGER.METHODS: We enrolled 15 symptomatic patients with a pathological esophageal 24-h pH-metry and bilimetry.Patients underwent endoscopy and biopsies were taken from the distal esophagus. Specimens were analyzed at histology and transmission electron microscopy (TEM).Patients were treated with omeprazole 40 mg/d for 3 mo and then endoscopy with biopsies was repeated. Patients with persistent heartburn and/or with an incomplete recovery of DIS were treated for 3 more months and endoscopy with biopsies was performed.RESULTS: Nine patients had a non-erosive reflux disease at endoscopy (NERD) while 6 had erosive esophagitis (ERD). At histology, of the 6 patients with erosive esophagus,5 had mild esophagitis and 1 moderate esophagitis. No patients with NERD showed histological signs of esophagitis.After 3 mo of therapy, 13/15 patients (86.7%, P<0.01)showed a complete recovery of DIS and disappearance of heartburn. Of the 2 patients treated for 3 more months,complete recovery of DIS and heartburn were achieved in one.CONCLUSION: Three or 6 mo of omeprazole therapy led to a complete regression of the ultrastructural esophageal damage in 86.7% and in 93% of patients with DGER, NERD and ERD respectively. The ultrastructural recovery of the epithelium was accompanied by regression of heartburn in all cases.

  7. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2014-04-01

    Full Text Available Mayank Ajmera,1 Amit D Raval,1 Chan Shen,2 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics and Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA Objective: To estimate excess health care expenditures associated with gastroesophageal reflux disease (GERD among elderly individuals with chronic obstructive pulmonary disease (COPD and examine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors to the excess expenditures, using the Blinder-Oaxaca linear decomposition technique. Methods: This study utilized a cross-sectional, retrospective study design, using data from multiple years (2006-2009 of the Medicare Current Beneficiary Survey linked with fee-for-service Medicare claims. Presence of COPD and GERD was identified using diagnoses codes. Health care expenditures consisted of inpatient, outpatient, prescription drugs, dental, medical provider, and other services. For the analysis, t-tests were used to examine unadjusted subgroup differences in average health care expenditures by the presence of GERD. Ordinary least squares regressions on log-transformed health care expenditures were conducted to estimate the excess health care expenditures associated with GERD. The Blinder-Oaxaca linear decomposition technique was used to determine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors, to excess health care expenditures associated with GERD. Results: Among elderly Medicare beneficiaries with COPD, 29.3% had co-occurring GERD. Elderly Medicare beneficiaries with COPD/GERD had 1.5 times higher ($36,793 vs $24,722 [P<0.001] expenditures than did those with COPD/no GERD. Ordinary

  8. 基于系统动力学构建胃食管反流病中医系统模型%To Build a Paradigm of Traditional Chinese Medicine for Gastroesophageal Reflux Disease Based on System Dynamics

    Institute of Scientific and Technical Information of China (English)

    刘菊; 戚经天; 李姿

    2016-01-01

    Objective:Under the guidance of visceral state theory of traditional Chinese medicine (TCM),sys-tem dynamics was applied to build a paradigm of TCM for gstroesophageal reflux disease. Methods:Data on gastroesophageal reflux disease was collected,to build a paradigm for gastroesphageal reflux disease with the Vensim software. Result:The pathogenic factors were the input information,symptoms were the output infor-mation. Heart,liver,spleen,lungs and kidneys are the five subsystems as the center,while Qi,blood and body fluid were the medium for information. A paradigm of TCM for gastroesophageal reflux disease was built. Conclusion:Gastroesophageal reflux disease is a disease system in which spleen is the center and five zang organs are integrated.%目的:在中医学藏象理论的指导下,运用系统动力学方法构建胃食管反流病中医系统模型。方法:通过临床研究为模型建立提供资料,运用系统动力学Vensim软件进行模型构建和系统分析。结果:致病因素为输入信息,疾病症状为输出信息,以心、肝、脾、肺、肾五脏子系统为中心,精、气、血、津液为信息媒介,构建了胃食管反流病的中医系统模型。结论:胃食管反流病是一个“以脾为主,五脏一体”的疾病系统。

  9. A novel once daily microparticulate dosage form comprising lansoprazole to prevent nocturnal acid breakthrough in the case of gastro-esophageal reflux disease: preparation, pharmacokinetic and pharmacodynamic evaluation.

    Science.gov (United States)

    Alai, Milind; Lin, Wen Jen

    2013-01-01

    The objective of this study was to formulate and evaluate the lansoprazole (LPZ)-loaded microparticles to prevent nocturnal acid breakthrough in the case of gastro-esophageal reflux disease (GERD). The microparticulate delivery system was prepared by solvent evaporation method using Eudragit RS100 as a matrix polymer followed by enteric coated with Eudragit S100 and hydroxypropyl methylcellulose phthalate HP55 using spray drying method. The enteric coated microparticles were stable in gastric pH condition. In vivo pharmacokinetic and pharmacodynamic studies in male Wistar rats demonstrated that enteric coated microparticles sustained release of LPZ and promoted ulcer healing activity. In other words, the microparticulate dosage form provided effective drug concentration for a longer period as compared to conventional extended release dosage form, and showed sufficient anti-acid secretion activity to treat acid related disorders including the enrichment of nocturnal acid breakthrough event based on a once daily administration.

  10. [Diagnosis and treatment of gastroesophageal reflux disease in the mentally retarded: guidelines of a multidisciplinary consensus work group. Dutch Association of Physicians in Care of Mentally Handicapped].

    Science.gov (United States)

    Gimbel, H

    2000-06-10

    Gastroesophageal reflux disease (GORD) is more frequent among people with intellectual disability than among the intellectually normal population. Also GORD is more serious in this population. The diagnosis is often missed, because most intellectually disabled cannot express their complaints of GORD. For that reason a multidisciplinary working group of the Dutch Association of physicians active in the care of persons with a mental handicap has developed guidelines. The working group recommends endoscopy in case of a (alarm) symptoms: haematemesis, prolonged vomiting, irondeficiency anaemia e.c.i., and a 24 hour oesophageal pH test in case of b (aspecific) symptoms: recurrent pneumonia, refusal of food, regurgitation, rumination, dental erosions. In general most patients are cured with drug treatment (omeprazol or another proton pump inhibitor). If symptoms are not improved after 6 months of optimal treatment, surgical treatment may be considered.

  11. The Law of Reflux

    OpenAIRE

    Sproul, Michael

    2010-01-01

    The law of reflux is explained using an example of backed money. In the example, government-issued money is backed by the government’s assets (mainly taxes receivable) while bank-issued money is backed by the bank’s assets. The value of both kinds of money is determined by the amount of backing held per unit of money issued. The example shows that reflux maintains money’s value, not by assuring that excessive issues of money reflux to their issuers, but by providing people with access to the ...

  12. Correlation of Laryngopharyngeal Reflux and Voice Diseases%咽喉反流和嗓音疾病相关性的初步探讨

    Institute of Scientific and Technical Information of China (English)

    秦辉

    2015-01-01

    Objective To analyze the correlation between laryngopharyngeal reflux ( LPR) and voice diseases. Methods One hundred and twelve patients with voice disorders and with reflux-related symptoms were recruited. The patients were eval-uated with reflux symptom index(RSI),reflux finding score (RFS)evaluation and 24 -hour dural-probe pH monitoring. They were divided into 4 groups:vocal process granuloma ( n=35 ) chronic pharyngolaryngitis ( n=27 ) , vocal polyps ( n=25 ) , and Reinke's edema(n=25). Recruiting 80 healthy persons as control group. Results According 24-hour dural-probe pH monitoring assessments,60. 7%(68/112) of the patients with voice disorders showed LPR positive. The positive rate in the vocal process granu-loma group 41. 1%(28/68) and Reinke's edema group 29. 4% (20/68)were significantly higher than the control group. RSI of the patients with Reinke's edema and vocal process granuloma were both significantly higher than the control group(P =0. 021,P =0. 013). RFS of the patients with vocal process granuloma were significantly higher than the control group(P=0. 011). The VHI of patients with voice disorders were significantly higher than the control group ( P <0. 05 ) . Conclusion The correlations between Reinke's edema,vocal process granuloma and LPR were stronger. Voice diseases can affect the physiological function, social function and psychological function of the patients.%目的 探讨咽喉反流( laryngopharyngeal reflux,LPR)与嗓音疾病的关系. 方法 对112例患有嗓音疾病疑有LPR相关症状的成年患者行反流症状指数量表( reflux symptom index,RSI)、反流体征计分量表( reflux finding score, RFS)、24小时双探头食道pH值监测及嗓音障碍指数量表( voice handicap index,VHI)评估. 其中声带接触性肉芽肿组35例,慢性喉炎组27例,声带息肉组25例,声带任克氏水肿组25例. 同时选取80名身体健康的志愿者作为对照组. 结果 112例嗓音疾病患者中LPR阳性者68

  13. Special features of sleep disorders and depressive disturbances in patients with isolated gastroesophageal reflux disease and in conjunction with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Галина Дмитриевна Фадеенко

    2015-10-01

    Full Text Available Aim – to study the special features of sleep disorders and depression intensity in patients with gastroesophageal reflux disease (GERD and GERD in conjunction with coronary artery disease (CAD by the method of questionnaire and to compare results with clinical and functional manifestations of comorbidity.Methods. There were examined 65 patients with GERD and CAD (group 1 and 29 patients with GERD (group 2. Sleep disorders and depression were studied using questionnaires: subjective sleep characteristics (SSC, (Epworth Sleepiness Scale (ESS,Beck scale for depression (BSD.Results. Sleep disorders took place in 41 (61,54 % patients from group 1 and 13 (44,83 % patients from group 2. The mean point of SSC was 17,75±1,98 in group 1 opposite to18,59±1,12 in group 2 (p= 0,043. The mean point of ESS was 9,75±1,59 in group 1opposite to 9,24±1,18 in group 2, p=0,103. The mean point of BDS was 11,89±4,38 in group 1opposite to 8,86±1,30 in group 2, p= 0,004. In the group 1 it was established a correlation between SSC and patient’s age (r=- 0320; p=0,0075, BSD and age (r=0,371; p=0,0024, ESS and body mass index(r=0,291; p=0,0188. There were established correlations between duration of CAD and SSC (r=-0,315; p=0,011, CAD and ESS (r=0,273; p=0,0280, CAD and BSD (r=0,379; p=0,0018, GERD heaviness and SSC (p=0,0498, BSD and SSC (r= - 0,676; p=0,000 and between BSD and ESS (r=0,583; p=0,000 in group 1. In group 2 ESS correlated with age (r=0,379; p=0,0426.Conclusions. The conjunction of GERD and CAD can be considered as two mutually potential pathological processes that have a negative effect on such indicators as sleep and psycho-emotional status of patient

  14. End-stage kidney disease probably due to reflux nephropathy with segmental hypoplasia (Ask-Upmark kidney) in young Boxer dogs in Norway. A retrospective study.

    Science.gov (United States)

    Kolbjørnsen, O; Heggelund, M; Jansen, J H

    2008-07-01

    This paper is a retrospective morphologic study of 7 young Boxer dogs, showing end-stage kidney lesions compatible with chronic pyelonephritis with severe segmental cortical atrophy and fibrosis, associated with chronic tubulointerstitial inflammation of varying degree. Azotemia was observed in 6 of the 7 cases. The gross kidney lesions were as follows: bilateral small kidneys with numerous segmental cortical scars causing depression of the renal cortical surface. Histologic examination revealed salient atrophy of nephrons, including paucity of glomeruli, glomerulocystic lesions, colloid-filled tubular microcysts, and a conspicuously increased occurrence of arteries with narrowed lumina caused by intimal thickening. These segmental abnormalities were accompanied by pronounced interstitial fibrosis. All but 1 dog showed salient tubulointerstitial lympho-plasmacytic infiltration, which in 3 cases also included diffuse infiltration of polymorphonuclear neutrophilic leukocyte (PMN)-cells and occurrence of tubular PMN-casts. Morphologic signs of abnormal metanephric differentiation (renal dysplasia) were observed in all cases in the form of atypical tubules or asynchronous nephronic development (immature glomeruli) or both. However, other morphologic primary dysplastic features were absent. Based on the morphologic features, it is concluded that the end-stage kidney disease in these young Boxer dogs was the result of chronic atrophic nonobstructive pyelonephritis, most probably caused by vesico-ureteral reflux, compatible with reflux nephropathy causing segmental hypoplasia (Ask-Upmark kidney) in man. It is proposed that atypical tubular epithelium in the form of adenomatoid proliferation of collecting duct epithelial cells should be considered an acquired compensatory lesion, rather than the result of disorganized metanephric development.

  15. Reproducibility of 24-hour combined multiple intraluminal impedance (MII) and pH measurements in infants and children. Evaluation of a diagnostic procedure for gastroesophageal reflux disease

    DEFF Research Database (Denmark)

    Dalby, Kasper; Nielsen, Rasmus G; Markoew, Simone;

    2007-01-01

    without dietary restrictions. Bland-Altman difference versus mean plots and calculation of the limits of agreement (LOA) were used for assessment of the reproducibility of the total number of acidic and nonacidic reflux episodes. LOA for the number of acidic reflux episodes on day 2 were 0.2-5.3 times...

  16. Gastroesophageal reflux diagnosed by occlusal splint tintion.

    Science.gov (United States)

    Cebrián-Carretero, José Luis; López-Arcas-Calleja, José María

    2006-01-01

    The gastroesophageal reflux (GER) disease is a very frequent digestive disorder, mainly characterised by the reflux of the gastric acidic content to the esophage in abnormal quantities. There are different situations that favour this situation but almost in all of them rely an incompetence of the esophagic sphincter. The clinical consequences are many, including oral manifestations. Among all of them the most frequent is the esophagitis followed by symptoms at the pharynx or larynx and finally, the oral cavity. At this level fundamentally we will find enamel and oral mucosa erosions. We report the case of a patient who was indirectly diagnosed of her esophague disease by the observation of the alterations in the occlusal splint induced by the gastric reflux. We review the literature concerning the above topic and its possible association with the miofascial syndrome.

  17. Use of acid-suppressive therapy before anti-reflux surgery in 2922 patients

    DEFF Research Database (Denmark)

    Lødrup, A; Pottegård, A; Hallas, J

    2015-01-01

    BACKGROUND: Guidelines recommend that patients with gastro-oesophageal reflux disease are adequately treated with acid-suppressive therapy before undergoing anti-reflux surgery. Little is known of the use of acid-suppressive drugs before anti-reflux surgery. AIM: To determine the use of proton pump...

  18. 胃食管反流病药物治疗110例%Gastroesophageal Reflux Disease 110 Cases of Drug Treatment

    Institute of Scientific and Technical Information of China (English)

    乔洪

    2015-01-01

    Objective To study the lansoprazole joint PuYuanHeWei capsule curative effect for the treatment of gas⁃troesophageal reflux disease. Methods The treatment group given LAN sola azole joint PuYuanHe stomach enteric-coated metformin hydrochloride capsules of oral. The control group given lansoprazole enteric-coated metformin hydro⁃chloride and ding Lin oral, a course of 6 weeks. To observe the clinical curative effect, change under gastroscope, adverse reactions and the recurrence rate. Results Both groups can effectively alleviate the symptoms of GERD patients, treat⁃ment group total effectiveness 96.3%, that of control group is 81.8%(P<0.05). Endoscopic treatment group total effective⁃ness 83.3%, that of control group is 64.7%(P<0.05). After follow-up after 2 months of treatment, the treatment group can good control the recurrence. The side effects of two groups were not significant. Conclusion Lansoprazole joint PuYuan⁃HeWei capsule in the treatment of gastroesophageal reflux disease satisfied curative effect, the recurrence rate is low. It is worth of clinical promotion.%目的:探讨兰索拉唑联合蒲元和胃胶囊治疗胃食管反流病的疗效。方法治疗组给予兰索拉唑肠溶片、蒲元和胃胶囊口服;对照组给予兰索拉唑肠溶片和吗丁啉口服,疗程均为6周。观察临床疗效、胃镜下改变、不良反应和复发率。结果两组均能有效缓解食管反流病患者的症状,治疗组总有效率96.3%,对照组的81.8%,两组比较,P<0.05。内镜下表现治疗组总有效率83.3%,对照组的64.7%(P<0.05)。经治疗两个月后随访,治疗组能够很好的控制复发。两组均没有发现明显的毒副作用。结论兰索拉唑、蒲元和胃胶囊治疗胃食管反流病疗效满意,复发率低,值得临床推广。

  19. Laparoscopic surgery for treatment of gastroesophageal reflux disease%胃食管反流病的腹腔镜外科治疗

    Institute of Scientific and Technical Information of China (English)

    李春雷; 邰沁文; 张金辉; 曹新玲

    2012-01-01

    目的:探讨腹腔镜手术治疗胃食管反流病的临床效果.方法:回顾性分析2008年1月—2011年9月对33例胃食管反流病患者行腹腔镜食管裂孔疝修补和胃底折叠术的临床资料.腹腔镜单纯胃底折叠术5例(Toupet式),腹腔镜食管裂孔疝修补加胃底折叠术25例(Nissen式3例,Toupet式22例),腹腔镜单纯食管裂孔疝修补术3例.结果:全组患者手术均获成功,手术时间90~185 min.术后平均住院6d.无中转开腹及死亡病例,无术后严重并发症.术后随访1~24个月,32例临床症状完全消失,1例明显好转.结论:对于胃食管反流性疾病,腹腔镜食管裂孔疝修补和胃底折叠术是一种微创、安全、有效的治疗方法.%Objective: To determine the clinical efficacy of laparoscopic surgery for treatment of gastroesophageal reflux disease (GERD).Methods: The clinical data from 33 patients undergoing laparoscopic repair of esophageal hiatal hernia and laparoscopic fundoplication from January 2008 to September 2011 were retrospectively analyzed. Of the patients, laparoscopic fundoplication (Toupet procedure) alone was performed in 5 cases, 25 cases underwent laparoscopic esophageal hiatal hernia repair plus a fundoplication (3 Nissen procedures and 22 Toupet procedures) and 3 cases had laparoscopic esophageal hiatal hernia repair alone.Results: The operations were successfully performed in all patients. The operatiive time was from 90 to 185 min and the average length of postoperative hospital stay was 6 days. There was no conversion to open procedure and no death occurred. No severe postoperative complications were observed. The postoperative follow-up period was from 1 month to 24 months. The symptoms of 32 patients completely disappeared, and 1 patient significantly improved.Conclusion: Laparoscopic repair of esophageal hiatal hernia and laparoscopic fundoplication are minimally-invasive, safe and effective procedures for gastroesophageal reflux disease.

  20. Prospective, randomized, and active controlled study of the efficacy of alginic acid and antacid in the treatment of patients with endoscopy-negative reflux disease

    Institute of Scientific and Technical Information of China (English)

    I-Rue Lai; Ming-Shiang Wu; Jaw-Town Lin

    2006-01-01

    AIM: To assess the efficacy and safety of a compound containing alginic acid plus antacid (Topaal ) compared to equal-strength antacid (Nacid ) in patients with endoscopy-negative reflux disease (ENRD).METHODS: A total of 121 patients with ENRD were randomized to receive Topaal (65 patients) or Nacid (56patients) for 6 weeks, with a consultation every 3 weeks.The primary end-point assessment was the change in the severity of heartburn as evaluated using a visual analog scale (VAS) at 6 weeks. The secondary end-point assessments were the VAS at 3 weeks, the change of frequency of the reflux symptom, the change of quality of life and the adverse effects.RESULTS: Demographics of randomized subjects in each treatment group were comparable except that the Topaal group included more males. The baseline characteristics between the groups were similar. After 6weeks of treatment, the reduction of VAS of heartburn was more prominent in the Topaal group (-6.29 cm vs -4.11 cm). At the 3rd week, Topaal group showed greater reduction of VAS for heartburn (P=0.0016),regurgitation (P= 0.0006), vomiting (P= 0.0373), and belching (P<0.0001). The patients of the Topaal group had lower frequency of heartburn (P= 0.0015) and pain (P= 0.0163) at the end of the 6-week treatment period.From the doctor's point of view, the Topaal group also showed significant reduction in the severity of heartburn (P=0.0020), regurgitation (P=0.0081), vomiting (P= 0.0182), and belching (P= 0.0018) at the end of the treatment. The improvement of the quality of life was more remarkable in the Topaal group at the end of the 6-week treatment period (P< 0.0001). For the adverse effect, there was no difference in both the groups.CONCLUSION: Topaal is more effective than Nacid for the treatment of symptoms presented by patients with ENRD.

  1. On-demand therapy in gastroesophageal reflux disease: a comparison of the early effects of single doses of fast-dissolving famotidine wafers and ranitidine tablets.

    Science.gov (United States)

    Johannessen, T; Kristensen, P

    1997-01-01

    In this double-masked, double-dummy, randomized, single crossover study, we compared single doses of a fast-dissolving wafer formulation of famotidine with a conventional tablet formulation of ranitidine in patients with gastroesophageal reflux disease (GERD). Patient preference time until symptomatic relief, and predictive characteristics of early responders were assessed. Eligible patients had a clinical diagnosis of GERD and symptoms of GERD of sufficient severity to require relief. The study treatment was one dose of famotidine (20-mg wafer) and one dose of ranitidine (150-mg tablet), which were given in a randomized order and taken as needed. The patients were instructed to measure the symptomatic effects on a seven-point categorical scale (1 = worse to 7 = free of symptoms) at 15, 30, 45, 60, 120, and 180 minutes. After the clinical phase of the trial, the patients indicated their global assessment of efficacy and their preference for the wafer or the tablet. Of the 829 patients who completed the study, significantly more preferred the wafer to the tablet. While there was no significant difference in the global assessment of efficacy, the famotidine wafer provided significantly better relief than the ranitidine tablet during the first hour after dosing. However, at 120 and 180 minutes, the degree of relief was similar for the two drugs. The time until a clinically significant effect was also similar for the two drugs, and approximately one half of the patients experienced such improvement within 3 hours. Multivariate analyses disclosed no predictive characteristics of early symptomatic effect.

  2. Comparison of presentation and impact on quality of life of gastroesophageal reflux disease between young and old adults in a Chinese population

    Institute of Scientific and Technical Information of China (English)

    Shou-Wu Lee; Chia-Ming Chang; Chi-Sen Chang; Ai-Wen Kao; Ming-Chih Chou

    2011-01-01

    AIM: To compare the presentation and impact on quality of life of gastroesophageal reflux disease (GERD) in old and young age groups.METHODS: Data from adult patients with GERD diagnosed by endoscopic and symptomic characteristics were collected between January and November 2009. Exclusion criteria included combined peptic ulcers, malignancy,prior surgery, antacid medication for more than 2 mo, and pregnancy. Enrolled patients were assigned to the elderly group if they were 65 years or older, or the younger group if they were under 65 years. They had completed the GERD impact scale, the Chinese GERD questionnaire, and the SF-36 questionnaire.Data from other cases without endoscopic findings or symptoms were collected and these subjects comprised the control group in our study.RESULTS: There were 111 patients with GERD and 44 normal cases: 78 (70.3%) and 33 patients (29.7%) were in the younger and elderly groups, respectively. There were more female patients (60.3%) in the younger group, and more males (72.7%) in the elderly group. The younger cases had more severe and frequent typical symptoms than the elderly patients. Significantly more impairment of daily activities was noted in the younger patients compared with the elderly group, except for physical functioning.CONCLUSION: Elderly patients with GERD were predominantly male with rare presentation of typical symptoms,and had less impaired quality of life compared with younger patients in a Chinese population.

  3. Gastroesophageal reflux - discharge

    Science.gov (United States)

    ... vegetables, such as citrus fruits, pineapple, tomatoes, or tomato-based dishes (pizza, chili, and spaghetti). Avoid items ... your stress and watch for stressful, tense times. Stress can bother your reflux ... medicines with plenty of water. When you start a new medicine, remember to ...

  4. Barrett食管与胃食管反流病及食管腺癌的关系%The Relationship between Barrett's Esophagus and Gastroesophageal Reflux Disease, Esophageal Adenocarcinoma:Literature Review

    Institute of Scientific and Technical Information of China (English)

    李治仝; 汪忠镐; 季锋; 高翔; 张成超; 胡志伟; 宁雅婵

    2011-01-01

    Gastroesophageal reflux is widespread in the population, the incidence rate of Barrett's esophagus (BE) and esophageal adenocarcinoma (EA) is rising year by year. In order to learn the relationship between BE, GERD and EA, this article reviewed the related literature of recent years, focusing on pathophysiology, diagnosis and treatments. The results showed three of the disease progression from normal esophageal mucosa, GERD, BE metaplasia, BE low and high hyperplasia to EA. In view of this, the treatment of BE should aim to reduce the GER symptoms. Regular screening and e-valuation of prognosis are valuable in early detection of EA.%胃食管反流( gastroesophageal reflux,GER)在人群中普遍存在,Barrett食管(Barrett's esophagus,BE)及食管腺癌( esophageal adenocarcinoma,EA)的发病率也在逐年升高.为了解BE与胃食管反流病(gastroesophageal reflux disease,GERD)、EA的关系,本文复习近年相关文献,从病理生理基础及诊断、治疗方法入手进行探讨,结果发现三者的病情进展过程为正常食管黏膜-GERD-BE化生-BE低度和高度异型增生-EA.故BE的治疗应以减轻GER症状为主,并定期筛检和评价预后,以早期发现EA.

  5. Milk /sup 99/Tcsup(m)-EHIDA test for enterogastric bile reflux

    Energy Technology Data Exchange (ETDEWEB)

    Mackie, C.R.; Wisbey, M.L.; Cuschieri, A. (Ninewells Hospital and Medical School, Dundee (UK))

    1982-02-01

    The study and clinical assessment of enterogastric bile reflux has been restricted for want of a simple non-invasive test for its detection and quantification. This paper describes such a test in which biliary excretion scintigraphy has been combined with a milk meal provocation. Two of 10 healthy volunteers studied showed probable reflux of approximately 5 per cent of total initial abdominal field activity. Among 73 patients studied, 37 patients showed definite reflux of up to 47 per cent. Reflux occurred in 19 of 22 post-gastric surgery patients and in 7 of 22 patients with peptic ulcer disease, gastritis or gastro-oesophageal reflux. None of 7 patients with 'non-specific' abdominal pain showed any reflux, but 11 of 22 patients with gallstone disease or previous cholecystectomy showed reflux of up to 35 per cent, including 9 of 11 patients with loss of gallbladder reservoir function.

  6. Epidemiological investigation of gastroesophageal reflux disease in offshore oil platform workers%海上石油平台作业人员胃食管反流病流行病学调查

    Institute of Scientific and Technical Information of China (English)

    长蒙; 温冰

    2016-01-01

    目的 调查海上石油平台作业人员胃食管反流病(gastroesophageal reflux disease,GERD)的发病率,分析与之相关的危险因素.方法 应用随机整群分层抽样的方法,对518名海上石油平台作业人员(均为男性)进行反流性疾病问卷(reflux disease questionnaire,RDQ)及相关危险因素调查,RDQ评分≥12分提示GRED诊断.调查方式均为面访试.调查资料均输入电脑并建立数据库,采用SPSS13.0软件行卡方检验、Logistic回归分析等.结果 海上石油平台作业人员GERD发病率为5.98%,与北京、上海两地普通人群的5.8%相近,高于广东的2.3%;低于海军官兵的27.1%.常食甜食、常饮浓茶、晕船、精神压力大、噪声环境、高脂饮食、常食辛辣食物、睡眠差可能为GERD的危险因素.结论 海上石油平台作业人员GERD的发病率与国内普通人群相近,但低于海军官兵人群,危险因素较多.%Objective To investigate the incidence of gastroesophageal reflux disease among offshore oil platform workers and analyze related risk factors of the disorder.Methods Reflux disease questionnaire (RDQ) and related risk factor survey were conducted among 518 offshore oil platform male workers by using random stratified cluster sampling method.The questionnaire survey was tarried out by personal interviews,and RDQ scores higher than 12 points indicated GERD diagnosis.SPSS 13.0 software chi-square test and Logistic regression analysis were used in the end results of the study.Results The incidence of gastroesophageal reflux disease among offshore oil platform workers was 5.98%,while that of the general population in Beijing and Shanghai was 5.77%,and it was obviously higher than that of the Guangdong general population (2.3%),but much lower than that of naval officers and enlisted (27.1%).Sweet diet,strong tea,seasickness,mental strain,noise,high-fat diet,spicy food and poor sleep might possibly the risk factors of the

  7. The diagnostic utility of anti-cyclic citrullinated peptide antibodies, matrix metalloproteinase-3, rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein in patients with erosive and non-erosive rheumatoid arthritis.

    Science.gov (United States)

    Shovman, O; Gilburd, B; Zandman-Goddard, G; Sherer, Y; Orbach, H; Gerli, R; Shoenfeld, Y

    2005-09-01

    To compare the diagnostic utility of laboratory variables, including matrix metalloproteinase-3 (MMP-3), anticyclic citrullinated peptide (CCP) antibodies, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) in patients with erosive and non-erosive rheumatoid arthritis (RA). We assembled a training set, consisting of 60 patients with RA, all fulfilling the revised criteria of the American College of Rheumatology. A commercial enzyme linked immunosorbent assay (ELISA) was used both to test for anti-CCP antibodies (second generation ELISA kit) and MMP; RF were detected by latex-enhanced immunonephelometric assay. CRP was measured by latex turbidimetric immunoassay. The levels of anti-CCP antibody titers and ESR were significantly higher in patients with erosive disease than those in non-erosive RA patients (p elevated titers of anti-CCP antibodies was found in RA patients with erosions compared to patients with non-erosive RA (78.3% vs. 43.2% respectively). The ROC curves of anti-CCP passed closer to the upper left corner than those other markers and area under the curve (AUC) of anti-CCP was significantly larger than AUC of other markers (0.755 for anti-CCP, 0.660 for ESR, 0.611 for CRP, 0.577 for RF, and 0.484 for MMP-3 female). A positive predictive value was higher for anti-CCP antibodies in comparison to other markers. We did not find significant statistical correlation between anti-CCP antibody titers and inflammatory markers such as ESR or CRP. However, we confirmed the correlation of elevated titers of anti-CCP antibodies and RF in both groups of patients whereas the degree of correlation was more significant in non-erosive patients. The results of our study suggest that the presence of elevated anti-CCP antibody titers have better diagnostic performance than MMP-3, RF, CRP and ESR in patients with erosive RA.

  8. 利用数据库分析胃食管反流病的发病因素与临床特点%Risk factors and clinical characteristics of gastroesophageal reflux disease:analysis based on a prospective database of functional gastrointestinal disease

    Institute of Scientific and Technical Information of China (English)

    陈丽萍; 黄载伟; 肖冰

    2016-01-01

    目的:利用完整的前瞻性功能性胃肠病数据库探讨非糜烂性胃食管反流病(NERD)的相关发病因素与临床特点。方法按照病例报告表(CRF)收集完整的个人信息和临床资料,将各项信息与资料录入到网络在线功能性胃肠病数据管理系统,部分病例完成高分辨率食管测压和多通道腔内阻抗-pH监测,导出检索数据进行统计分析。结果在数据库中录入了504例NERD临床资料及152例对照组资料,NERD患者中,女性266例(52.8%)、男性238例(47.2%);商人(23.1%)、公务员(19.6%)、无业(19.2%)、工人(17.1%),城市病源(67.3%)、农村病源(32.7%);平均病程(27.88±16.33)月;不良生活事件(P=0.045,OR=1.954)、长期频繁饮酒(P=0.040,OR=3.957)、打鼾(P=0.002,OR=2.334)、进食夜宵(P=0.002,OR=2.752)、合并焦虑抑郁(P=0.003,OR=2.723)等是NERD的独立危险因素;60.81%NERD患者存在不同程度的食管体部无效收缩,其中存在食管裂孔疝(HH)与无HH的NERD患者两组之间在总液体反流事件方面存在明显差异(P<0.05)。结论不良生活与饮食习惯、焦虑抑郁与不良事件、打鼾、食管运动功能差、HH等与NERD的发病具有重要相关性,30~50岁为高发人群,并与职业和生活区域有一定相关。%Objective To explore the risk factors and clinical characteristics of non-erosive reflux disease (NERD) based on a prospective single disease database of functional gastrointestinal disease. Methods Using a customized case report form, we collected the personal and clinical data of all study participants in an online database for further analysis. High-resolution manometry and multichannel intraluminal impedance-pH monitoring were performed in some cases. Results A total of 504 NERD cases and 152 control cases were included in our database. The NERD patients consisted of 266 (52.8%) female patients

  9. Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§

    Science.gov (United States)

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

    2014-01-01

    Study Objectives : Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. Methods : A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. Results : In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Conclusion : Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups. PMID:25352924

  10. Menthol suppresses laryngeal C-fiber hypersensitivity to cigarette smoke in a rat model of gastroesophageal reflux disease: the role of TRPM8.

    Science.gov (United States)

    Liu, Bi-Yu; Lin, Yu-Jung; Lee, Hung-Fu; Ho, Ching-Yin; Ruan, Ting; Kou, Yu Ru

    2015-03-01

    Patients with gastroesophageal reflux disease (GERD) display enhanced laryngeal reflex reactivity to stimuli that may be due to sensitization of the laryngeal C-fibers by acid and pepsin. Menthol, a ligand of transient receptor potential melastatin-8 (TRPM8), relieves throat irritation. However, the possibility that GERD induces laryngeal C-fiber hypersensitivity to cigarette smoke (CS) and that menthol suppresses this event has not been investigated. We delivered CS into functionally isolated larynxes of 160 anesthetized rats. Laryngeal pH 5-pepsin treatment, but not pH 5-denatured pepsin, augmented the apneic response to CS, which was blocked by denervation or perineural capsaicin treatment (a procedure that blocks the conduction of C fibers) of the superior laryngeal nerves. This augmented apnea was partially attenuated by capsazepine [an transient receptor potential vanilloid 1 (TRPV1) antagonist], SB-366791 (a TRPV1 antagonist), and HC030031 [a transient receptor potential ankyrin 1 (TRPA1) antagonist] and was completely prevented by a combination of TRPV1 and TRPA1 antagonists. Local application of menthol significantly suppressed the augmented apnea and this effect was reversed by pretreatment with AMTB (a TRPM8 antagonist). Our electrophysiological studies consistently revealed that laryngeal pH 5-pepsin treatment increased the sensitivity of laryngeal C-fibers to CS. Likewise, menthol suppressed this laryngeal C-fiber hypersensitivity and its effect could be reversed by pretreatment with AMTB. Our results suggest that laryngeal pH 5-pepsin treatment increases sensitivity to CS of both TRPV1 and TRPA1, which are presumably located at the terminals of laryngeal C-fibers. This sensory sensitization leads to enhanced laryngeal reflex reactivity and augmentation of the laryngeal C-fiber responses to CS, which can be suppressed by menthol acting via TRPM8.

  11. 胃食管反流病患者唾液腺功能的变化%The function change of salivary gland in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    王亚锋; 法永红; 陈秀; 王凌云; 蔡兴伟; 李颖华

    2010-01-01

    目的 探讨胃食管反流病(gastroesophageal reflux disease,GERD)患者的非刺激性唾液(unstimulated whole saliva,UWS)和刺激性唾液(stimulated whole saliva,SWS)初始pH值、唾液缓冲能力和唾液流率等唾液腺功能的改变.方法 收集57例确诊的GERD住院患者和24名健康人的非刺激性唾液、刺激性唾液各2ml,测定唾液的pH值、唾液缓冲能力和唾液流率.结果 ①GERD组刺激性唾液的初始pH值极显著高于非刺激性唾液(P<0.001);②对照组非刺激性唾液的缓冲能力显著高于GERD组非刺激性唾液的缓冲能力(P<0.01),对照组刺激性唾液的缓冲能力高于GERD组刺激性唾液的缓冲能力(P<0.05);③对照组非刺激性唾液的流率极显著高于GERD组非刺激性唾液的流率(P<0.001),对照组刺激性唾液的流率显著高于GERD组刺激性唾液的流率(P<0.01).结论 GERD患者唾液腺功能降低.

  12. Observer agreement of lower limb venous reflux assessed by duplex ultrasound scanning using manual and pneumatic cuff compression in patients with chronic venous disease and controls

    DEFF Research Database (Denmark)

    Broholm, R; Kreiner, S; Bækgaard, Niels;

    2011-01-01

    The study aimed to evaluate observer agreement between two experienced ultrasound operators examining deep venous reflux assessed by duplex ultrasound (DU) using either manual or pneumatic cuff compression. In addition, the two methods were compared with each other with regard to immediate...

  13. Vesical-ureteral reflux in children; Reflux vesico-ureteral chez l`enfant

    Energy Technology Data Exchange (ETDEWEB)

    Desvignes, V.; Palcoux, J.B. [Hotel-Dieu, 63 - Clermont-Ferrand (France); Cochat, P. [Hopital Edouard-Herriot, 69 - Lyon (France)

    1995-12-31

    The vesical-ureteral reflux is the most frequent uropathy in children. The diagnosis is made by uretero-cystography, often after pyelonephritis, sometimes after ante-natal diagnosis from echographic abnormalities. Spontaneous recovery is possible in 50 to 80% of cases. This is especially true in grade 1, 2 and 3, however complications may occur. They are more frequent in the case of reflux nephropathy with a resulting risk of hypertension and chronic renal failure. The therapeutic choice is between the conservative management with urinary antiseptics ad the surgical treatment with ureters re-implantation or endoscopic treatment. The therapeutic indications take into account vesical-ureteral reflux grades, the child`s age, the associated diseases and the child`s and parents` compliance. (authors). 22 refs., 2 figs.

  14. Clinical Analysis of 36 Cases of Otitis Media of Effusion Caused by Gastroesophageal Reflux Disease%胃食管反流疾病致分泌性中耳炎36例临床分析

    Institute of Scientific and Technical Information of China (English)

    魏璐璐

    2016-01-01

    Objective To investigate the diagnosis and treatment of otitis media of effusion caused by gastroesophageal reflux disease and the influencing factors of the disease.Methods The diagnosis and treatment of otitis media of effusion caused by gastroesophageal reflux disease in 36 patients were retrospectively analyzed.Results In 36 cases,18 cases were markedly effective(50.0%),12 cases were effective (33.3%),6 cases were ineffective(16.7%),the total effective rate was 83.3%(30/36).Conclusion Otitis media of effusion induced by gastroesophageal reflux disease is effective in the treatment of secretory otitis media.%目的:探讨胃食管反流疾病致分泌性中耳炎的诊疗以及该疾病发生的影响因素。方法回顾性分析36例胃食管反流疾病致分泌性中耳炎患者的诊疗过程、治疗效果及影响因素。结果36例患者中显效18例(50.0%),有效12例(33.3%),无效6例(16.7%),总有效率达83.3%(30/36)。结论胃食管反流疾病致分泌性中耳炎通过有效制酸、促胃动力治疗,疗效确切。

  15. Asthma symptoms improvement in moderate persistent asthma patients with gastroesophageal reflux disease (GERD: the role of proton-pump inhibitor

    Directory of Open Access Journals (Sweden)

    Agus D. Susanto

    2008-09-01

    Full Text Available This study aimed to evaluate effect of proton pump inhibitor (esomeprazole on asthma symptoms, use of inhaled bronchodilator and peak expiratory flow rate (PEFR in moderate persistent asthma with gastroesofageal refluks disease (GERD. This randomized single blind, controlled clinical trial study was conducted at Persahabatan Hospital, Jakarta from July 2004 until October 2005. Samples were moderate persistent asthma patients with GERD. GERD is diagnosed GERD symptoms and proof of oesophagitis from endoscopy and or histapatologic examination from oesophagus biopsy. Phase 1:2 week run-in period patient received inhaled budesonide 2x200 ug/day. Phase 2: patient randomised to receive inhaled budesonide 2 x 400 ug/day with esomeprazole 40 mg/day or without esomeprazole (control group for 8 weeks. Phase 3: 4 week wash out period, patient receive inhaled budesonide 2 x 200 ug/day. Diary cards were assessed at run-in periode, after treatment 4 weeks, 8 weeks and wash out. There were 32 patients (23 female and 9 male completed the study. Mean total asthma symptoms score daily were significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-2.29 vs -0.90; p < 0.05. Mean use of inhaled bronchodilator was significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-1.09 vs -0.42; p < 0.05. Morning and evening PEFR improved higher on esomeprazole than without esomeprazol but were not significantly difference. In conclusion, administration esomeprazole 40 mg daily improved asthma symptoms and lower the use of inhaled bronchodilator in moderate persistent asthma patients with GERD. (Med J Indones 2008; 17: 169-74Keywords: Asthma symptoms, inhaled bronchodilator, moderate persistent asthma, GERD, esomeprazole

  16. Study on the relationship between obesity and gastroesophageal reflux disease%肥胖与胃食管反流病关系的研究

    Institute of Scientific and Technical Information of China (English)

    刘冬梅; 刘建军; 田书瑞; 战秀岚; 卢芳芳; 纪涛; 邓昌荣; 吴继敏

    2015-01-01

    Objective To investigate the relationship between obesity and esophageal high resolutionmanometry ,24‐hour pH monitoring and gastroscopic results of patients with gastroesophageal reflux disease (GERD) .Methods A total of 196 patients with GERD(DeMeester score>14 .72) were selected and divided into normal weight group (18 .5 kg/m2 0 .05) .The percent total time pH≤4 of obesity group was 15 .42% (10 .31% to 21 .49% ) ,percent supine time pH≤4 was 14 .21% (5 .75% to 34 .98% ) and percent upright time pH≤4 was 14 .25% (8 .19% to 18 .13% ) .The reflux episodes (106 .50 ,67 .00 to 145 .75) and the longest duration of reflux episodes (28 .10 min ,10 .90 min to 47 .93 min) were more than those of normal group (9 .74% ,5 .35% to 15 .96% ;7 .31% ,3 .25% to 11 .80% ;8 .45% ,5 .43% to 17 .48% ;72 .50 ,53 .00 to 100 .50;15 .80 min ,9 .90 min to 21 .28 min) and overweight group (11 .36% , 6 .74% to 15 .87% ;7 .74% ,2 .36% to 15 .05% ;11 .27% ,3 .37% to 14 .73% ;85 .50 ,58 .75 to 117 .75;21 .40 min ,11 .50 min to 39 .90 min) ,and the differences were statistically significant (Z=7 .054 ,11 .181 , 6 .429 ,6 .452 ,8 .246 ,all P0 .05) .There was no statistically significant difference in the incidence of Barrett′s esophagus among three groups (all P>0 .05) .Conclusions Compared with that of normal weight group and overweight group of patiento with GERD ,abdominal length of LES of obesity group was shorter .With an increase in BMI , acid exposure and the incidences of reflux esophagitis and hiatal hernia also increased .%目的:探讨肥胖与GERD患者在食管压力测定、24 h pH监测、胃镜检查结果之间的关系。方法选取GERD(DeMeester积分>14.72)患者196例,根据BMI分为正常体质量组(18.5 kg/m2<BM I<24 kg/m2)、超重组(24 kg/m2≤BM I<28 kg/m2)和肥胖组(BM I≥28 kg/m2)。进行高分辨率食管测压、24 h pH监测,计算DeMeester积分;同期行胃镜检查,食管炎分级采用洛杉矶

  17. To Observe the Effect of Omeprazole on Reflux Disease Curative Effect of Stomach%奥美拉唑治疗小儿胃食管反流病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王敏华

    2014-01-01

    Objective Explore the omeprazole for treatment of children with gastroesophageal reflux disease.Methods To 50 cases esophageal reflux sex disease were randomly divided into observation group and control group(25 cases)and observation group treated with omeprazole,ranitidine group applied treatment,compare the curative ef ect of two groups of patients.Results The total ef ective rate was 96%of observation group was obviously higher than that of control group,the dif erences were statistical y significant ( <0.05).Conclusion Omeprazole treatment of children with gastroesophageal reflux disease curative ef ect,high ef iciency,no obvious adverse reactions,worthy of clinical popularization and application.%目的探讨奥美拉唑治疗小儿胃食管反流病的临床效果。方法将50例反流性食管病患儿随机分为观察组和对照组(各25例),观察组应用奥美拉唑进行治疗,对照组应用雷尼替丁治疗,比较两组患者的疗效。结果观察组的总有效率为96%,明显高于对照组,差异均具有统计学意义(<0.05)。结论奥美拉唑治疗小儿胃食管反流病疗效确切,有效率高,无明显不良反应,值得临床推广应用。

  18. Vesicoureteric reflux in children

    Directory of Open Access Journals (Sweden)

    Jameela A Kari

    2013-01-01

    Full Text Available Aim: This study aimed to identify the differences between primary and secondary vesicoureteric reflux (VUR and the effect of associated bladder abnormalities on kidney function. Patients and Methods: We retrospectively reviewed the medical records of children with VUR who were followed up at King Abdulaziz University Hospital from January 2005 to December 2010. The review included results of radiological investigations and kidney function tests. We used Chi-square test for statistical analysis and paired t-test to compare group means for initial and last creatinine levels. Results: Ninety-nine children were included in this study. Twenty (20.2% had primary VUR, 11 had high-grade VUR, while 9 had low-grade reflux. All children with low-grade VUR had normal dimercaptosuccinic acid (DMSA. Renal scars were present in 72% of the children with high-grade VUR. The mean creatinine levels (initial and last for both groups were normal. Seventy-nine (79.8% children had secondary VUR, which was due to posterior urethral valves (PUV (46.8%, neurogenic bladder caused by meningomyelocele (25.3%, non-neurogenic neurogenic bladder (NNB (21.5%, or neurogenic bladder associated with prune belly syndrome (6.3%. Children with NNB, meningomyelocele and PUV had high creatinine at presentation with no considerable worsening of their kidney functions during the last visit. Renal scars were present in 49.4% of the children with secondary VUR. Conclusion: Children with primary VUR and normal bladder had good-functioning kidneys, while those with secondary VUR associated with abnormal bladder caused by NNB, spina bifida or PUV had abnormal kidney functions. DMSA scans were useful in predicting higher grades of VUR in children with primary reflux.

  19. [Vesicoureteral reflux in adults].

    Science.gov (United States)

    Rollino, Cristiana; D'Urso, Leonardo; Beltrame, Giulietta; Ferro, Michela; Quattrocchio, Giacomo; Quarello, Francesco

    2011-01-01

    Vesicoureteral reflux (VUR) may be congenital or acquired. The most frequent form of congenital VUR is primary VUR. Its prevalence in adults is not exactly known, but it is higher in women, whose greater propensity for urinary tract infections increases the likelihood of an instrumental examination leading to the diagnosis of less severe cases. In men, even severe VUR may go undiagnosed for a long time. Primary VUR is due to a defect in the valve mechanism of the ureterovesical junction. In physiological conditions, the terminal ureter enters the bladder wall obliquely and bladder contraction leads to compression of this intravesical portion. Abnormal length of the intravesical portion of the ureter due to a genetic mutation (whose location is yet to be established) leads to VUR. In its less severe forms VUR may be asymptomatic, but in 50-70% of cases it manifests with recurrent cystitis or pyelonephritis. The manifestations leading to a diagnosis of VUR in adults, besides urinary tract infections, are proteinuria, renal failure and hypertension. The gold-standard diagnostic examination is a micturating cystourethrogram. Reflux nephropathy develops as a result of a pathogenetic mechanism unrelated to high cavity pressure or urinary tract infections but due to reduced formation of the normal renal parenchyma (hypoplasia or dysplasia). Abnormal renal parenchyma development is attributable to the same genes that control the development of the ureters and ureterovesical junction. VUR is considered only a marker of this abnormal development, playing no role in scar formation. There is no conclusive evidence regarding the indications for VUR correction. However, the risk that VUR leads to recurrent pyelonephritis and reflux nephropathy must be kept in mind. VUR certainly has to be corrected in women who contemplate pregnancy.

  20. The role of Helicobacter pylori in gastroesophageal reflux disease%幽门螺杆菌在胃食管反流病中的作用

    Institute of Scientific and Technical Information of China (English)

    刘燕; 于晓峰; 宓林

    2015-01-01

    目的 探讨幽门螺杆菌(H.pylori)感染与胃食管反流病(gastroesophageal reflux disease,GERD)的关系.方法 收集并前瞻性分析2013年1月-2014年1月在复旦大学附属华东医院内镜室行胃镜检查的患者,纳入GERD患者984例及慢性浅表性胃炎患者2 136例,两组均行快速尿素酶试验进行H.pylori检测,对比两组H.pylori感染情况;将984例GERD患者分为NERD、RE-A、B组及RE-C、D组,对比三组H.pylori感染情况;随机选取60例H.pylori(+)GERD患者,均采用标准四联方案,其中54例成功根治H.pylori后的GERD患者继续随访3个月了解患者症状变化.结果 GERD组H.pylori感染的阳性率(35.98%)低于对照组(36.99%),但差异无统计学意义(P>0.05).NERD组、RE-A、B组和RE-C、D组H.pylori感染率分别是36.19%、35.58%、35.96%,三组之间差异无统计学意义(P>0.05).54例成功根除H.pylori的GERD患者随访3个月患者症状无明显改善.结论 H.pylori感染与GERD之间无明显相关性,且H.pylori阳性GERD患者行H.pylori根治后症状无明显改善.

  1. Potentiated clinoptilolite: artificially enhanced aluminosilicate reduces symptoms associated with endoscopically negative gastroesophageal reflux disease and nonsteroidal anti-inflammatory drug induced gastritis

    Directory of Open Access Journals (Sweden)

    Potgieter W

    2014-07-01

    Full Text Available Wilna Potgieter, Caroline Selma Samuels, Jacques Renè SnymanDepartment of Pharmacology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, Gauteng, South AfricaPurpose: The cation exchanger, a potentiated clinoptilolite (Absorbatox™ 2.4D, is a synthetically enhanced aluminosilicate. The aim of this study was to evaluate the possible benefits of a potentiated clinoptilolite as a gastroprotective agent in reducing the severity of clinical symptoms and signs associated with 1 endoscopically negative gastroesophageal reflux disease (ENGORD and 2 nonsteroidal anti-inflammatory drug (NSAID medication.Methods and patients: Two randomized, double-blind, placebo-controlled, pilot studies, the ENGORD and NSAID studies, were conducted. After initial negative gastroscopy, a total of 25 patients suffering from ENGORD were randomized to receive either placebo capsules or 750 mg Absorbatox twice daily for 14 days. The NSAID study recruited 23 healthy patients who received orally either 1,500 mg Absorbatox or placebo three times daily, plus 500 mg naproxen twice daily. Patients underwent gastroscopic evaluation of their stomach linings prior to and on day 14 of the study. Gastric biopsies were obtained and evaluated via the upgraded Sydney system, whereas visible gastric events and status of the gastric mucosa were evaluated via a 0–3 rating scale. During both studies, patients recorded gastric symptoms in a daily symptom diary.Results: In the ENGORD study, patients who received the potentiated clinoptilolite reported a significant reduction (P≤0.05 in severity of symptoms including reduction in heartburn (44%, discomfort (54%, and pain (56%. Symptom-free days improved by 41% compared to the group who received placebo (not significant. This was over and above the benefits seen with the proton pump inhibitor. In the NSAID study, the reduction in gastric symptom severity was echoed in the group who received the potentiated

  2. Challenges of correlating pH change with relief of clinical symptoms in gastro esophageal reflux disease: a phase III, randomized study of Zegerid versus Losec.

    Directory of Open Access Journals (Sweden)

    Dave Walker

    Full Text Available Zegerid (on demand immediate-release omeprazole and sodium bicarbonate combination therapy has demonstrated earlier absorption and more rapid pH change compared with Losec (standard enteric coated omeprazole, suggesting more rapid clinical relief of heartburn. This Phase III, multicenter, double-blind, double-dummy, randomized study assessed the clinical superiority of Zegerid versus Losec for rapid relief of heartburn associated with gastro-esophageal reflux disease (GERD.Patients with a history of frequent (2 3 days/week uncomplicated GERD, were randomized to receive Zegerid (20 mg or Losec (20 mg with corresponding placebo. Study medication was self-administered on the first episode of heartburn, and could be taken for up to 3 days within a 14 day study period. Heartburn severity was self assessed up to 180 minutes post dose (9 point Likert scale. Primary endpoint was median time to sustained response (≥3 point reduction in heartburn severity for ≥45 minutes.Of patients randomized to Zegerid (N=122 or Losec (N=117, 228/239 had recorded ≥1 evaluable heartburn episodes and were included in the modified intent-to-treat population. No significant between-group differences were observed for median time to sustained response (60.0 vs. 52.2 minutes, Zegerid [N=117] and Losec [N=111], respectively, sustained partial response (both, 37.5 minutes and sustained total relief (both, 105 minutes. Significantly more patients treated with Zegerid reached sustained total relief within 0-30 minutes post dose in all analysis sets (p<0.05. Both treatments were well tolerated and did not raise any safety concerns.Superiority of Zegerid over Losec for rapid heartburn relief was not demonstrated; both treatments were equally effective however the rapid onset of action of Losec was unexpected. Factors, including aspects of study design may have contributed to this. This study supports previously reported difficulty in correlating intra-gastric pH change with

  3. Comparison between the Reflux Finding Score and the Reflux Symptom Index in the Practice of Otorhinolaryngology.

    Science.gov (United States)

    Nunes, Heloisa Sobreira; Pinto, José Antonio; Zavanela, Adma Roberta; Cavallini, André Freitas; Freitas, Gabriel Santos; Garcia, Fabiola Esteves

    2016-07-01

    The Gastroesophageal Reflux Disease has a prevalence of ∼12% of the urban population in Brazil. Koufman proposed the term to designate Laryngeal Pharyngeal Reflux (LPR) symptoms, signs or tissue damage resulting from aggression of the gastrointestinal contents in the upper aerodigestive tract. Belafsky et al proposed a score that points to inflammatory laryngeal signs through videolaryngoscopic findings, the Reflux Finding Score (RFS). Moreover, in 2002, they published the Reflux Symptom Index (RSI). The objective of this study is to provide a comparison between the Reflux Finding Score and the Reflux Symptom Index in the practice of Otorhinolaryngology. Our study involved a total of 135 patients who visited the Ear, Nose, and Throat (ENT) clinic Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo between April 2014 and May 2015 with suspected LPR. We excluded nine patients and the study group was 126 patients. All patients were ranked by their RSI and RFS scores. The study group consisted of 126 patients (88 women and 38 men). Their main complaints were cough (40.4%), globus (21.4%), dysphonia (19.8%), throat clearing (15.8%), postnasal drip (3.17%), snoring (1.5%), dysphagia (1.5%), cacosmia (0.7%), and regurgitation (1.5%). The RSI ranges from 13 to 42 with a mean of 20.7 (SD = 6.67). The RFS ranged from 3 to 19 with a mean of 9.53 (SD = 2.64). The RSI and RFS can easily be included in ENT routines as objective parameters, with low cost and high practicality. Based on the clinical index, the specialist can evaluate the need for further tests.

  4. Long-term follow-up of reflux nephropathy in adults with vesicoureteral reflux - radiological and pathoanatomical analysis

    Energy Technology Data Exchange (ETDEWEB)

    Koehler, J.; Thysell, H.; Tencer, J. [Univ. Hospital, Lund (Sweden). Dept. of Nephrology; Forsberg, L.; Hellstroem, M. [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Diagnostic Radiology

    2001-03-01

    Purpose: To study the long-term development of urographic renal morphology in adults with vesicoureteral reflux, to investigate the relationship between renal damage and reflux grade, and to analyse the association between the long-term urographic outcome and the occurrence of acute pyelonephritis and reflux during follow-up. The purpose was also to try to distinguish between acquired and developmental renal damage, based on analyses of renal histological specimens and urographic features, and to analyse associated congenital urogenital abnormalities and family history of reflux, reflux nephropathy, urological malformation or death from end-stage renal disease. Material and Methods: Renal damage was identified in 100 (83 women) of 115 adults, selected because of documented reflux. Eighty-seven patients had two urographies done (median interval 14.3 years). The extent and progression of renal damage were assessed and features of developmental renal damage were determined. Histological renal specimens were available in 23 patients with renal damage. Results and Conclusions: The extent of renal damage correlated positively with the severity of reflux. No renal damage developed during the follow-up in 45 previously undamaged kidneys and progression of renal damage was rare (4 of 120 previously damaged kidneys), despite persisting reflux in half of the cases and episodes of acute pyelonephritis during follow-up. Thus, repeated renal imaging is rarely justified in adults with reflux nephropathy. Histological examination showed 'chronic pyelonephritis' in all 23 cases and co-existing renal dysplasia in 1 case. The detailed urographic analysis did not reveal support for developmental renal damage. High frequencies of associated congenital urogenital abnormalities and of a positive family history were found. Thus, congenital and/or hereditary factors cannot be discarded as background factors for the development of renal damage.

  5. The Protection Mechanism of Helicobacter Pylori Infection to Gastroesophageal Reflux Disease%幽门螺杆菌感染对胃食管反流病保护机制的研究现状

    Institute of Scientific and Technical Information of China (English)

    周丽丽

    2011-01-01

    胃食管反流病(GERD)是一种常见的上消化道动力障碍性疾病,严重影响人们的生活质量,且发病率呈上升趋势,越来越受到重视.幽门螺杆菌(Hp)感染对GERD的影响是近来年消化病学领域的研究热点.有研究显示Hp感染对GERD并无影响,也有研究报道Hp感染可以促进GERD的发生,但是国内外大部分的研究结果支持Hp感染可能对GERD具有保护作用.%Gastro-esophageal reflux disease is a common upper gastrointestinal tract dyskinesis disease.It influences the quality of people's life seriously.The incidence rate is increasing.People pay more attention to gastro-esophageal reflux disease( GERD ).Recently, the influence of Helicobacter pylori infection to GERD is a research hot in Digestion study field.Some studies demonstrate that Helicobacter pylori infection has no influence to GERD.There are also some studies demonstrate that Helicobacter pylori infection can promote GERD.While most studies support that Helicobacter pylori infection may play a protect role in GERD.

  6. 延续护理对胃食管反流病患者的影响%Effect of continuous nursing in patients with gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    杨静华; 吴温玉; 彭冬梅; 卢小红

    2014-01-01

    Objective To explore the effect of continuous nursing in patients with gastroesophageal reflux disease ( GERD ) .Methods One hundred GERD patients were chosen and randomly divided into the intervention group and the control group , each with 50 cases.All patients received the routine nursing and the discharge guidance in the hospital , and the control group received the traditional outpatient follow-up model, and the intervention group received the continuous nursing in the process of home nursing .The intervention effect was evaluated by the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), the compliance questionnaire and the reflux diagnostic questionnaire ( RDQ ) before and six months after the intervention . Results No differences were found in the scores of SAS , SDS, RDQ, mastering the knowledge of disease and the compliance in two groups before the intervention ( P >0.05 ).The scores of RDQ, SAS, SDS were respectively (6.82 ±2.16), (36.85 ±6.81), (43.33 ±7.12) in the intervention group six months after intervention , and were lower than those in the control group , and the differences were statistically significant (t=9.24, -5.86, -4.62, respectively;P<0.01).The scores of SAS, SDS and RDQ in two groups after intervention were lower than those before intervention , and the difference was statistically significant ( P <0.05).The scores of mastering the knowledge of disease and compliance were respectively (8.73 ±0.28), (25.53 ±1.28) in the intervention group, and were higher than those in the control group , and the differences were statistically significant (t=11.24, 5.62, respectively;P<0.01).Conclusions The continuous nursing in GERD patients can improve their prevention knowledge , and promote their self-management ability and health behavior , and increases their compliance , and consolidate and improve the therapeutic effect .%目的:探讨延续护理对胃食管反流病( GERD)患者的影响。方法将100例GERD患

  7. 胃食管反流病的危险因素以及相关疾病的研究概况%Risk Factors and Related Diseases of Gastroesophageal Reflux Disease

    Institute of Scientific and Technical Information of China (English)

    张玉琴; 巴亚斯古楞; 任建林

    2012-01-01

    胃食管反流病(GERD)是西方国家比较常见的疾病,近年亚洲国家的发病率呈上升趋势,其发病机制复杂.与GERD发生相关的分子机制主要包括IL-1β、IL-8、E-钙黏蛋白、PAR-2、COL3A1等,遗传因素、肥胖、生活方式、精神心理因素、药物、人口因素、食管裂孔疝等可能是GERD的危险因素.此外,GERD可导致多种食管外相关疾病和食管腺癌.本文就此作一综述.%Gastroesophageal reflux disease (GERD) is common in Western countries, and the incidence of GERD is increasing in Asian in recent years, the pathogenesis of GERD is complicated. The molecular mechanism of GERD includes IL-1β, IL-8, E-cadherin, PAR-2, COL3A1, etc. Genetic factor, obesity, life style, psychological factor, drugs, demography and esophageal hiatal hernia can be considered as risk factors for CERD. Moreover, GERD can cause extraesophageal related diseases and esophageal adenocarcinoma. This article reviewed the risk factors and related diseases of GERD.

  8. [EVALUATION OF QUALITY INDICATORS OF LIFE AS A CRITERION OF THE EFFICIENCY OF TREATMENT FOR LIQUIDATORS OF THE ACCIDENT AT CHERNOBYL AEROSPHORUS, PATIENTS WITH HYPERTENSION DISEASE COMORBID WITH GASTROESOPHAGEAL REFLUX DISEASE].

    Science.gov (United States)

    Synelnik, V; Oparin, A

    2017-04-01

    In order to assess the quality of life of liquidators of the accident at the Chernobyl nuclear power plant (CHPP) of patients with hypertensive comorbid disease with gastroesophageal reflux disease, 52 patients aged 46 to 71 years (mean age 57.5±0, 8 years old) who were on inpatient treatment in the therapeutic department of the Regional Clinical Specialized Dispensary for Radiation Protection of the Population of Kharkov from January 2016 to December 2016. The men among the examined were 44 (84.6%), women - 8 (15.4 All patients were divided into 2 groups, Group I patients received standard therapy, Group II patients, in addition to standard therapy, respectively nosology, received additionally the drug Actovegin ® Takeda Austria GmbH. All quality of life indicators were evaluated before the treatment and after In group I patients, after the standard treatment of GB comorbid with GERD, statistically significantly reduced the limitations on the scale of body pain (BP), therefore, in points, on the contrary, to 18.8±2.8 points increased, indicating a decrease in pain after treatment In patients. In patients with group II GB comorbid with GERD after standard treatment with additional use of Actovegin ®, the daily activity limitations associated with the disease on the scales of physical functioning (PF), role activity (RP), physical pain (BP), Vitality (VT), emotional state (RE).

  9. Analysis of Risk Factors for Gastroesophageal Reflux Disease%胃食管反流病相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    高鸿亮; 冯文涛; 姚萍

    2012-01-01

    背景:胃食管反流病(GERD)的发病与多种因素有关,我国以及亚洲地区患病率呈上升趋势.目的:分析GERD相关危险因素.方法:纳入2010年5~10月新疆医科大学第一附属医院有典型胃食管反流症状、反流性疾病问卷(RDQ)评分>12或内镜检查发现食管黏膜破损者作为病例组,以同期非GERD患者和健康体检者作为对照组,采用问卷调查的方式采集人口统计学资料、生活方式、饮食习惯等信息,对19个可能与GERD有关的变量行单因素分析,有统计学意义者进一步行多因素条件logistic回归.结果:病例组和对照组例数分别为100例和120例.单因素分析显示年龄、体质指数(BMI)、浓茶、进食过饱、辛辣饮食、高盐饮食、食管裂孔疝(HH)、幽门螺杆菌(H.pylori感染、非甾体消炎药(NSAIDs)、民族、便秘11个变量与GERD相关(P<0.05).多因素条件logistic回归分析显示HH(OR:3.614,95% CI:1.188 ~ 10.993,P=0.024)、辛辣饮食(OR:5.469,95% CI:2.570 ~11.640,P=0.000)、便秘(OR:3.760,95% CI:1.592~8.884,P=0.003)、中老年(OR:3.229,95% CI:1.090~8.587,P=0.005; OR:2.275,95% CI:1.004~6.667,P=0.004)为GERD发病的危险因素.结论:认识和避免GERD发病相关危险因素,养成良好的生活、饮食习惯以及治疗HH将对GERD的预防产生积极影响.%Gastroesophageal reflux disease ( GERD) is considered to be associated with multiple factors, and its prevalence is increasing in China and Asian countries. Aims; To investigate the risk factors for GERD. Methods: Patients diagnosed as GERD by the presence of typical GERD symptoms ( reflux disease questionnaire score > 12) or by the presence of erosive esophagitis on endoscopy from May 2010 to Oct. 2010 at the First Affiliated Hospital of Xinjiang Medical University were enrolled. Non-GERD patients and healthy subjects selected in the same time period were served as controls. A questionnaire consisting of demographic data

  10. Clinical and pharmacoeconomic profile of esomeprazole in acid-related diseases

    Directory of Open Access Journals (Sweden)

    Orietta Zaniolo

    2006-09-01

    Full Text Available Protonic pump inhibitors (PPIs are the most prescribed drugs for acute and maintenance therapy of gastroesophageal reflux disease, H. pylori-eradication (in association with antibacterial therapy, for ulcers prevention and cure and, recently, for prevention of NSAIDs-induced gastropathy. The high prevalence of these acid-related disorders induces a large consumption of PPIs; actually, they are the first drug class in terms of National Health Service pharmaceutical expenditure. This widespread and gradually increasing use enforces the need of a rational assessment of their impact on health care resources. This paper provides an updated profile of esomeprazole, the first PPI developed as a pure isomer, which property involves an advantageous metabolism, resulting in enhanced delivery to the proton pump compared with racemic omeprazole. Several studies showed that the success rate for healing reflux esophagitis is greater for esomeprazole than for omeprazole and some other PPIs. According to an Italian pharmacoeconomic model, esomeprazole therapy for erosive esophagitis is associated with higher benefits and lower costs as compared to omeprazole and pantoprazole. For long-term management of non-erosive gastroesophageal reflux disease, on-demand approach with esomeprazole shows clinical outcomes similar to daily treatment regimens, with substantial cost-saving. Furthermore, esomeprazole is the only PPI approved for 1-week triple therapy for both the eradication and the healing of H. pylori-associated duodenal ulcer, while the other PPIs registered the indication for H. pylori-eradication and, separately, a dosing scheme for ulcer healing (independently from etiology.

  11. Study on the risk factors that are related to gastroesophageal reflux disease%胃食管反流病相关因素研究

    Institute of Scientific and Technical Information of China (English)

    周文武; 吴华勇; 邹多武

    2013-01-01

    Objective To investigate the pathogenesis of gastroesophageal reflux (GERD) diseaserelated risk factors.Methods A questionnaire survey of 1213 patients in our hospital gastroenterology clinic visits was conducted,including irregular feeding time,eating too full,eating before going to bed,like greasy food,spicy food and alcohol consumption,and smoking.The results of the investigation were rated;95 patients were selected as the observation group,another 30 healthy volunteers were selected as the control group.Esophageal and gastric pressures were measured on the observation group and control subjects,respectively.Results Multivariate logistic regression analysis showed that often eating to satiety (OR =11.5322,P =0.0135),before going to bed eating (OR =14.6537,P =0.0005),like greasy food (OR =11.6547,P =0.0089),spicy food (OR =12.5674,P =0.0031),heavy drinking (OR =10.9874,P =0.0003),and smoking (OR =10.3846,P =0.0013) were important factors affecting the incidence of GERD; length of lower esophageal sphincter (LESL) mean of the observation group was (3.27 ±0.29)cm,intragastric pressure (GP) mean (1.63 ± 1.12) kPa,lower esophageal sphincter pressure/intragastric pressure (LESP/GP) =0.55 ±0.41,LESP-GP mean (-0.33 ±0.34) kPa,with the control group [(3.90 ± 0.42) cm,(1.12 ± 0.94) kPa,1.72 ± 0.82,(0.88 ± 0.41) kPa] were statistically significant (t' =8.99,P <0.05,t =2.43,P <0.05,t' =8.18,P <0.05,t =7.91,P <0.01).Conclusions Eating too full,eating before going to bed,like greasy food,spicy food,heavy drinking,smoking,and other bad diet and lifestyle were important risk factors of GERD.The lower esophageal sphincter dysfunction and esophageal clearance capacity play important role in the pathogenesis of gastroesophageal reflux disease.%目的 探讨胃食管反流病(GERD)发病的相关危险因素.方法 对本院消化内科门诊就诊的1213例患者进行问卷调查,包括进食时间不规律、进食过饱、睡前进食,喜油腻食物、辛辣

  12. Clinical Observation on Fire Needle Therapy for Gastroesophageal Reflux Disease%火针治疗胃食管反流病临床观察

    Institute of Scientific and Technical Information of China (English)

    李永红; 张万龙; 汪芗; 杨文婷; 钟亚彬; 王丹; 张俞

    2015-01-01

    Objective To observe the fire needle therapy for GERD symptom scores and endoscopic results impact. Methods Fifty six patients were randomly divided into two groups. Patients in the treatment group received acupuncture combined with fire needles. Patients in the control group were given omeprazole treatment for 8 weeks. The therapeutic effects and TCM syndrome scores were observed.(1)Main symptoms:burning sensation after observing sternum heart,chest pain,discomfort Chung.(2)Sub - mouth disease on a sour or bitter taste,stomach contents:chest fullness or pain,acid regurgitation,belching,epigastric noisy,emo-tional irritability or depression,foreign body sensation in the throat,stomach pain or bloating,early satiety,ab-dominal fullness or pain,abnormal stools and other symptoms. Results After treatment,symptom scores im-proved significantly compared with those before treatment(P <0. 05). The 28 cases in treatment group achieved the efficiency rate of 92. 6 % ,and the control group had the efficiency rate of 80. 6% . There was statistically significant difference between the two groups(P <0. 05). Conclusion Fire acupuncture treating gastroesopha-geal reflux disease has a good effect,and it is the economic and secure which should be widely applied.%目的:观察火针疗法对胃食管反流病患者的临床疗效及症状评分的影响。方法将56例随机分为两组,治疗组采用火针结合针刺进行治疗,对照组服用奥美拉唑治疗,疗程9周。观察两组患者治疗后临床疗效及中医症状评分。主症:反酸,嘈杂,胸骨后灼痛,两肋胀满;次症:心烦,易怒,口干口苦,大便秘结等症状变化,采用症状程度评分对治疗前后疗效进行对比。结果两组治疗后,症状评分均较治疗前明显改善(P <0.05)。治疗组28例,有效率92.6%,对照组28例,有效率80.6%%,两组有效率比较,差异有统计学意义(P <0.05),治疗组疗效优于对照组。结

  13. An epidemiological investigation of gastroesophageal reflux disease among a troop stationed on the plateau%高原某部胃食管反流病流行病学调查

    Institute of Scientific and Technical Information of China (English)

    明平良; 曹永忠; 尹贤德; 陶琬珠; 汤岚; 孙桂魏

    2011-01-01

    Objective To study the prevalence of gastroesophageal reflux disease(GERD) in a troop stationed on the plateau and to identify related diseases and risk factors of GERD. Methods 712 service men on the Sichuan -Tibet plateau were recruited to answer the gastroesophageal reflux disease questionnaires ( GerdQ). According to GerdQ, a cut - off score of 8 was set to discriminate between GERD patients (sum score >8) and controls (sum score <8). The software SPSS 17.0 was used to perform the Chi -square test and logistic regression analysis. Results 698 valid questionnaires were collected. The prevalence of GERD was 17. 19% in this troop, mainly in the U -20 group, the group of 30 years old or above, and the group with 10 - 14 years of service. The main symptoms included reflux(70.83% ),heartburn(51.67% ) and acid reflux(48.33% ). GERD was closely associated with extraesophageal diseases, such as pharyngitis, laryngitis,otopathy,sinusitis,asthma ,and bronchitis. Logistic regression ananlysis showed that age, length of service, overeating, drinking, stress,overwork and dyschezia were the most likely risk factors for GERD. Conclusions There is a high incidence of GERD with definite features in the plateau - stationed troop. To improve training conditions can help reduce the incidence of GERD and improve combat effectiveness of plateau troops.%目的 了解高原部队官兵胃食管反流病(gastroesophageal reflux disease,GERD)患病率及其相关疾病和危险因素.方法 对驻川藏高原某部712名官兵进行整体问卷调查.以胃食管反流病问卷(GerdQ)总分≥8分为GERD病例组,<8分为对照组.采用SPSS17.0统计软件进行x2检验和Logistic多元回归分析.结果 共回收有效问卷698份.高原某部GERD患病率为17.19%,并以年龄20岁以下和30岁以上、军龄10 ~ 14年患病率为高.主要症状分别为烧心(70.83%)、反流(51.67%)和反酸(48.33%),病例组伴发咽炎、喉炎、耳病、鼻窦炎、哮喘和支

  14. Laryngopharyngeal Reflux: Diagnosis, Treatment, and Latest Research

    Directory of Open Access Journals (Sweden)

    Campagnolo, Andrea Maria

    2014-01-01

    Full Text Available Introduction Laryngopharyngeal reflux (LPR is a highly prevalent disease and commonly encountered in the otolaryngologist's office. Objective To review the literature on the diagnosis and treatment of LPR. Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin. Conclusion Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

  15. Infant Reflux: Symptoms and Causes

    Science.gov (United States)

    ... the stomach contents to have enough acid to irritate the throat or esophagus and to cause signs ... as: GERD. The reflux has enough acid to irritate and damage the lining of the esophagus. Pyloric ...

  16. [Subglottic stenosis and gastroesophageal reflux].

    Science.gov (United States)

    Fligny, I; François, M; Aigrain, Y; Polonovski, J M; Contencin, P; Narcy, P

    1989-01-01

    The authors report the cases of ten children treated for sub-glottic laryngeal stenosis, in the Department of Pr. Narcy in Hospital Robert-Debre. Medical treatment of the laryngeal stenosis had failed in these cases. Treatment, most often surgical, of the gastro-oesophageal reflux present in these ten cases enabled these children to be cured. A review of the literature stresses the role and responsibility of gastro-oesophageal reflux in laryngeal pathology. Based on their experience, the authors suggest: systematic investigation for gastro-oesophageal reflux during management of laryngeal stenosis, especially when laryngeal inflammation is encountered; the adoption of an interventionist attitude vis-a-vis gastro-oesophageal reflux which would seem to have an important pathogenic role in certain laryngeal stenoses.

  17. A meta-analysis of long follow-up outcomes of laparoscopic Nissen (total) versus Toupet (270°) fundoplication for gastro-esophageal reflux disease based on randomized controlled trials in adults.

    Science.gov (United States)

    Du, Xing; Hu, Zhiwei; Yan, Chao; Zhang, Chao; Wang, Zhonggao; Wu, Jimin

    2016-08-02

    Laparoscopic Nissen fundoplication (LNF) is the most common surgical procedure for the surgical management of gastro-esophageal reflux disease (GERD). Laparoscopic Toupet fundoplication (LTF) has been reported to have a lower prevalence of postoperative complications yet still obtain a similar level of reflux control. We conducted a meta-analysis to confirm the value of LNF and LTF. PubMed, Medline, Embase, Cochrane Library and Springerlink were searched for randomized controlled trials (RCTs) comparing LNF and LTF. Data regarding the benefits and adverse results of two techniques were extracted and compared using a meta-analysis. Eight eligible RCTs comparing LNF (n = 625) and LTF (n = 567) were identified. There were no significant differences between LNF and LTF with regard to hospitalization duration, perioperative complications, patient satisfaction, postoperative heartburn, regurgitation, postoperative DeMeester scores, or esophagites. A shorter operative time and higher postoperative lower esophageal sphincter pressure were associated with LNF. Prevalence of postoperative dysphagia, gas-bloating, inability to belch, dilatation for dysphagia and reoperation were higher after LNF, but subgroup analyses showed that differences with respect to dysphagia between LNF and LTF disappeared over time. Subgroup analyses did not support "tailored therapy" according to preoperative esophageal motility. LNF and LTF have equivalently good control of GERD and result in a similar prevalence of patient satisfaction. Based on current evidence, it is not rational or advisable to abandon LNF when choosing a surgical procedure for GERD.

  18. Inducing and Aggravating Factors of Gastroesophageal Reflux Symptoms

    Directory of Open Access Journals (Sweden)

    Radhiyatam Mardhiyah

    2016-12-01

    Full Text Available Gastroesophageal reflux disease (subsequently abbreviated as GERD is a disease commonly found in the community. Several factors have been recognized as inducing and aggravating factors of GERD symptoms such as older age, female gender, obesity, smoking habit, alcohol consumption, certain diet and poor eating habit like eating fatty, spicy, and acid food.

  19. Venographic diagnosis of lower extremity venous reflux disease(analysis of 123 cases)%下肢静脉倒流性疾病的造影诊断(附123例分析)

    Institute of Scientific and Technical Information of China (English)

    耿坚; 王菊凤; 丁永红; 张安君; 黄学菁; 沈家根

    2001-01-01

    目的:探讨下肢静脉倒流性疾病的最佳造影检查方法。材料和方法:分别对123例下肢静脉病变行顺行造影、经皮穿刺腘静脉插管造影及改良法下肢静脉造影,比较分析不同检查方法显示下肢深静脉瓣膜功能、浅-深静脉交通支及浅静脉病变的价值。结果:顺行造影显示42条下肢原发性下肢深静脉瓣膜功能不全(PDVI)、13条单纯性浅静脉曲张,腘穿造影显示PDVI39条、单纯性浅静脉曲张4条;改良法显示PDVI36条,单纯性浅静脉曲张1条。此外,腘穿造影及改良法还分别显示了不同程度的血液倒流及瓣膜功能损害。结论:改良法较单纯顺行及?穿造影能更好地显示下肢浅静脉及深静脉瓣膜功能异常。%Objective:To explore the best method for diagnosis of lowerextremity venous reflux disease.Material and Methods:One hundred and twenty-three cases with lower extremity venous disease were examined by antegrade,transpopliteal of venous catheterization and modified method(combination of antegrade and transpopliteal venous venography) of venography.Their venographic appearances(including superficial venous,deep venous valve function) were evaluated.Results:Forty-two primary lower extremity deep venous valve insufficiency(PDVI) and 13 superficial venous varices were shown by antegrade venography,39 PDVI,four superficial venous varices were shown by transpopliteal venography,and modified method showed 36 PDVI,one superficial venous varix.The latter two methods also showed various extent of reflux and venous valve dysfunction.Conclusion:The modified method is best for diagnosis of lower extremity venous reflux disease.

  20. 腹腔镜手术治疗食管裂孔疝及胃食管反流性疾病的临床体会%Clinical experiences on treating hiatal hernia and gastroesophageal reflux diseases by laparoscopy

    Institute of Scientific and Technical Information of China (English)

    李忠; 左旭辉; 肖越华; 王卫斌; 周旺; 唐果

    2013-01-01

    Objective; To evaluate the efficacy and safety of laparoscopic treatment for hiatal hernia and gastroesophageal reflux diseases. Methods; The clinical data of 36 patients who underwent laparoscopic surgery (n =20) and laparotomy (n - 16) for hiatal hernia and gastroesophageal reflux disease from Jan. 2009 to Nov. 2012 were analyzed retrospectively. The operation time, intraoperative blood loss, postoperative hospital stay, periods of antibiotic use, postoperative gastrointestinal functional recovery time and postoperative complications were served as observational indicators. Results;Twenty patients were treated by laparoscopic operation (55. 6% ) and 16 patients were treated by open surgery (44. 4% ). The laparoscopic group showed more advantages over open group on operation time,intraoperative blood loss, postoperative hospital stay, periods of antibiotic use, postoperative gastrointestinal functional recovery time and postoperative complications (P<0.05). Conclusions; Laparoscopic treatment for hiatal hernia and gastroesophageal reflux diseases is safe and reliable,it has wide prospect of clinical application.%目的:探讨腹腔镜手术治疗食管裂孔疝及胃食管反流性疾病的临床疗效及安全性.方法:回顾分析2009年1月至2012年11月36例食管裂孔疝及胃食管反流性疾病患者的临床资料,20例行腹腔镜手术(腹腔镜组),16例行开腹手术(开腹组).观察两组患者手术时间、术中出血量、术后住院时间、术后抗生素使用时间、术后胃肠道功能恢复时间及术后并发症.结果:腹腔镜组手术时间、术中出血量、术后住院时间、术后抗生素使用时间、术后胃肠道功能恢复时间及术后并发症发生率均显著优于开腹组(P<0.05).结论:腹腔镜手术治疗食管裂孔疝及胃食管反流性疾病安全、可靠,具有广阔的临床应用前景.

  1. Correcting Reflux Laparoscopically

    Directory of Open Access Journals (Sweden)

    Eric C Poulin

    1998-01-01

    Full Text Available Most operations in the abdominal cavity and chest can be performed using minimally invasive techniques. As yet it has not been determined which laparoscopic procedures are preferable to the same operations done through conventional laparotomy. However, most surgeons who have completed the learning curves of these procedures believe that most minimally invasive techniques will be scientifically recognized soon. The evolution, validation and justification of advanced laparoscopic surgical methods seem inevitable. Most believe that the trend towards procedures that minimize or eliminate the trauma of surgery while adhering to accepted surgical principles is irreversible. The functional results of laparoscopic antireflux surgery in the seven years since its inception have been virtually identical to the success curves generated with open fundoplication in past years. Furthermore, overall patient outcomes with laparoscopic procedures have been superior to outcomes with the traditional approach. Success is determined by patient selection and operative technique. Patient evaluation should include esophagogastroduodenoscopy, barium swallow, 24 h pH study and esophageal motility study. Gastric emptying also should be evaluated. Patients who have abnormal propulsion in the esophagus should not receive a complete fundoplication (Nissen because it adds a factor of obstruction. Dor or Toupet procedures are adequate alternatives. Prokinetic agents, dilation or pyloroplasty are used for pyloric obstruction ranging from little to more severe. Correcting reflux laparoscopically is more difficult in patients with obesity, peptic strictures, paraesophageal hernias, short esophagus, or a history of previous upper abdominal or antireflux surgery.

  2. Relationship between occult pancreaticobiliary reflux and biliary diseases%隐匿性胰液反流与胆道疾病间的相关性

    Institute of Scientific and Technical Information of China (English)

    杨慧慧; 李会兵; 刘爽; 刘贤英

    2016-01-01

    目的 探讨隐匿性胰液反流(OPR)与胆道疾病间的相关性.方法 收集44例原发性胆道疾病患者,取血检测血清淀粉酶活性,收集胆总管胆汁,测定胆汁淀粉酶活性,计算胆总管的△胆汁淀粉酶活性(即胆总管胆汁淀粉酶活性-血清淀粉酶活性).以胆总管胆汁淀粉酶活性高于血清淀粉酶活性视为该患者存在OPR,将其纳入OPR组,反之则纳入未发生OPR的对照组.结果 44例胆道疾病患者中32例存在OPR,发生率为72.7%.OPR组患者胆汁淀粉酶、血清淀粉酶活性分别为(1 513±2 725)、(45 ±21)U/L,对照组为(18±14)、(38±16) U/L,OPR组胆汁淀粉酶活性显著高于对照组,差异有统计学意义(P<0.05),而两组血清淀粉酶活性差异无统计学意义.OPR组中单纯胆总管结石患者的OPR发生率为100%,胆汁淀粉酶活性为(1 048±1 317)U/L,△胆汁淀粉酶活性为(996±1 322)U/L;胆总管结石合并胆囊结石患者分别为75%,(2 457 ±3 312)、(2 412 ±3 320) U/L;单纯胆囊结石患者分别为80%,(95±82)、(57±76)U/L;胆总管恶性肿瘤患者为50%,(73±54)、(40±37) U/L.结论 OPR的发生与胆总管结石、胆总管结石合并胆囊结石密切相关,OPR可能是发生胆系结石的主要致病因素之一.%Objective To investigate the relationship between occult pancreaticobiliary reflux (OPR) and biliary diseases.Methods Forty-four patients with primary biliary diseases was enrolled,and serum amylase level was determined,and the bile in common bile duct (CBD) was collected to measure the amylase level,then the △ amylase was calculated,which equals bile amylase level minus serum amylase level.OPR was confirmed if bile amylase level was higher than serum amylase level,otherwise it would be defined as the control group.Results Among the 44 patients with primary biliary diseases,the incidence of OPR was 72.7% (n =32).The bile and serum amylase activity of patients with OPR were (1 513 ± 2 725),(44 ± 21)U

  3. [Rabeprazole test and comparison of the effectiveness of course treatment with rabeprazole in patients with gastroesophageal reflux disease and non-coronary chest pain].

    Science.gov (United States)

    Maev, I V; Iurenev, G L; Burkov, S G; V'iuchnova, E S

    2007-01-01

    Proton pump inhibitors (PPI) are efficient for ex juvantibus diagnostics of non-coronary chest pain (NCCP) of gastroesophageal reflux origin as well as for its course treatment. The aim of this randomized cross-over study was to compare the efficiency of rabeprasol and omeprasol as means of both diagnostics and long-term treatment. In rabeprasol group the symptoms disappeared more quickly, and the maximum effect was achieved by day three, while in omeprasol group the best results were achieved only by day six (p omeprazol patients (p < 0.05). Thus, response to rabeprasol takes place twice as quick as response to omeprasol, which makes it possible to shorten the time of NCCP diagnostics. Furthermore, rabeprasol test is more sensitive and specific. Course treatment with high doses of PPI increase the number of patients with eliminated pain syndrome, and rabeprasol here is more efficient than omeprasol.

  4. LINX(®) Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux.

    Science.gov (United States)

    Bonavina, Luigi; Saino, Greta; Lipham, John C; Demeester, Tom R

    2013-07-01

    Gastroesophageal reflux disease (GERD) results from incompetency of the lower esophageal sphincter that allows the contents of the stomach to reflux into the esophagus, the airways, and the mouth. The disease affects about 10% of the western population and has a profound negative impact on quality of life. The majority of patients are successfully treated with proton-pump inhibitors, but up to 40% have incomplete relief of symptoms even after dose adjustment. The laparoscopic Nissen fundoplication represents the surgical gold standard, but is largely underused because of the level of technical difficulty and the prevalence of side effects. These factors have contributed to the propensity of patients to continue with medical therapy despite inadequate symptom control and complications of the disease. As a consequence, a significant 'therapy gap' in the treatment of GERD remains evident in current clinical practice. The LINX(®) Reflux Management System (Torax Medical, St. Paul, MN, USA) is designed to provide a permanent solution to GERD by augmenting the sphincter barrier with a standardized, reproducible laparoscopic procedure that does not alter gastric anatomy and is easily reversible. Two single-group trials confirmed that a magnetic device designed to augment the lower esophageal sphincter can be safely and effectively implanted using a standard laparoscopic approach. The device decreased esophageal acid exposure, improved reflux symptoms and quality of life, and allowed cessation of proton-pump inhibitors in the majority of patients.

  5. The human laryngeal microbiome: effects of cigarette smoke and reflux

    Science.gov (United States)

    Jetté, Marie E.; Dill-McFarland, Kimberly A.; Hanshew, Alissa S.; Suen, Garret; Thibeault, Susan L.

    2016-01-01

    Prolonged diffuse laryngeal inflammation from smoking and/or reflux is commonly diagnosed as chronic laryngitis and treated empirically with expensive drugs that have not proven effective. Shifts in microbiota have been associated with many inflammatory diseases, though little is known about how resident microbes may contribute to chronic laryngitis. We sought to characterize the core microbiota of disease-free human laryngeal tissue and to investigate shifts in microbial community membership associated with exposure to cigarette smoke and reflux. Using 454 pyrosequencing of the 16S rRNA gene, we compared bacterial communities of laryngeal tissue biopsies collected from 97 non-treatment-seeking volunteers based on reflux and smoking status. The core community was characterized by a highly abundant OTU within the family Comamonadaceae found in all laryngeal tissues. Smokers demonstrated less microbial diversity than nonsmokers, with differences in relative abundances of OTUs classified as Streptococcus, unclassified Comamonadaceae, Cloacibacterium, and Helicobacter. Reflux status did not affect microbial diversity nor community structure nor composition. Comparison of healthy laryngeal microbial communities to benign vocal fold disease samples revealed greater abundance of Streptococcus in benign vocal fold disease suggesting that mucosal dominance by Streptococcus may be a factor in disease etiology. PMID:27775059

  6. Estudo de alterações na cavidade oral em pacientes com doença do refluxo gastroesofágico Study in oral cavity alterations in patients with gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Maria Carolina Canteras Scarillo Falotico Corrêa

    2008-06-01

    Full Text Available RACIONAL: A doença do refluxo gastroesofágico, afecção de elevada e crescente incidência, pode se manifestar através de sintomas típicos (pirose e regurgitação e atípicos (pulmonares, otorrinolaringológicos e bucais. OBJETIVO:Analisar as alterações na cavidade oral de pacientes com a doença do refluxo gastroesofágico. MÉTODOS: Foram estudados 100 pacientes, sendo 50 acometidos por doença do refluxo gastroesofágico (grupo 1 e 50 controles (grupo 2. Todos os pacientes foram submetidos a exame clínico oral e questionário específico, e naqueles do grupo 1, foram realizadas endoscopia digestiva alta e manometria e pHmetria esofágicas. RESULTADOS: A endoscopia digestiva alta demonstrou esofagite em todos os pacientes, sendo erosiva em 20, não-erosiva em 30 e hérnia hiatal em 38. A pressão média no esfíncter inferior do esôfago foi de 11 ± 4,8 mm Hg e no superior de 75 ± 26,5 mm Hg. Em 42 pacientes do grupo 1 (84% foi observado refluxo gastroesofágico patológico. O exame clínico oral mostrou: erosões dentárias no grupo 1: 273 faces e no grupo 2: 5; dentes cariados no grupo 1: 23 e 115 no grupo 2; abrasão no grupo 1: 58 e no grupo 2: 95; desgaste por atrito: 408 no grupo 1 e 224 no grupo 2. A face dental mais acometida foi a palatina. No grupo 1, 21 pacientes referiam queixas de aftas freqüentes, 35 sensibilidade dentária, 26 ardência bucal e 42 gosto azedo na boca. Naqueles do grupo 2 estas queixas foram observadas em menor número de pacientes. CONCLUSÕES: Os doentes com doença do refluxo gastroesofágico apresentam maior incidência de erosões dentárias, aftas, ardência bucal, sensibilidade dentária e gosto azedo que os controles e menor incidência de lesões cariosas em relação aos controles.BACKGROUND: The gastroesophageal reflux disease, which has become highly and increasingly incident, may be manifested by typical (pyrosis and regurgitation and atypical (pulmonary, otorhinolaryngological and buccal

  7. Gastroesophageal reflux disease: A review of surgicaldecision making

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Gastroesophageal reflux disease (GERD) is a verycommon disorder with increasing prevalence. It isestimated that up to 20%-25% of Americans experiencesymptoms of GERD weekly. Excessive reflux ofacidic often with alkaline bile salt gastric and duodenalcontents results in a multitude of symptoms for thepatient including heartburn, regurgitation, cough, anddysphagia. There are also associated complications ofGERD including erosive esophagitis, Barrett's esophagus,stricture and adenocarcinoma of the esophagus. Whilefirst line treatments for GERD involve mainly lifestyleand non-surgical therapies, surgical interventions haveproven to be effective in appropriate circumstances.Anti-reflux operations are aimed at creating an effectivebarrier to reflux at the gastroesophageal junction andthus attempt to improve physiologic and mechanicalissues that may be involved in the pathogenesis ofGERD. The decision for surgical intervention in thetreatment of GERD, moreover, requires an objectiveconfirmation of the diagnosis. Confirmation is achievedusing various preoperative evaluations includingambulatory pH monitoring, esophageal manometry,upper endoscopy (esophagogastroduodenoscopy) andbarium swallow. Upon confirmation of the diagnosisand with appropriate patient criteria met, an antirefluxoperation is a good alternative to prolongedmedical therapy. Currently, minimally invasive gastroesophagealfundoplication is the gold standard forsurgical intervention of GERD. Our review outlines themany factors that are involved in surgical decisionmaking.We will review the prominent features thatreflect appropriate anti-reflux surgery and presentsuggestions that are pertinent to surgical practices,based on evidence-based studies.

  8. A Study on the Relationship between Reflux Esophagitis and Periodontitis.

    Science.gov (United States)

    Adachi, Kyoichi; Mishiro, Tomoko; Tanaka, Shino; Yoshikawa, Hiroo; Kinoshita, Yoshikazu

    2016-01-01

    Objective Metabolic syndrome and dental erosion have been demonstrated to correlate with gastroesophageal acid reflux disease (GERD), while periodontitis has been reported to have a positive relationship with metabolic syndrome. However, no correlation between periodontitis and GERD has yet been reported. We therefore investigated the relationship between periodontitis and GERD. Methods The subjects consisted of 280 individuals who visited the Health Center for a detailed medical checkup examination. Each underwent upper endoscopy and periodontitis examinations, with the latter performed by measuring the concentrations of lactate dehydrogenase and hemoglobin in saliva. The subjects were divided into those with positive and negative periodontitis findings, and the prevalence rates of endoscopically proven reflux esophagitis, dyslipidemia, hypertension, and hyperglycemia were compared. Results The number of subjects positive for periodontitis was 93, while 187 had negative findings. The prevalence of reflux esophagitis was not different between the positive and negative groups (8.6% vs. 8.0%). In addition, a multiple logistic regression analysis did not identify a positive relationship between the presence of periodontitis and reflux esophagitis. On the other hand, dyslipidemia and hypertension were more frequently observed in the subjects that were positive for periodontitis. Conclusion We did not find an association between periodontitis and reflux esophagitis in the present study. On the other hand, the presence of periodontitis was found to correlate with hypertension and dyslipidemia.

  9. Pediatric Celiac Disease

    Science.gov (United States)

    ... Free Diet Guide Eosinophilic Esophagitis Inflammatory Bowel Disease Nutrition & Obesity Reflux & GERD Search Keyword Connect with Facebook Additional ... Nutrition (NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  10. Evaluation of reflux nephropathy, pyelonephritis and renal dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Grattan-Smith, J.D. [Emory University School of Medicine, Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Little, Stephen B. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Jones, Richard A. [Emory University School of Medicine, Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States)

    2008-01-15

    MR urography has the potential to significantly improve our understanding of the relationship between reflux nephropathy, pyelonephritis, vesicoureteric reflux and renal dysplasia. MR urography utilizes multiple parameters to assess both renal anatomy and function and provides a more complete characterization of acquired and congenital disease. Pyelonephritis and renal scarring can be distinguished by assessing the parenchymal contours and signal intensity. Characteristic imaging features of renal dysplasia include small size, subcortical cysts, disorganized architecture, decreased and patchy contrast enhancement as well as a dysmorphic pelvicalyceal system. Because of its ability to subdivide and categorize this heterogeneous group of disorders, it seems inevitable that MR urography will replace DMSA renal scintigraphy as the gold standard for assessment of pyelonephritis and renal scarring. MR urography will contribute to our understanding of renal dysplasia and its relationship to reflux nephropathy. (orig.)

  11. Morphine-augmented cholescintigraphy enhances duodenogastric reflux

    Energy Technology Data Exchange (ETDEWEB)

    Shih, Wei-Jen; Magoun, S.; Wierzbinski, B.; Ryo, U-Yun [Kentucky Univ., Lexington, KY (United States). Medical Center; Lee, Jong-Kang

    1995-11-01

    Morphine intervention in cholescintigraphy decreases imaging time to diagnose acute cholecystitis. Not infrequently we observe duodenogastric reflux during scintigraphy with and without morphine intervention. To evaluate occurrence of duodenogastric reflux related to morphine, we reviewed 55 patients who underwent cholescintigraphy with (32) and without (23) morphine intervention. Morphine was injected when there was bowel activity with non-visualization of the gallbladder at 60 min. Duodenogastric reflux was identified by the appearance of activity in the area just below or immediately adjacent to the tip of the left hepatic lobe laterally. Among 32 patients with morphine intervention, 19 had acute cholecystitis and 13 chronic cholecystitis. Eleven of 19 (58%) with acute cholecystitis had duodenogastric reflux and 6 of 13 (46%) had duodenogastric reflux in chronic cholecystitis. The total of duodenogastric reflux in the group with morphine injection was 53%. Two patients` duodenogastric reflux occurred before morphine injection and was more apparent after morphine was given. In the without morphine group, 3 had acute cholecystitis and 20 had chronic cholecystitis; 2 (one acute and one chronic cholecystitis) of these 23 (9%) had duodenogastric reflux. Our results indicate: occurrence of duodenogastric reflux in morphine augmented cholescintigraphy is not significantly different in cholecystitis from that in chronic cholecystitis; duodenogastric reflux in morphine augmentation occurs significantly more often than without morphine intervention (p<0.001). We conclude that cholescintigraphy with morphine enhances duodenogastric reflux. The degree of duodenogastric reflux in the acute cholecystitis patients has been more severe than in the chronic cholecystitis patients. (author).

  12. Urodynamics in boys after prenatally diagnosed vesicoureteric reflux

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens

    1996-01-01

    Over the years, several theories have been presented regarding the pathogenesis of vesicoureteral reflux (VUR) in children without neurological disease or posterior urethral valves. Primary VUR is one of many fetal uropathies detectable by prenatal sonography. Thirteen boys with a prenatal...

  13. Robotic-Assisted Laparoscopic Management of Vesicoureteral Reflux

    OpenAIRE

    Thomas Lendvay

    2008-01-01

    Robotic-assisted laparoscopy (RAL) has become a promising means for performing correction of vesicoureteral reflux disease in children through both intravesical and extravesical techniques. We describe the importance of patient selection, intraoperative patient positioning, employing certain helpful techniques for exposure, and recognizing the limitations and potential complications of robotic reimplant surgery. As more clinicians embrace robotic surgery and more urology residents are traine...

  14. 24-hour esophageal pH-monitoring in children suspected of gastroesophageal reflux disease: Analysis of intraesophageal pH monitoring values recorded in distal and proximal channel at diagnosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess values of 24-h esophageal pH-monitoring parameters with dual-channel probe (distal and proximal channel) in children suspected of gastroesophageal reflux disease (GERD).METHODS: 264 children suspected of gastroesophageal reflux (GER) were enrolled in a study (mean age χ = 20.78 ± 17.23 mo). The outcomes of this study,immunoallerrgological tests and positive result of oral food challenge test with a potentially noxious nutrient,enabled to qualify children into particular study groups.RESULTS: 32 (12.1%) infants (group 1) had physiological GER diagnosed. Pathological acid GER was confirmed in 138 (52.3%) children. Primary GER was diagnosed in 76 (28.8%) children (group 2) and GER secondary to allergy to cow milk protein and/or other food (CMA/FA) in 62 (23.5%) children (group 3). 32(12.1%) of them had CMA/FA (group 4-reference group),and in remaining 62 (23.5%) children neither GER nor CMA/FA was confirmed (group 5). Mean values of pH monitoring parameters measured in distal and proximal channel were analyzed in individual groups. This analysis showed statistically significant differentiation of mean values in the case of: number of episodes of acid GER,episodes of acid GER lasting > 5 min, duration of the longest episode of acid GER in both channels, acid GER index total and supine in proximal channel. Statistically significant differences of mean values among examined groups, especially between group 2 and 3 in the case of total acid GER index (only distal channel) were confirmed.CONCLUSION: 24-h esophageal pH monitoring confirmed pathological acid GER in 52.3% of children with typical and atypical symptoms of GERD. The similar pH-monitoring values obtained in group 2 and 3 confirm the necessity of implementation of differential diagnosis for primary vs secondary cause of GER.

  15. Vesicoureteral reflux: A historical perspective

    African Journals Online (AJOL)

    K.N. DeCotiis

    2016-12-28

    Dec 28, 2016 ... has evolved considerably throughout the years due to a dynamic ... 3. Grading of reflux is not important. 4. Bladder outlet obstruction ... ureteral reimplantation became the gold standard therapy for treat- ... In order to standardize terminology ... sified by Nguyen, et al. proposed imaging studies for patients.

  16. The Association between Childhood Overweight and Reflux Esophagitis

    Directory of Open Access Journals (Sweden)

    Nirav R. Patel

    2010-01-01

    Full Text Available Background. In adults, it has been shown that obesity is associated with gastroesophageal reflux disease (GERD and GERD-related complications. There are sparse pediatric data demonstrating associations between childhood overweight and GERD. Objective. To investigate the association between childhood overweight and RE. Methods. We performed a retrospective chart review of 230 children (M : F=114 : 116 who underwent esophagogastroduodenoscopy (EGD with biopsies between January 2000 and April 2006. Patient demographics, weight, height, clinical indications for the procedure, the prevalence of BMI classification groups, the prevalence of RE and usage of anti-reflux medications were reviewed. For these analyses, the overweight group was defined to include subjects with BMI≥ 85th percentile. The normal weight group was defined to include subjects with BMI 5th to 85th percentile. Results. Among the 230 subjects, 67 (29.1% had BMI percentiles above the 85th percentile for age and gender. The prevalence of RE in the overweight group did not differ significantly from that in the normal weight group (23.9% versus 24.5%, resp.. Overweight subjects taking anti-reflux medications clearly demonstrated a higher prevalence of biopsy-proven RE compared to overweight subjects not taking anti-reflux medications (34.1% versus 7.7%, =.009. Conclusions. There was no significant difference in the prevalence of biopsy-proven RE in the overweight group compared to the normal weight group. However, the prevalence of RE was significantly higher in overweight subjects on anti-reflux medications compared to overweight subjects not taking anti-reflux medications. This finding emphasizes the importance of early recognition and treatment of GERD for the overweight pediatric patients with symptoms in conjunction with weight loss program for this population to reduce long-term morbidities associated with GERD.

  17. Detection of Gastroesophageal Reflux Esophagitis Using 2-fluoro-2-deoxy-d-glucose Positron Emission Tomography

    OpenAIRE

    Min-Kuei Tsai; Hueisch-Jy Ding; Hsueh-Chou Lai; Kuo-Yang Yen; Chia-Ing Li; Yu-Yi Lin; Kai-Yuan Cheng; Keh-Bin Wang; Chia-Hung Kao

    2012-01-01

    Background. Gastroesophageal reflux disease (GERD) is a common disease and a major upper gastrointestinal problem. The purpose of the present study is to evaluate the use of noninvasive 2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) to detect gastroesophageal reflux esophagitis. Materials and Methods. This is a retrospective study reviewing 408 healthy check-up subjects (169 females and 239 men), who underwent both FDG-PET and upper gastrointestinal endoscopy during Septemb...

  18. Dilated intercellular spaces in subtypes of gastroesophagic reflux disease Dilatación de los espacios intercelulares en los subtipos de la enfermedad por reflujo gastroesofágico

    Directory of Open Access Journals (Sweden)

    J. C. Álvaro-Villegas

    2010-05-01

    Full Text Available Background: dilatation of the intercellular spaces by electron microscopy has been considered as an early morphological marker of tissue injury in gastroesophageal reflux disease. The degree of dilatation in Barrett's esophagus is currently unknown. Objectives: to determine the frequency of dilated intercellular spaces in Barrett's esophagus. Material and methods: cross-sectional and prospective analysis of consecutive patients with gastroesophageal reflux disease. We selected symptomatic patients > 18 years and both sexes. Patients with recent PPI use (Introducción: la dilatación de los espacios intercelulares mediante microscopia electrónica se considera un marcador morfológico temprano de daño tisular en la enfermedad por reflujo gastroesofágico. El grado de dilatación en el esófago de Barrett se desconoce actualmente. Objetivos: determinar la frecuencia y grado de la dilatación de los espacios intercelulares en el esófago de Barrett. Material y métodos: series de casos consecutivos con análisis transversal y prospectivo de pacientes con reflujo gastroesofágico. Criterios de selección: > 18 años, sintomáticos, ambos sexos. Se excluyeron aquellos con ingesta de IBP, antagonistas H-2, AINE y cirugía previa. Tomamos datos clínicos, cuestionario de Carlsson-Dent, endoscopia, pH-metría (no erosivos, y biopsias de la mucosa normal a 2 y 5 cm por encima de la unión escamo-columnar. La medición de la dilatación de los espacios intercelulares fue por microscopia electrónica. Estadística: descriptiva. Prueba de Chi-cuadrado con nivel de significancia de 0,05. Se compararon 4 grupos: a enfermedad por reflujo no erosiva (n = 14; b esofagitis erosiva (n = 5; c esófago de Barrett (n = 13; y d controles sanos (n = 5. Resultados: hubo mayor dilatación de los espacios intercelulares en el esófago de Barrett (5 cm, 2,72 ± 1,3 μm vs. 2 cm, 1,7 ± 0,48 μm (p = 0,001. Los otros grupos mostraron menor dilatación y sin diferencias

  19. Videolaparoscopia no tratamento da doença por refluxo gastroesofágico Videolaparoscopy in the treatment of esophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Hamilton Luiz Xavier Funes

    2000-10-01

    Full Text Available A doença por refluxo gastroesofágico (DRGE é uma entidade relativamente recente que vem se tornando freqüente na prática clínica, haja vista que responde por 75% das doenças de esôfago. A introdução rotineira de métodos investigatórios mais apurados, como a pHmetria de 24 horas e a esofagomanometria, aliadas à endoscopia com biópsia, trouxeram ao cirurgião dados que lhe permitiram utilizar com segurança a videolaparoscopia na cura cirúrgica desta afecção. A confecção de válvulas anti-refluxo, parciais ou totais, proporcionam resultados bastante animadores. Na série apresentada, foram estudados 30 pacientes operados por videolaparoscopia, num período de 36 meses, com excelentes resultados, sendo que apenas um paciente, após seis meses de cirurgia, apresentou, à endoscopia de controle, hérnia de hiato, com esofagite leve, mas absolutamente assintomática. Concluindo, os resultados mostraram que a fundoplicatura por via laparoscópica é um método seguro para a cura da doença por refluxo gastroesofágico, estando indicada em suas complicações e em pacientes refratários ao tratamento clínico, pelo baixo índice de morbimortalidade apresentado.The aim of this study is to show the effectiveness of videolaparoscopic fundoplication as the definitive treatment of GERD. From April 1996 to April 1999, 30 patients underwent fundoplication and hiatoplasty for the treatment of reflux esophagitis through videolaparoscopy. Sixteen (53% were males and 14 (46% females. The mean age was 44.1, ranging from 3 to 70 years old. Indications for surgery were refractory GERD after prolonged clinical treatment and paraesophageal hernia with hemorrhage (0.3%. Five trocars were employed for each surgical procedure. Hiatoplasty was performed with 00 cotton sutures, wrapping with a X both arms of the diaphragmatic pillars. For fundoplication, after the tranposition of the gastric fundus behind the abdominal portion of the esophagus, an inicial

  20. 一例初诊胃食管反流性疾病患者的循证治疗%Evidence-Based Treatment for First-visit Gastro-esophageal Reflux Disease

    Institute of Scientific and Technical Information of China (English)

    季梦遥; 董卫国; 吕晓光; 吴娜; 彭秀兰

    2011-01-01

    Objective To make an individualized treatment plan for one first-visit gastro-esophageal reflux disease patient via evidence-based medicine methods.Methods The condition of the patient was evaluated comprehensively,then clinical problems were put forward according to PICO principle, and high-quality evidence was collected from The Cochrane Library (1990 to 2010), PubMed (1990 to 2010), and EMbase (1990 to 2010).The treatment plan was designed based on the evaluation of evidence, doctor's experience, and patient's preferences.Results A total of 17 RCTs and 10 meta-analyses/systematic reviews were included.The evidence showed that the therapeutic effect of PPI was better than that of H2RA, and meanwhile prokinetic drugs should be used.When PPI needed to be use for a long time, HP eradication operation was required for the combination of HP inflammation.Laparoscopic fundoplication surgery was a better choice if the operation was required.Based on the above evidence combined with the patient's preferences, the combination of general treatment, esomeprazole and cisaPride were adopted to treat.Meanwhile, anti-HP medicine was used to control the HP inflammation caused by the long-term maintenance therapy.The gastro-esophageal reflux symptoms were remarkably relieved six months after the treatment.Conclusion PPI plus prokinetic drugs, combined with HP eradication of gastroesophageal reflux surgery, can improve the clinical outcomes and patient's quality of life.However, longterm prognostic benefits need to be confirmed by further follow-up.%目的 借助循证医学方法为1例初诊胃食管反流性疾病患者确定治疗方案.方法 在充分评估患者情况后,按照PICO原则提出临床问题并转化,计算机检索Cochrane图书馆(1990~2010)、PubMed(1990~2010)、Embase(1990~2010),收集相关高质量证据进行评价,并结合医生经验及患者愿望制定治疗方案.结果 共纳入RCI 17篇,Meta分析/系统评价10篇.结果 显示,选用质

  1. RELATIVE RISK FACTORS OF GASTROESOPHAGEAL REFLUX DISEASE AMONG MINING AREA RESIDENTS%矿区居民胃食管反流病相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    樊民强; 王宏伟; 周涛

    2015-01-01

    Objective To analyze related risk factors for GERD residents of the mining area,and to provide a scientific control measures.Methods The patients with gastroesophageal reflux symptoms were investi-gated by using gastroesophageal reflux disease (RDQ)scale,RDQ score≥12 points or endoscopically with reflux esophagitis image were as a typical case group,non- GERD patients as the control group.Some possible risk factors were analyzed in two groups.Results Univariate analysis showed that age,waist circumference,body mass index (BMI),sex,coffee hobby,greasy food,eating too full,hiatal hernia (HH),spicy foods,Helicobacter pylori (Hp)infection,fatigue,non-steroidal anti-inflammatory drugs (NSAIDS),constipation,GERD-related career were relative with GERD mine residents (P <005).Mul-tivariate Logistic regression analysis showed that Hp (OR=3.005,P =0.020),fatigue (OR=0.150,P =0.001),spicy foods (OR=9.166,P = 0.000),constipation (OR=13.969,P =0.000)were the risk fac-tors for GERD mine residents.Conclusion Raising awareness of risk factors associated with GERD for mining area residents can improve the quality of life by enhancing health education,advocating science diet, developing good habits and individualized treatment.%目的:分析矿区居民胃食管反流病(GERD)的相关危险因素,为矿区居民提供科学的防治措施。方法使用胃食管反流病量表(RDQ)调查胃食管反流症状的患者,RDQ 评分≥12分或者胃镜下有反流性食管炎典型图像作为病例组,以非 GERD 患者作为对照组,分析可能的危险因素,有统计学意义的因素进一步作 Logistic 回归。结果单因素分析显示年龄、腹围、体重指数(BMI)、性别、咖啡、油腻食物、进食过饱、食管裂孔疝(HH)、辛辣食物、幽门螺旋杆菌(Hp)、劳累、非甾体抗炎药(NSAIDs)、便秘、职业与矿区居民 GERD 相关(P <0.05);多因素 Logistic 回归显示 Hp(OR =3.005,P =0.020)、劳累(OR =0.150,P=0.001)、辛辣食物(OR=9

  2. [Roxatidine acetate in therapy of reflux esophagitis].

    Science.gov (United States)

    Friedrich, P; Botzler, R; Mayershofer, R; Kriech, W

    1996-06-10

    A total of 3409 patients with gastro-oesophageal reflux disease were treated with roxatidine acetate. 60.7% of the patients received a daily dose of 2 x 75 mg roxatidine acetate, and the median duration of treatment was 5 weeks. Symptoms improved in about 90% of patients. For 1687 patients, endoscopic findings were available at the beginning and end of the treatment period. The overall endoscopic healing rate was 65.3%, and, depending on the initial finding (if), decreased from 92.9% (if: Savary-Miller stage I) to 67.5% (if: stage II), 40.7% (if: stage III), and to 22.5% (if: stage IV). Twenty-one patients experienced adverse events during the course of treatment, which, however, were either only minor or not related to the use of roxatidine acetate.

  3. Interplay between vesicoureteric reflux and kidney infection in the development of reflux nephropathy in mice.

    Science.gov (United States)

    Bowen, Samantha E; Watt, Christine L; Murawski, Inga J; Gupta, Indra R; Abraham, Soman N

    2013-07-01

    Vesicoureteric reflux (VUR) is a common congenital defect of the urinary tract that is usually discovered after a child develops a urinary tract infection. It is associated with reflux nephropathy, a renal lesion characterized by the presence of chronic tubulointersitial inflammation and fibrosis. Most patients are diagnosed with reflux nephropathy after one or more febrile urinary tract infections, suggesting a potential role for infection in its development. We have recently shown that the C3H mouse has a 100% incidence of VUR. Here, we evaluate the roles of VUR and uropathogenic Escherichia coli infection in the development of reflux nephropathy in the C3H mouse. We find that VUR in combination with sustained kidney infection is crucial to the development of reflux nephropathy, whereas sterile reflux alone fails to induce reflux nephropathy. A single bout of kidney infection without reflux fails to induce reflux nephropathy. The host immune response to infection was examined in two refluxing C3H substrains, HeN and HeJ. HeJ mice, which have a defect in innate immunity and bacterial clearance, demonstrate more significant renal inflammation and reflux nephropathy compared with HeN mice. These studies demonstrate the crucial synergy between VUR, sustained kidney infection and the host immune response in the development of reflux nephropathy in a mouse model of VUR.

  4. Salivary transforming growth factor alpha in patients with Sjögren's syndrome and reflux laryngitis

    Directory of Open Access Journals (Sweden)

    Marco Antonio dos Anjos Corvo

    2014-12-01

    Full Text Available Introduction: Saliva plays a key role in the homeostasis of the digestive tract, through its inorganic components and its protein growth factors. Sjögren's syndrome patients have a higher prevalence of gastroesophageal reflux disease and laryngopharyngeal reflux. Decreased salivary transforming growth factor alpha levels were observed in dyspeptic patients, but there have been no studies in patients with Sjögren's syndrome and laryngopharyngeal reflux. Objective: To compare the salivary transforming growth factor alpha levels of patients with Sjögren's syndrome and laryngopharyngeal reflux to those of healthy controls. Methods: This is a prospective controlled study. Twelve patients with Sjögren's syndrome and laryngopharyngeal reflux and 11 controls were prospectively evaluated. Spontaneous and stimulated saliva samples were obtained to establish salivary transforming growth factor alpha concentrations. Results: The salivary transforming growth factor alpha levels of patients were significantly higher than those of healthy controls. Five patients with laryngopharyngeal reflux also had erosive esophagitis; their salivary transforming growth factor alpha levels were comparable to controls. Conclusion: Salivary transforming growth factor alpha level was significantly higher in patients with Sjögren's syndrome and laryngopharyngeal reflux when compared to the control group.

  5. Personal Experience in TCM Treatment of Reflux Esophagitis

    Institute of Scientific and Technical Information of China (English)

    洪流

    2003-01-01

    @@ Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus.

  6. Complex pathogenesis of Hirschsprung's disease in a patient with hydrocephalus, vesico-ureteral reflux and a balanced translocation t(3;17)(p12;q11)

    NARCIS (Netherlands)

    Griseri, Paola; Vos, Yvonne; Giorda, Roberto; Gimelli, Stefania; Beri, Silvana; Santamaria, Giuseppe; Mognato, Guendalina; Hofstra, Robert M. W.; Gimelli, Giorgio; Ceccherini, Isabella

    2009-01-01

    Hirschsprung's disease (HSCR), a congenital complex disorder of intestinal innervation, is often associated with other inherited syndromes. Identifying genes involved in syndromic HSCR cases will not only help understanding the specific underlying diseases, but it will also give an insight into the

  7. Treatment of vesicoureteric reflux by endoscopic injection of Teflon.

    OpenAIRE

    1984-01-01

    Thirteen girls with grade III-V vesicoureteric reflux were treated by endoscopic injection of Teflon paste behind the intravesical ureter. Fourteen of the 18 treated ureters showed complete absence of reflux after one injection of Teflon. Three ureters required a second injection of Teflon for successful treatment of the reflux. One ureter with grade IV reflux was converted to grade II reflux. Properly carried out, this procedure corrects reflux. It takes less than 15 minutes, may be done as ...

  8. Acid reflux directly causes sleep disturbances in rat with chronic esophagitis.

    Directory of Open Access Journals (Sweden)

    Kenichi Nakahara

    Full Text Available BACKGROUND & AIMS: Gastroesophageal reflux disease (GERD is strongly associated with sleep disturbances. Proton pump inhibitor (PPI therapy improves subjective but not objective sleep parameters in patients with GERD. This study aimed to investigate the association between GERD and sleep, and the effect of PPI on sleep by using a rat model of chronic acid reflux esophagitis. METHODS: Acid reflux esophagitis was induced by ligating the transitional region between the forestomach and the glandular portion and then wrapping the duodenum near the pylorus. Rats underwent surgery for implantation of electrodes for electroencephalogram and electromyogram recordings, and they were transferred to a soundproof recording chamber. Polygraphic recordings were scored by using 10-s epochs for wake, rapid eye movement sleep, and non-rapid eye movement (NREM sleep. To examine the role of acid reflux, rats were subcutaneously administered a PPI, omeprazole, at a dose of 20 mg/kg once daily. RESULTS: Rats with reflux esophagitis presented with several erosions, ulcers, and mucosal thickening with basal hyperplasia and marked inflammatory infiltration. The reflux esophagitis group showed a 34.0% increase in wake (232.2±11.4 min and 173.3±7.4 min in the reflux esophagitis and control groups, respectively; p<0.01 accompanied by a reduction in NREM sleep during light period, an increase in sleep fragmentation, and more frequent stage transitions. The use of omeprazole significantly improved sleep disturbances caused by reflux esophagitis, and this effect was not observed when the PPI was withdrawn. CONCLUSIONS: Acid reflux directly causes sleep disturbances in rats with chronic esophagitis.

  9. Relationship Between Gastroesophageal Reflux Symptoms and Dietary Factors in Korea

    OpenAIRE

    Song, Ji Hyun; Chung, Su Jin; Lee, Jun Haeng; Kim, Young-Ho; Chang, Dong Kyung; Son, Hee Jung; Kim, Jae J.; Rhee, Jong Chul; Rhee, Poong-Lyul

    2011-01-01

    Background/Aims The incidence of gastroesophageal reflux disease (GERD) is increasing in Korea. The aim of this study was to evaluate the relationship between GERD symptoms and dietary factors in Korea. Methods From January 2007 to April 2008, 162 subjects were enrolled (81 in GERD group and 81 in control group). They were asked to complete the questionnaires about GERD symptoms and dietary habits. The symptom severity score was recorded by visual analogue scale. Results Subjects with overwei...

  10. Cough in asthma triggered by reflux episodes.

    Science.gov (United States)

    Mehta, Devendra; He, Zhaoping; Padman, Raj

    2014-05-01

    With combined pH and impedance monitoring, non-acid, as well as acid reflux episodes, are more commonly detected immediately prior to cough in asthma in children. Gastroesophageal reflux should be evaluated as a trigger for cough in difficult childhood asthma.

  11. 中国西北地区胃食管反流病患者临床特征的多中心研究%Clinical characteristics of patients with gastro esophageal reflux disease in several centers of Northwest China

    Institute of Scientific and Technical Information of China (English)

    高麦仓; 沈强; 王学红; 杨力; 周永宁; 张洪芳; 张蓉; 殷彩桥; 张军

    2013-01-01

    Objective To investigate the clinical characteristics of gastro esophageal reflux disease (GERD) in several endoscopy centers of Northwest China.Methods From September 2008 to September 2009,a questionnaire survey was carried out in the endoscopy centers of four hospitals in Xi'an,Xining,Lanzhou and Yinchuan.Reflux diagnostic questionnaire (RDQ) was used as diagnostic evidence.The score of symptom degree and frequency over 12 was considered as initial screening standard.One third GERD patients diagnosed by questionnaire were randomly selected.From each quadrant below the squamocolumnar junction (SCJ),one specimen was taken for pathologic examination.All the data were input into database with EpiData 3.0 software and analyzed with SPSS 15.0 software.Results A total of 12 454 eligible questionnaires were collected,1246 GERD patients were diagnosed according to RDQ,the total detection rate was 10.0%.A total of 425 cases received biopsy,the percentage of cases with upward shift of the SCJ less than 3 cm was 73.6% (313/425) and over 3 cm was 26.4 % (112/425).The pathologic results indicated the percentage of normal mucosa was 9.9% (42/425),chronic oesophagitis was 80.2% (341/425),intestinal metaplasia was 7.1% (30/425),mild atypical hyperplasia was 1.9% (8/425),severe atypical hyperplasia and squamous cell carcinoma was 0.2% (1/425) and adenocarcinoma was 0.4% (2/425).Among the GERD patients with and upward shift of SCJ less than 3 cm and over 3 cm,the incidence of chronic inflammation,intestinal metaplasia,atypical hyperplasia and neoplasm was 85.3% (267/313),1.3% (4/313),0.9% (3/313),0 and 66.0% (74/112),23.2% (26/112),5.4% (6/112),2.7% (3/112) respectively.The pathogenesis of GERD was closely related with smoking,age,gender,body mass index (BMI),alcohol intake,esophageal hiatal hernia and bile reflux.Conclusions The detection rate of GERD was high in Northwest China endoscopy centers.Age,BMI,alcohol,smoking,esophageal hiatal hernia and

  12. Operative Treatments for Reflux After Bariatric Surgery: Current and Emerging Management Options.

    Science.gov (United States)

    Treitl, Daniela; Nieber, Derek; Ben-David, Kfir

    2017-03-01

    Gastroesophageal reflux disease (GERD) is a common disorder that has a well-established connection with obesity. To ameliorate the morbidity associated with obesity, bariatric procedures have become an established pathway to accomplish sustained weight loss. In some procedures, such as with the Roux-en-Y gastric bypass surgery, weight loss is also accompanied by the resolution of GERD symptoms. However, other popular bariatric surgeries, such as the sleeve gastrectomy, have a controversial impact on their effect on reflux. Consequently, increased attention has been given to the development of strategies for the management of de novo or recurrent reflux after bariatric surgery. This article aims to discuss medical and surgical strategies for reflux after bariatric surgery, and their outcomes.

  13. Prevalence of heartburn and gastroesophageal reflux disease in the urban Brazilian population Prevalência da pirose e da doença gastroesofágica numa população urbana brasileira

    Directory of Open Access Journals (Sweden)

    Joaquim Prado P. Moraes-Filho

    2005-06-01

    Full Text Available BACKGROUND: The epidemiological aspects of heartburn and gastroesophageal reflux disease have been object of growing interest in the last decade because of its increasing prevalence and the complications of the disease. AIMS: To evaluate the prevalence of heartburn and gastroesophageal reflux disease as well as their main characteristics in the Brazilian urban population. METHODS: A national inquire enrolling 13,959 adults was conducted in 22 Brazilian cities. The inclusion criteria were the presence of heartburn at least once a week ("heartburn group" and age greater than 16 years old. Individuals with heartburn with frequency of more than once a week were considered as having gastroesophageal reflux disease (GERD group. Factors related to the complaint were asked such as predisposing factors, habits (tobacco, alcohol and coffee intake and body mass index. In this populational study a probabilistic model was used. RESULTS: The results are presented in absolute and relative frequency, which were ponderated estimates of the respective population figures. The global prevalence of heartburn was 11.9% (1,651 persons. Heartburn once a week was present in 4.6% (637 persons and GERD in 7.3% (1,014 persons. The average ages of both groups were similar (men: 36.9 ± 15.0; women: 39.6 ± 15.1 yrs. Females were more affected in both groups. The occurrence of GERD increased with age and was more prevalent after 55 years old. The body mass index was in the normal range and similar in both groups (men: 24.7 ± 4.6; women: 25.3 ± 5.2 kg/m². In both groups the individuals related their symptoms to food intake, fatty and spicy foods (heartburn group: 64.7%, 28.5%, 17.7%; GERD group: 55.0%, 25.9%, 11.7% respectively. In GERD group, stress (24.2%, health problems (22.3% were more related to the symptoms than in heartburn group (20.0% and 15.0% respectively. CONCLUSIONS: The global prevalence of heartburn (11.9% is relatively high in the Brazilian urban

  14. Correlation between the level of saliva pepsinogen and gastroesophageal reflux disease%唾液中胃蛋白酶原的浓度与胃食管反流病的相关性

    Institute of Scientific and Technical Information of China (English)

    毛华; 丘文丹; 唐银丽; 卢敏

    2013-01-01

    Objective To investigate the correlation between the concentration of saliva pepsinogen and gastroesophageal reflux disease. Methods 27 cases with gastroesophageal reflux disease (GERD group), 29 cases with chronic gastritis (gastritis group), and 20 cases of healthy controls (control group) in our hospital were included. 3-5 mL of saliva of all cases was collected in the morning, then the concentrations of saliva pepsinogen Ⅰ (PG Ⅰ ) and saliva pepsinogen Ⅱ (PG Ⅱ ) were detected by particle-enhanced turbidimetric immunoassay. Results As compared to those in control group, the concentration of PG I and the total concentration of PG Ⅰ and PG Ⅱ in GERD group was higher (P = 0.00, P = 0.01). The concentration of PG I in GERD group was higher than that in gastritis group (P = 0.02). There was a positive correlation between GerdQ scores and the concentration of PG Ⅰcut-off value for GERD, the sensitivity and specificity were 70.4% and 71.4%, respectively. Conclusion The concentration of PGⅠ in saliva was a sensitive index for indicating regurgitation, and the concentration of PG Ⅰ in saliva was positively correlated with GERD.%目的:探讨测定唾液中胃蛋白酶原的浓度与胃食管反流病的相关性研究.方法:选取我院确诊的胃食管反流病患者27例(GERD组),慢性胃炎患者29例(慢性胃炎组),健康者20例(健康对照组),晨起空腹收集唾液3~5mL,以乳胶增强免疫比浊法检测唾液中胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)的浓度.结果:与健康对照组比较,GERD组PG Ⅰ浓度、PG总浓度均较高(PⅠ=0.00,P总=0.01);与慢性胃炎组比较,GERD组PG Ⅰ浓度较高(P=0.02).GERD组患者的GerdQ表评分与PG Ⅰ浓度存在正相关关系,ROC分析显示,PG Ⅰ临界值取2.5 μg/L时,对GERD的诊断敏感度为70.4%,特异度为71.4%.结论:唾液中的PG Ⅰ浓度是提示反流症状的一个敏感指标,唾液中PG Ⅰ浓度与胃食管反流病存在相关性.

  15. Laparoscopic anti-reflux surgery for gastroesophageal reflux disease with hiatal hernia:A clinical analysis of 650 patients%腹腔镜手术治疗胃食管反流病合并食管裂孔疝650例临床分析

    Institute of Scientific and Technical Information of China (English)

    克力木; 阿力木江·麦斯依提; 张成; 阿扎提江; 皮尔地瓦斯; 王志

    2014-01-01

    Objective To evaluate the efficacy and safety of laparoscopic hiatal hernioraphy plus fundoplication for gastroesophageal reflux disease (GERD). Methods The clinical data of 650 patients underwent laparoscopic hiatal hernioraphy plus fundoplication from September 2005 to August 2013 in People’s Hospital of Xinjiang Uyghur Autonomous Region were analyzed retrospectively. Results Laparoscopic hiatal herniorrhaphy plus fundoplication were successfully performed in all 650 patients without conversion. Combined operation was performed in 135 patients (20.8%). The average duration of operation was 64.3 min (45-90min) and the average amount of bleeding was 18 mL (5-50mL). No intraoperative or postoperative blood transfusion. Liquid diet was used in 24-48 h after operation. Postoperative hospital stay was 2-8 d. All the patients were followed up for 6 months to 8 years. Postoperative dysphagia occurred in 21 patients. Recurrent hiatal hernia (gastric wrap herniated into the chest) occurred in 4 patients. Recurrence of symptoms occurred in 14 patients. Gas bloating syndrome occurred in 6 patients. Conclusion Laparoscopic hiatal hernioraphy plus fundoplication is safe and effective with less invasive,faster recovery,fewer complication, which can combine surgical treatment of other diseases and is the ideal choice for GERD with hiatal hernia.%目的:探讨腹腔镜下抗反流手术治疗胃食管反流病(GERD)合并食管裂孔疝的安全性和疗效。方法回顾性分析2005年9月至2013年8月新疆维吾尔自治区人民医院收治的650例GERD合并食管裂孔疝病人的临床资料,均行腹腔镜食管裂孔疝修补术+胃底折叠术。结果650例均成功完成腹腔镜食管裂孔疝修补+胃底折叠术,无一例中转开腹或开胸。其中联合手术135例,占20.8%。手术时间平均64.3(45~90)min;术中出血量平均18(5~50)mL,无术中术后输血者。术后24~48 h全流饮食。术后住院2~8 d。650

  16. 胃食管反流病与支气管哮喘的相关性研究进展%Progress of Relationship between Gastro Esophageal Reflux Disease and Bronchial Asthma

    Institute of Scientific and Technical Information of China (English)

    鲍永波; 元熙哲; 金花

    2012-01-01

    Many factors can cause or aggravate asthma. Epidemiological and clinical studies have confirmed that gastro esophageal reflux disease ( GERD) and bronchial asthma are closely related. Particularly, it is difficult to control, because a serious condition of more frequent asthma attacks is linked with GERD. Thus GERD and asthma influence mutually on each other, so in the result, the symptoms of asthma are not well controlled for a long time. Therefore it is necessary to understand and study well the GERD and its relationship with asthma. In recent years, it became a global hot topic in the field of medical research. Now its pathogenesis, pathophysiology, clinical manifestations, diagnosis and progress in treatment are outlined below.%许多因素可以引发或加重支气管哮喘(哮喘),流行病学和临床研究均证实胃食管反流病(GERD)与哮喘的关系密切,特别是一些难以控制、病情严重及频繁发作的哮喘多与GERD有关.GERD和哮喘相互影响、互为因果,致使哮喘的症状长时间得不到良好的控制.因此非常有必要更好地认识和研究GERD及其与哮喘的关系,也是近年来成为全球性医学研究的热点课题之一,现将其发病机制、病理生理、临床表现、诊断和治疗的研究进展概述如下.

  17. 右旋兰索拉唑的药理学特点及在胃食管反流病治疗中的应用%Pharmacology of dexlansoprazole and its application in treating gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    韩英

    2012-01-01

    Although proton pump inhibitors (PPI) have achieved a remarkable success in the management of gastroesophageal reflux disease (CERD). However, the challenges such as insufficient action duration and poor compliance still exist as the reason for treatment failure. Recently, dexlansoprazole dual delayed release (DDR, Takeda Pharmaceuticals) under the trade name of Dexilant got approved by FDA, which provides longer duration of action and more effective acid suppression. It is currently approved for the treatment of erosive esophagitis (acute, maintenance) and symptom release of NERD.%虽然质子泵抑制剂( PPI)在胃食管反流病(GERD)治疗方面取得了很大的成功,但是抑酸时间不足、患者依从性差等挑战仍然存在.近期,美国FDA批准了一种新的PPI药物右旋兰索拉唑(dexlansoprazole,日本武田公司开发,商品名:DexliantTM),目前主要用于糜烂性食管炎急性期及维持期的治疗,以及非糜烂性胃食管反流疾病烧心症状的控制.该药物采用独特的双层缓释技术,可以维持更长的作用时间,达到更好的抑酸效果,且安全性和耐受性良好.

  18. Editorial: Reflux, dyspepsia, and Rome III (or Rome IV?).

    Science.gov (United States)

    Stanghellini, Vincenzo; Frisoni, Chiara

    2010-12-01

    The paper by Xiao et al. in this issue of American Journal of Gastroenterology reports that patients with functional dyspepsia (FD) complaining of epigastric burning have a higher probability to present abnormal gastroesophageal acid reflux, as well as response to proton pump inhibitor therapy than those complaining of epigastric pain, bothersome postprandial fullness, or early satiety. No differences in the above parameters were detected when comparing patients with epigastric pain syndrome and postprandial distress syndrome, as proposed by the Rome III classification of FD. If confirmed, these results contribute to clarify the relationship between FD and gastroesophageal reflux disease and, at the same time, highlight the importance of analyzing individual symptoms rather than clusters of symptoms, when managing patients complaining of upper gastrointestinal symptoms.

  19. Prevalence of overweightedness in patients with gastro-esophageal reflux

    Institute of Scientific and Technical Information of China (English)

    Luca Piretta; Federico Alghisi; Fiorella Anzini; Enrico Corazziari

    2007-01-01

    AIM: To evaluate whether the prevalence of overweight and obese conditions is increased in gastro-esophageal reflux disease (GERD) patients (with 24-h pathological pH recordings) in comparison to general population.METHODS: A total of 196 consecutive patients (103females, age range 18-83 years) with symptoms of gastro-esophageal reflux (GER) and 24-h pathological esophageal pH-metry. Body mass index (BMI) of the patients was calculated and its distribution (%) was compared with that of the Italian general population as assessed by National Bureau of Census (ISTAT). To evaluate the association of GERD with weight categories,the binomial test was employed. P < 0.05 was considered statistically significant.RESULTS: In males, overweightedness (BMI 25-25.9)was present in 43% of GERD patients vs 41.8% of Italian population (IP) (ns), obesity (BMI ≥ 30) in 10.9% vs9.1% (ns). In females overweight was present in 34.9%of GERD patients vs 25.7% of IP (P < 0.01), obesity in 13.6% of GERD patients vs 9.1% of IP (P < 0.01). No statistically significant differences were noted in different age classes.CONCLUSION: In comparison to the Italian general population, the prevalence of overweightedness and obesity is increased in female but not in male patients with ascertained gastro-esophageal reflux disease.

  20. Endoscopic and laparoscopic treatment of gastroesophageal reflux.

    Science.gov (United States)

    Watson, David I; Immanuel, Arul

    2010-04-01

    Gastroesophageal reflux is extremely common in Western countries. For selected patients, there is an established role for the surgical treatment of reflux, and possibly an emerging role for endoscopic antireflux procedures. Randomized trials have compared medical versus surgical management, laparoscopic versus open surgery and partial versus total fundoplications. However, the evidence base for endoscopic procedures is limited to some small sham-controlled studies, and cohort studies with short-term follow-up. Laparoscopic fundoplication has been shown to be an effective antireflux operation. It facilitates quicker convalescence and is associated with fewer complications, but has a similar longer term outcome compared with open antireflux surgery. In most randomized trials, antireflux surgery achieves at least as good control of reflux as medical therapy, and these studies support a wider application of surgery for the treatment of moderate-to-severe reflux. Laparoscopic partial fundoplication is an effective surgical procedure with fewer side effects, and it may achieve high rates of patient satisfaction at late follow-up. Many of the early endoscopic antireflux procedures have failed to achieve effective reflux control, and they have been withdrawn from the market. Newer procedures have the potential to fashion a surgical fundoplication. However, at present there is insufficient evidence to establish the safety and efficacy of endoscopic procedures for the treatment of gastroesophageal reflux, and no endoscopic procedure has achieved equivalent reflux control to that achieved by surgical fundoplication.

  1. Bacterial biota in reflux esophagitis and Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Zhiheng Pei; Liying Yang; Richard M Peek; Jr Steven M Levine; David T Pride; Martin J Blaser

    2005-01-01

    AIM: To identify the bacterial flora in conditions such as Barrett's esophagus and reflux esophagitis to determine if they are similar to normal esophageal flora.METHODS: Using broad-range 16S rDNA PCR,esophageal biopsies were examined from 24 patients [9with normal esophageal mucosa, 12 with gastroesophageal reflux disease (GERD), and 3 with Barrett's esophagus].Two separate broad-range PCR reactions were performed for each patient, and the resulting products were cloned.In one patient with Barrett's esophagus, g9 PCR clones were analyzed.RESULTS: Two separate clones were recovered from each patient (total = 48), representing 24 different species, with 14 species homologous to known bacteria,5 homologous to unidentified bacteria, and 5 were not homologous (<97% identity) to any known bacterial 16S rDNA sequences. Seventeen species were found in the reflux esophagitis patients, 5 in the Barrett's esophagus patients, and 10 in normal esophagus patients.Further analysis concentrating on a single biopsy from an individual with Barrett's esophagus revealed the presence of 21. distinct bacterial species. Members of four phyla were represented, including Bacteroidetes,Firmicutes, Proteobacteria, and Actinobacteria.Microscopic examination of each biopsy demonstrated bacteria in intimate association with the distal esophageal epithelium, suggesting that the presence of these bacteria is not transitory.CONCLUSION: These findings provide evidence for a complex, residential bacterial population in esophageal reflux-related disorders. While much of this biota is present in the normal esophagus, more detailed comparisons may help identify potential disease associations.

  2. 食管微小病变对胃食管反流病的诊断意义及其临床特点%Diagnostic significance and clinical characteristics of esophageal minimal change in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    陶丽媛; 吕宾; 范一宏; 张璐

    2015-01-01

    Objective To evaluate the diagnostic significance of esophageal minimal change in gastroesophageal reflux disease (GERD) and explore its clinical characteristics.Methods From May to September in 2013,patients with minimal esophageal mucosa changes including esophageal mucosa rough,white secretin adhesion,erythema,edema,increased brittleness,blurring of the Z line or zigzag looking and blurring of paliform blood vessel,or patients with Los Angeles classification (LA) which were identified by endoscopy were enrolled.The subjects received gastroesophageal reflux disease questionnaire (GcrdQ) investigation and the related history were collected.The total score of GerdQ over eight was set as the criteria for GERD diagnosis.The R × C chi-square test was performed for statistical analysis.Results A total of 417 valid questionnaires were completed.Of which,202 cases were in minimal change group,176 were in LA A group and 36 were in LA-B group.The diagnostic rate of GERD in minimal change group was 20.3% (41/202),which was lower than that of LA-A group (74.4%,131/176) and LA-B group (83.3 %,30/36),and the differences were statistically significant (x2 =129.144,P<0.01).The incidences of heartburn in minimal change group,LA A group and LA-B group were 25.7% (52/202),62.5% (110/176) and 86.1% (31/36),respectively.The incidences of reflux were 29.7% (60/202),67.6% (119/176) and 75.0% (27/36),respectively.The incidences of non cardiac chest pain were 5.4% (11/202),22.2% (39/176) and 22.2%(8/36),respectively.The incidences of heartburn,reflux and non cardiac chcst pain of minimal change group were all lower than those of LA A group and LA-B group,and the differences were statistically significant (x2 =75.775,64.120,24.016;all P<0.01).The leading cause of endoscopy examination in minimal change group was abdominal discomfort,which accounted for 49.0%(99/202).The leading causes of endoscopy examination in LA A group and LA-B group were esophageal

  3. Bronchial hyperreactivity in non-atopic children with asthma and reflux: effect of anti-reflux treatment.

    Science.gov (United States)

    Khoshoo, Vikram; Mohnot, Sopan; Haydel, Robert; Saturno, Emilio; Edell, Dean; Kobernick, Aaron

    2009-11-01

    The prevalence of bronchial hyperreactivity (BHR) or the effect of anti-reflux treatment on BHR in children with asthma and gastroesophageal reflux disease (GERD) is not known. Thirty non-atopic children with persistent asthma were studied. Extended esophageal pH monitoring was used to diagnose GERD and methacholine challenge test (MCT) was used as a marker of BHR and performed before and 2 years after anti-GERD treatment. Of the 21 patients positive for GERD (group A), 15 had positive MCT suggesting BHR. Of the 9 patients negative for GERD (group B), 5 had positive MCT. On repeat testing 2 years later, 11/15 group A patients and 3/5 group B patients tested negative for BHR. Group A patients were receiving fewer asthma medications and experienced fewer exacerbations than Group B patients. BHR is prevalent in children with asthma and GERD and improves with anti-GERD treatment.

  4. Deanxit combined with omeprazole and mosapride for gastroesophageal reflux disease in 129 senile patients%黛力新辅助奥美拉唑、莫沙必利治疗老年患者胃食管反流病的临床研究(129例)

    Institute of Scientific and Technical Information of China (English)

    冯永航; 高川

    2013-01-01

    Objective: To explore the efficacy of deanxit combined with omeprazole and mosapride in treatment of elderly patients with gastroesophageal reflux disease. Methods:A total of 129 elderly patients with gastroesophageal reflux disease in our hospital,were randomly assigned to omeprazole,mosapride combined with deanxit(n=70) or omeprazole plus mosapride(n=59). the clinical efficacy and reflux, heartburn symptom score of the two groups were evaluated. Results: The total effective rate was higner in omeprazole,mosapride combined with deanxit (94.28%) than in omeprazole plus mosapride (61.02%). Reflux and heartburn and other symptoms in two groups were improved, and reflux symptoms score was significantly lower in omeprazole,mosapride combined with deanxit than in omeprazole plus mosapride(P< 0.05); Conclusion: improvement effect on reflux, heartburn and other symptoms is better in omeprazole,mosapride combined with deanxit than in omeprazole plus mosapride in senile patients with gastroesophageal reflux disease, and worthy of clinical application.%  目的:观察黛力新辅助奥美拉唑、莫沙必利治疗老年人胃食管反流病的临床疗效。方法:选取我院收治的129例老年胃食管反流病患者,随机分为观察组70例和对照组59例,对照组采用奥美拉唑联合莫沙必利治疗,观察组在对照组基础上加用黛力新。观察治疗后两组患者临床疗效以及反酸、烧心症状评分。结果:治疗后观察组总有效率为94.28%,对照组为61.02%,观察组总有效率明显高于对照组(P <0.05);两组患者治疗后反酸和烧心等症状均有所改善,其中观察组4周后反酸症状评分明显低于对照组(P <0.05);2周末烧心症状评分观察组优于对照组(P <0.05)。结论:黛力新辅助奥美拉唑、莫沙必利治疗老年人胃食管反流病临床疗效明显,对反酸、烧心等症状有明显改善作用,值得临床推广应用。

  5. [Influence of chest physiotherapy on gastro-œsophageal reflux in children].

    Science.gov (United States)

    Reychler, G; Jacques, L; Arnold, D; Scheers, I; Smets, F; Sokal, E; Stephenne, X

    2015-05-01

    Chest physiotherapy is regularly prescribed for children, particularly in cystic fibrosis. Gastro-oesophageal reflux is common in this disease and is associated with certain chest physiotherapy manoeuvres. To evaluate the influence of two chest physiotherapy techniques on gastro-oesophageal reflux in children. Twenty-nine children were investigated by routine pHmetry. During the examination, they performed two chest physiotherapy manoeuvres in a seated position for 10 minutes each with a 5 minutes rest between them. The two manoeuvres used were a slow expiration technique (ELPr) and positive expiratory pressure (PEP). It was a prospective study and the order of manoeuvres was randomised. The pH traces were analysed blindly when all the studies had been completed. In the sample, 21% of children had gastro-oesophageal reflux during the physiotherapy session. No relationship was found between reflux during physiotherapy and pathological reflux (P=0.411) nor the physiotherapy technique used (P=0.219). The use of these two chest physiotherapy techniques in children in a seated position can produce gastro-oesophageal reflux. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  6. Relationship between endoscopic esophagitis and patterns of gastroesophageal reflux in ambulatory pHmetry.

    Science.gov (United States)

    Sánchez-Gey Venegas, S; Yerro Páez, V M; Pellicer Bautista, F J; Fuerte Seda, M; Herrerías Gutiérrez, J M

    1999-02-01

    to evaluate the possible relationship between the various grades of endoscopic esophagitis and the different patterns of reflux determined by 24-hour ambulatory pH-metry. we selected 80 patients with symptoms of gastroesophageal reflux disease in whom upper digestive tract endoscopy revealed some degree of mucosal lesion. These patients subsequently underwent 24-hour ambulatory pH-metry. The lesions of the mucosa were classified into 4 grades according to the criteria of Savary and Miller. The patterns of reflux were determined by 24-hour pH-metry and classified according to the severity of reflux (slight, moderate or severe, using DeMeester's table) and the type of reflux (in bipedestation, supine or mixed) according to the percentage of time at pH bipedestation, in decubitus or in both positions. patients with grades I and II esophagitis showed variable patterns of reflux, although the most frequent seemed to be slight in bipedestation, which we observed in 34% of the patients. Most (76. 2%) of the patients with grades III or IV (p patients at higher risk for developing severe esophagitis or other complications.

  7. Evaluation of bile reflux in HIDA images based on fluid mechanics.

    Science.gov (United States)

    Lo, Rong-Chin; Huang, Wen-Lin; Fan, Yu-Ming

    2015-05-01

    We propose a new method to help physicians assess, using a hepatobiliary iminodiacetic acid scan image, whether or not there is bile reflux into the stomach. The degree of bile reflux is an important index for clinical diagnosis of stomach diseases. The proposed method applies image-processing technology combined with a hydrodynamic model to determine the extent of bile reflux or whether the duodenum is also folded above the stomach. This condition in 2D dynamic images suggests that bile refluxes into the stomach, when endoscopy shows no bile reflux. In this study, we used optical flow to analyze images from Tc99m-diisopropyl iminodiacetic acid cholescintigraphy (Tc99m-DISIDA) to ascertain the direction and velocity of bile passing through the pylorus. In clinical diagnoses, single photon emission computed tomography (SPECT) is the main clinical tool for evaluating functional images of hepatobiliary metabolism. Computed tomography (CT) shows anatomical images of the external contours of the stomach, liver, and biliary extent. By exploiting the functional fusion of the two kinds of medical image, physicians can obtain a more accurate diagnosis. We accordingly reconstructed 3D images from SPECT and CT to help physicians choose which cross sections to fuse with software and to help them more accurately diagnose the extent and quantity of bile reflux.

  8. Evaluating the autonomic nervous system in patients with laryngopharyngeal reflux.

    Science.gov (United States)

    Huang, Wan-Ju; Shu, Chih-Hung; Chou, Kun-Ta; Wang, Yi-Fen; Hsu, Yen-Bin; Ho, Ching-Yin; Lan, Ming-Ying

    2013-06-01

    The pathogenesis of laryngopharyngeal reflux (LPR) remains unclear. It is linked to but distinct from gastroesophageal reflux disease (GERD), which has been shown to be related to disturbed autonomic regulation. The aim of this study is to investigate whether autonomic dysfunction also plays a role in the pathogenesis of LPR. Case-control study. Tertiary care center. Seventeen patients with LPR and 19 healthy controls, aged between 19 and 50 years, were enrolled in the study. The patients were diagnosed with LPR if they had a reflux symptom index (RSI) ≥ 13 and a reflux finding score (RFS) ≥ 7. Spectral analysis of heart rate variability (HRV) analysis was used to assess autonomic function. Anxiety and depression levels measured by the Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI-II) were also conducted. In HRV analysis, high frequency (HF) represents the parasympathetic activity of the autonomic nervous system, whereas low frequency (LF) represents the total autonomic activity. There were no significant differences in the LF power and HF power between the 2 groups. However, significantly lower HF% (P = .003) and a higher LF/HF ratio (P = .012) were found in patients with LPR, who demonstrated poor autonomic modulation and higher sympathetic activity. Anxiety was also frequently observed in the patient group. The study suggests that autonomic dysfunction seems to be involved in the pathogenesis of LPR. The potential beneficial effect of autonomic nervous system modulation as a therapeutic modality for LPR merits further investigation.

  9. Animal study for airway inflammation triggered by gastroesophageal reflux

    Institute of Scientific and Technical Information of China (English)

    LAI Yun-gang; WANG Zhong-gao; JI Feng; WU Ji-min; CHEN Xiu; LI Zhen; DONG Shu-kui

    2009-01-01

    Background Gastroesophageal reflux disease with extra-esophageal symptoms, especially those with respiratory istress was attracting more and more attention. The related mechanisms were still in controversy. The purpose of the work was to explore airway inflammation triggered by gastroesophageal reflux.Methods Sixteen Sprague-Dawley rats were used as study group and 9 as control. In the study group, a plastic extender with a trumpet-shaped distal end was inserted into the lower esophagus to dilate the cardia, the pylorus was ligated. One ml of 0.1 mol/L hydrochloric acid was injected into the stomach, While a simple laparotomy was performed for control animals. All animals from two groups were sacrificed 24 hours after operation. Then tracheotomy was carried and the bronchoalveolar lavage fluid was collected in all animals. Cells in the fluid were counted and levels of intedeukin (IL)-5, -6, -8 in it were measured.Results Compared with control group, the study group presented a neutrophil pattem of airway inflammation and an elevated concentration of IL-5, -6, -8 with no significant difference regarding eosinophil count.Conclusion The gastroesophageal reflux-triggered airway inflammation is characterized by a neutrophilic airway inflammation which differed from that caused by asthma, and enhanced levels of IL-5, -6 and -8, which are similar to that caused by asthma.

  10. Barrett's esophagus and its correlation with gastroesophageal reflux in Chinese

    Institute of Scientific and Technical Information of China (English)

    Jun Zhang; Xiao-Li Chen; Kang-Min Wang; Xiao-Dan Guo; Ai-Li Zuo; Jun Gong

    2004-01-01

    AIM: To study the prevalence of Barrett's esophagus in Chinese and its correlation with gastroesophageal reflux.METHODS: This study was carried out in a large prospective series of 391 patients who had undergone upper endoscopy.The patients were divided into 3 groups according to the position of squamocolumnar junction (SCJ). Reflux esophagitis (RE) and its degree were recorded. Intestinal metaplasia (IlMl) in biopsy specimen was typed according to histochemistry and HE and alcian blue (pH2.5) staining separately. Results correlating with clinical, endoscopic, and pathological data were analysed.RESULTS: The prevalence of IM endoscopically appearing Long-segment Barrett's Esophagus (LSBE) was 26.53%,Short-segment Barrett's Esophagus (SSBE) was 33.85% and gastroesophageal junction (GFJ) was 34.00% . IM increased with age of above 40 years old and no difference was found between male and female. Twelve were diagnosed as dysplasia (7 low -grade, 5 high-grade), 16 were diagnosed as cardiac adenocarcinoma and 1 as esophageal adenocarcinoma. The more far away the SCJ moved upward above GFJ, the higher the prevalence and the more severe the RE were.CONCLUSION: There was no difference of the prevalence of IM in different places of SCJ, and IM increased with age of above 40 years old. It is important to pay attention to dysplasia in the distal esophagus and gastro-esophageal junction, and adenocarcinoma is more common in cardia than in esophagus. BE is a consequence of gastroesophageal reflux disease.

  11. Integrative Treatment of Reflux and Functional Dyspepsia in Children

    Directory of Open Access Journals (Sweden)

    Ann Ming Yeh

    2014-08-01

    Full Text Available Gastroesophageal reflux disease (GERD and functional dyspepsia (FD are common problems in the pediatric population, with up to 7% of school-age children and up to 8% of adolescents suffering from epigastric pain, heartburn, and regurgitation. Reflux is defined as the passage of stomach contents into the esophagus, while GERD refers to reflux symptoms that are associated with symptoms or complications—such as pain, asthma, aspiration pneumonia, or chronic cough. FD, as defined by the Rome III classification, is a persistent upper abdominal pain or discomfort, not related to bowel movements, and without any organic cause, that is present for at least two months prior to diagnosis. Endoscopic examination is typically negative in FD, whereas patients with GERD may have evidence of esophagitis or gastritis either grossly or microscopically. Up to 70% of children with dyspepsia exhibit delayed gastric emptying. Treatment of GERD and FD requires an integrative approach that may include pharmacologic therapy, treating concurrent constipation, botanicals, mind body techniques, improving sleep hygiene, increasing physical activity, and traditional Chinese medicine and acupuncture.

  12. Laparoscopic Anti-Reflux (GERD) Surgery

    Science.gov (United States)

    ... Sponsorship Opportunities Log In Laparoscopic Anti-Reflux (GERD) Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Surgery for “Heartburn” If you suffer from moderate to ...

  13. Relationship between gastroesophageal reflux symptoms and dietary factors in Korea.

    Science.gov (United States)

    Song, Ji Hyun; Chung, Su Jin; Lee, Jun Haeng; Kim, Young-Ho; Chang, Dong Kyung; Son, Hee Jung; Kim, Jae J; Rhee, Jong Chul; Rhee, Poong-Lyul

    2011-01-01

    The incidence of gastroesophageal reflux disease (GERD) is increasing in Korea. The aim of this study was to evaluate the relationship between GERD symptoms and dietary factors in Korea. From January 2007 to April 2008, 162 subjects were enrolled (81 in GERD group and 81 in control group). They were asked to complete the questionnaires about GERD symptoms and dietary habits. The symptom severity score was recorded by visual analogue scale. Subjects with overweight or obesity had an increased risk for GERD (OR, 2.52; 95% CI, 1.18-5.39). Irregular dietary intake was one of the risk factors for GERD (OR, 2.33; 95% CI, 1.11-4.89). Acid regurgitation was the most suffering (2.85 ± 2.95 by visual analogue scale) and frequent reflux-related symptom (57.5%) in GERD. Noodles (OR, 1.22; 95% CI, 1.12-1.34), spicy foods (OR, 1.09; 95% CI, 1.02-1.16), fatty meals (OR, 1.20; 95% CI, 1.09-1.33), sweets (OR, 1.42; 95% CI, 1.00-2.02), alcohol (OR, 1.16; 95% CI, 1.03-1.31), breads (OR, 1.17; 95% CI, 1.01-1.34), carbonated drinks (OR, 1.69; 95% CI, 1.04-2.74) and caffeinated drinks (OR,1.41; 95% CI, 1.15-1.73) were associated with symptom aggravation in GERD. Among the investigated noodles, ramen (instant noodle) caused reflux-related symptoms most frequently (52.4%). We found that noodles, spicy foods, fatty meals, sweets, alcohol, breads, carbonated drinks and caffeinated drinks were associated with reflux-related symptoms.

  14. Surgical management of vesicoureteral reflux in children.

    Science.gov (United States)

    Sung, Jennifer; Skoog, Steven

    2012-04-01

    Vesicoureteral reflux (VUR) is the most common uropathy affecting children. Compared to children without VUR, those with VUR have a higher rate of pyelonephritis and renal scarring following urinary tract infection (UTI). Options for treatment include observation with or without antibiotic prophylaxis and surgical repair. Surgical intervention may be necessary in patients with persistent reflux, renal scarring, and recurrent or breakthrough febrile UTI. Both open and endoscopic approaches to reflux correction are successful and reduce the occurrence of febrile UTI. Estimated success rates of open and endoscopic reflux correction are 98.1% (95% CI 95.1, 99.1) and 83.0% (95% CI 69.1, 91.4), respectively. Factors that affect the success of endoscopic injection include pre-operative reflux grade and presence of functional or anatomic bladder abnormalities including voiding dysfunction and duplicated collecting systems. Few studies have evaluated the long-term outcomes of endoscopic injection, and with variable results. In patients treated endoscopically, recurrent febrile UTI occurred in 0-21%, new renal damage in 9-12%, and recurrent reflux in 17-47.6% of treated ureters with at least 1 year follow-up. These studies highlight the need for standardized outcome reporting and longer follow-up after endoscopic treatment.

  15. Diagnosis and clinical implications of pancreatobiliary reflux

    Institute of Scientific and Technical Information of China (English)

    Terumi Kamisawa; Hajime Anjiki; Naoto Egawa; Masanao Kurata; Goro Honda; Kouji Tsuruta

    2008-01-01

    The sphincter of Oddi is located at the distal end of the pancreatic and bile ducts and regulates the outflow of bile and pancreatic juice.A common channel can be so long that the junction of the pancreatic and bile ducts is located outside of the duodenal wall,as occurs in pancreaticobiliary maljunction (PBM);in such cases,sphincter action does not functionally affect the junction.As the hydropressure within the pancreatic duct is usually greater than in the bile duct,pancreatic juice frequently refluxes into the biliary duct (pancreatobiliary reflux) in PBM,resulting in carcinogenetic conditions in the biliary tract.Pancreatobiliary reflux can be diagnosed from elevated amylase level in the bile,secretinstimulated dynamic magnetic resonance cholangiop ancreatography,and pancreatography via the minor duodenal papilla.Recently,it has become obvious that pancreatobiliary reflux can occur in individuals without PBM.Pancreatobiliary reflux might be related to biliary carcinogenesis even in some individuals without PBM.Since few systemic studies exist with respect to clinical relevance and implications of the pancreatobiliary reflux in individuals with normal pancreaticobiliary junction,further prospective clinical studies including appropriate management should be performed.

  16. Small saphenous vein: where does reflux go?

    Directory of Open Access Journals (Sweden)

    Guillermo Gustavo Rossi

    2013-06-01

    Full Text Available BACKGROUND: The anatomy of small saphenous vein (SSV is very variable because of its complex embryological origin. SSV incompetence often causes reflux that goes to the perforating veins, sometimes not respecting the anatomical course. OBJECTIVE: To analyze differences in reflux direction and reentry in the SSV. METHODS: In this prospective, observational study, 60 lower limbs with SSV incompetence of 43 patients were assessed using a color Doppler ultrasound protocol. RESULTS: Reentry variations were grouped into four types and subtypes. Percentage results were: Type A, perforating veins on the medial side = 25/60 cases (41.66%; subtypes: Cockett, Sherman, paratibial and vertex; Type B, lateral malleolus and perforating veins on the lateral side (fibular 17-26 cm = 15/60 cases (25%; subtypes: fibular and malleolus; Type C, two branches = 19/60 cases (31.66%; subtypes: gastrocnemius and Cockett, gastrocnemius and malleolus, and/or fibular, Cockett and malleolus, Cockett-vertex and fibular; Type D, reflux in the superficial system = 1/60 cases (1.66%. CONCLUSION: On most of the lower limbs assessed, reflux did not follow the classical anatomic course. Our findings demonstrated a high degree of variation in reflux/reentry, but no SSV anatomical variations. Reflux seems to, either look for the most accessible anatomical connection for reentry or be originated in the distal area and then reach the SSV.

  17. Role of PH Monitoring in Laryngopharyngeal Reflux Patients with Voice Disorders

    Science.gov (United States)

    Maldhure, Swati; Chandrasekharan, Ramanathan; Dutta, Amit- Kumar; Chacko, Ashok; Kurien, Mary

    2016-01-01

    Introduction: Laryngopharyngeal reflux (LPR) is considered an important cause of voice disorder. We aimed to determine the frequency of LPR in patients with voice disorder and the association between Koufman Reflux Symptom Index (RSI), Reflux Finding Score (RFS), gastroesophageal reflux disease (GERD), and proximal acid reflux in these patients. Materials and Methods: We performed a prospective study in patients aged more than 18 years presenting at the ear, nose, and throat (ENT) clinic with a change in voice lasting more than 3 weeks. All patients underwent nasopharyngolaryngoscopy and a dual-probe esophageal pH study. LPR was diagnosed by a Koufman RSI of >13 and/or RFS of >7. GERD was diagnosed according to a DeMeester Johnson score of >14.7. Proximal acid reflux was diagnosed if acid exposure time was >0.02% in a proximal pH probe. Results: The study included 30 patients with a voice disorder. The mean age of participants was 38.5 years and 40% of patients were female. Using either of the two criteria, LPR was present in 46.7% of patients, half of whom had GERD. Among the remaining 53.3% patients with a voice disorder and no evidence of LPR, GERD was present in 25%. There was no significant association between the presence of LPR based on RSI (P=1) and GERD or RFS and GERD (P=0.06). Proximal acid reflux was present in only 10% patients with a voice disorder, and there was no significant association of this test with RFS (P=1) or RSI (P=1). Conclusions: Approximately half of the patients with a voice disorder have LPR, and only a subset of these patients have evidence of GERD. Fiberoptic laryngoscopic findings (RFS) complementing RSI appears to be important in diagnosing possible reflux etiology in voice disorders and can be an indicator for instituting anti-reflux therapy. However, there is no significant association between RSI, RFS, and GERD suggesting that these tests evaluate different features of the disease. Proximal acid reflux is uncommon in patients

  18. Clinical study of omeprazole in the treatment of gastroesophageal reflux disease%奥美拉唑治疗胃食管反流病的临床研究

    Institute of Scientific and Technical Information of China (English)

    杜红霞

    2015-01-01

    Objective:To investigate the clinical curative effect of omeprazole in the treatment of gastroesophageal reflux disease(GERD).Methods:60 patients with GERD were selected from September 2013 to June 2014.They were randomly divided into the control group and the observation group with 30 cases in each.The observation group were given omeprazole enteric-coated tablets 20 mg/time,2 times/d;the control group were given ranitidine 150 mg/time,2 times/d.After 8 weeks of the treatment,we observed the changes of clinical symptoms score and endoscopic classification of two groups.Results:The changes of clinical symptoms score and endoscopic grading of the observation group were improved significantly better than those of the control group after the treatment.The total efficiency was 93.33%.Conclusion:The clinical curative effect of omeprazole for GERD is significantly.The curative effect is better than the H2 receptor antagonist ranitidine.%目的:探讨奥美拉唑治疗胃食管反流病(GERD)的临床疗效。方法:2013年9月-2014年6月收治GERD患者60例,随机分成对照组和观察组,各30例,观察组服用奥美拉唑肠溶片20 mg/次,2次/d;对照组服用雷尼替丁150 mg/次,2次/d。治疗8周后,观察两组的临床症状积分和内镜分级。结果:观察组治疗后的临床症状积分和内镜分级改善明显优于对照组,总有效率93.33%。结论:奥美拉唑治疗GERD疗效显著,且疗效优于H2受体阻滞剂雷尼替丁。

  19. Investigation and analysis of medication of gastroesophageal reflux disease%中日友好医院胃食管反流病患者药品使用调查分析

    Institute of Scientific and Technical Information of China (English)

    秦耿; 崔媛; 刘畅

    2016-01-01

    目的:探究影响胃食管反流病治疗效果不佳的因素。方法:通过调取中日友好医院2013年1月至2014年1月期间,门诊持续使用质子泵抑制剂(PPI)抗反流治疗>8周初治患者用药情况,以发放调查问卷形式进行资料收集并整理。结果:体重指数超标、间断不规律服药、饮食习惯未调整、生活方式未调整、合并便秘患者均为胃食管反流病。结论:治疗效果差、停药困难患者,除了要考虑药物因素,还要加强服药依从性监管、加强饮食生活方式教育、控制肥胖、治疗便秘。%Objective: To investigate the influence factors of poor treatment in patients with gastroesophageal reflux disease. Methods: Outpatients who used PPI (proton pump inhibitor) for more than 8 weeks in initial treatment of anti relfux therapy from January 2013 to January 2014 were involved. The medicines usage were collected and analyzed using questionnaires.Results:In patients with exceeding body mass index, irregular and intermittent medication, diet without adjustment, lifestyle without adjustment, and combined constipation, are the participation factors of GERD patients, which in the treatment course of more than 8 weeks.Conclusion:Patients with poor therapeutic effect and drug withdrawal dififcult, in addition to consider drug factors, but also need to strengthen the supervision of medication adherence and diet life style education, control obesity, and treat constipation.

  20. Effect of Helicobacter pylori Eradication on Reflux Esophagitis Therapy: A Multi-center Randomized Control Study

    Institute of Scientific and Technical Information of China (English)

    Yan Xue; Li-Ya Zhou; San-Ren Lin; Xiao-Hua Hou; Zhao-Shen Li; Min-Hu Chen; Xiu-E Yan

    2015-01-01

    Background:Helicobacterpylori (H.pylori) frequently colonizes the stomach.Gastroesophageal reflux disease (GERD) is a common and costly disease.But the relationship ofH.pylori and GERD is still unclear.This study aimed to explore the effect ofH.pylori and its eradication on reflux esophagitis therapy.Methods:Patients diagnosed with reflux esophagitis by endoscopy were enrolled;based on rapid urease test and Warth-Starry stain,they were divided into H.pylori positive and negative groups.H.pylori positive patients were randomly given H.pylori eradication treatment for 1 0 days,then esomeprazole 20 mg bid for 46 days.The other patients received esomeprazole 20 mg bid therapy for 8 weeks.After treatment,three patient groups were obtained:H.pylori positive eradicated,H.pylori positive uneradicated,and H.pylori negative.Before and after therapy,reflux symptoms were scored and compared.Healing rates were compared among groups.The x2 test and t-test were used,respectively,for enumeration and measurement data.Results:There were 176 H.pylori positive (with 92 eradication cases) and 180 negative cases.Healing rates in the H.pylori positive eradicated and H.pylori positive uneradicated groups reached 80.4% and 79.8% (P =0.911),with reflux symptom scores of 0.22 and 0.14 (P =0.588).Healing rates of esophagitis in the H.pylori positive uneradicated and H.pylori negative groups were,respectively,79.8% and 82.2% (P =0.848);reflux symptom scores were 0.14 and 0.21 (P =0.546).Conclusions:Based on esomeprazole therapy,H.pylori infection and eradication have no significant effect on reflux esophagitis therapy.

  1. Endoscopic treatment of vesicoureteral reflux with polyacrylate polyalcohol copolymer and dextranomer/hyaluronic acid in adults

    Directory of Open Access Journals (Sweden)

    Akif Turk

    2014-06-01

    Full Text Available Purpose Aim of this study is to examine the effectiveness of dextranomer/hyaluronic acid copolymer and polyacrylate polyalcohol copolymer in endoscopic treatment of vesicoureteral reflux disease in adult patients with and without chronic renal failure. Materials and Methods Thirty two patients (12 female, 20 male with a total of 50 renal units were treated for vesicoureteral reflux. There were 26 (81% chronic renal failure patients. The success of treatment was evaluated by voiding cystouretrography at 3rd and 12th months after subureteric injection. The persistence of reflux was considered as failure. Patients were divided into two groups according to injected material. Age, sex, grade of reflux and treatment results were recorded and evaluated. Results Reflux was scored as grade 1 in seven (14%, grade 2 in 16 (32%, grade 3 in 21 (42% and grade 4 in six (12% renal units. There was not patient with grade 5 reflux. Fourteen renal units (28% were treated with dextranomer/hyaluronic acid copolymer (group 1 and 36 renal units (72% were treated with polyacrylate polyalcohol copolymer (group 2. The overall treatment success was achieved at 40 renal units (80%. The treatment was successful at 11 renal units (79% in group 1 and 29 renal units (81% in group 2 (p = 0.71. There was not statistically significant difference between two groups with patients with chronic renal failure in terms of treatment success (p = 1.00. Conclusions The effectiveness of two bulking agents was similar in treatment of vesicoureteral reflux disease in adult patients and patients with chronic renal failure.

  2. The position of the acid pocket as a major risk factor for acidic reflux in healthy subjects and patients with GORD

    NARCIS (Netherlands)

    H. Beaumont; R.J. Bennink; J. de Jong; G.E. Boeckxstaens

    2010-01-01

    Gastro-oesophageal reflux occurs twice as much during transient lower oesophageal sphincter relaxations (TLOSRs) in patients with gastro-oesophageal reflux disease (GORD) compared to healthy volunteers (HVs). Our aim was to assess whether the localisation of the postprandial acid pocket and its inte

  3. Gastroesophageal Reflux Disease (GERD) (For Teens)<