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https://www.readbyqxmd.com/read/29034088/emerging-dilemmas-in-the-diagnosis-and-management-of-gastroesophageal-reflux-disease
#1
REVIEW
Peter Kahrilas, Rena Yadlapati, Sabine Roman
Gastroesophageal reflux disease (GERD) is common, but less so than widely reported because of inconsistencies in definition. In clinical practice, the diagnosis is usually based on a symptom assessment without testing, and the extent of diagnostic testing pursued should be limited to that which guides management or which protects the patient from the risks of a potentially morbid treatment or an undetected early (or imminent) esophageal adenocarcinoma or which does both. When testing is pursued, upper gastrointestinal endoscopy is the most useful initial diagnostic test because it evaluates for the major potential morbidities (Barrett's, stricture, and cancer) associated with GERD and facilitates the identification of some alternative diagnostic possibilities such as eosinophilic esophagitis...
2017: F1000Research
https://www.readbyqxmd.com/read/28980336/incidence-and-predictors-of-osteoporotic-fractures-in-patients-with-barrett-s-oesophagus-a-population-based-nested-case-control-study
#2
S Kumar, M T Drake, C D Schleck, M L Johnson, J A Alexander, D A Katzka, P G Iyer
BACKGROUND: Proton pump inhibitors (PPI) are inconsistently associated with osteoporotic fractures. Barrett's oesophagus (BO) patients are treated with high PPI doses for prolonged periods, but there are limited data on the incidence of osteoporosis and fractures in this group pf patients. AIM: To estimate the incidence of (and risk factors for) low bone mass (osteoporosis and/or osteopenia) related fractures in a population-based BO cohort. METHODS: All subjects with BO and a diagnosis of osteoporosis and fractures were identified using Rochester Epidemiology Project resources...
December 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28881340/additional-benefits-of-routine-drugs-on-gastrointestinal-cancer-statins-metformin-and-proton-pump-inhibitors
#3
Moon Kyung Joo, Jong-Jae Park, Hoon Jai Chun
BACKGROUND: Commonly used medications including statins, metformin, and proton pump inhibitors (PPIs) effectively reduce the risk of esophageal, gastric, and colorectal cancer (CRC). SUMMARY: A number of observational studies and meta-analyses have shown that long-term statin use significantly reduces the incidence of gastrointestinal (GI) cancer. Moreover, statin use after GI cancer diagnosis has been significantly associated with better prognosis in large-scale cohort studies...
2018: Digestive Diseases
https://www.readbyqxmd.com/read/28702854/gastroesophageal-reflux-disease-and-pulmonary-diseases-associated-with-aspergillosis-is-there-a-connection
#4
Maria N Gamaletsou, David W Denning
INTRODUCTION: We studied the relationship between GORD and allergic bronchopulmonary aspergillosis (ABPA), chronic pulmonary aspergillosis (CPA), or Aspergillus bronchitis. BACKGROUND: Gastroesophageal reflux disease (GORD) is well known to initiate or exacerbate pulmonary inflammatory conditions, inducing bronchial asthma and chronic obstructive lung disease. METHODS: We reviewed four patients referred with elevated Aspergillus serology markers and marked pulmonary symptoms for ABPA, CPA, and Aspergillus bronchitis, and discussed the underlying pathophysiological relationship with GORD...
December 2017: Mycopathologia
https://www.readbyqxmd.com/read/28533674/impact-of-gastroesophageal-reflux-control-through-tailored-proton-pump-inhibition-therapy-or-fundoplication-in-patients-with-barrett-s-esophagus
#5
Francisco Baldaque-Silva, Michael Vieth, Mumen Debel, Bengt Håkanson, Anders Thorell, Nuno Lunet, Huan Song, Miguel Mascarenhas-Saraiva, Gisela Pereira, Lars Lundell, Hanns-Ulrich Marschall
AIM: To determine the impact of upwards titration of proton pump inhibition (PPI) on acid reflux, symptom scores and histology, compared to clinically successful fundoplication. METHODS: Two cohorts of long-segment Barrett's esophagus (BE) patients were studied. In group 1 (n = 24), increasing doses of PPI were administered in 8-wk intervals until acid reflux normalization. At each assessment, ambulatory 24 h pH recording, endoscopy with biopsies and symptom scoring (by a gastroesophageal reflux disease health related quality of life questionnaire, GERD/HRLQ) were performed...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28500192/deprescribing-proton-pump-inhibitors-evidence-based-clinical-practice-guideline
#6
Barbara Farrell, Kevin Pottie, Wade Thompson, Taline Boghossian, Lisa Pizzola, Farah Joy Rashid, Carlos Rojas-Fernandez, Kate Walsh, Vivian Welch, Paul Moayyedi
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper or stop proton pump inhibitors (PPIs); to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes. METHODS: Five health professionals (1 family physician, 3 pharmacists, and 1 gastroenterologist) and 5 nonvoting members comprised the overall team; members disclosed conflicts of interest...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28280615/the-frequency-of-histologically-confirmed-barrett-s-esophagus-varies-by-the-combination-of-ethnicity-and-gender
#7
Sian S Chisholm, Joe E Khoury, M Mazen Jamal, Carlos Palacio, Sunitha Pudhota, Kenneth J Vega
BACKGROUND: Barrett's esophagus (BE) is the primary risk factor for esophageal adenocarcinoma (EAC). Limited data exists regarding the frequency of histologically confirmed BE by both gender and ethnicity in the United States. The study aim was to determine whether the frequency of histologically confirmed BE varies by ethnicity and gender. METHODS: The University of Florida-Jacksonville endoscopy database was reviewed for all cases of salmon colored esophageal mucosa from September 2002 to August 2007...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28263955/pathway-cross-talk-analysis-in-detecting-significant-pathways-in-barrett-s-esophagus-patients
#8
Zhengyuan Xu, Yan Yan, Jian He, Xinfang Shan, Weiguo Wu
BACKGROUND The pathological mechanism of Barrett's esophagus (BE) is still unclear. In the present study, pathway cross-talks were analyzed to identify hub pathways for BE, with the purpose of finding an efficient and cost-effective detection method to discover BE at its early stage and take steps to prevent its progression. MATERIAL AND METHODS We collected and preprocessed gene expression profile data, original pathway data, and protein-protein interaction (PPI) data. Then, we constructed a background pathway cross-talk network (BPCN) based on the original pathway data and PPI data, and a disease pathway cross-talk network (DPCN) based on the differential pathways between the PPI data and the BE and normal control...
March 6, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28257716/the-risks-and-benefits-of-long-term-use-of-proton-pump-inhibitors-expert-review-and-best-practice-advice-from-the-american-gastroenterological-association
#9
REVIEW
Daniel E Freedberg, Lawrence S Kim, Yu-Xiao Yang
BACKGROUND & AIMS: The purpose of this review is to evaluate the risks associated with long-term use of proton pump inhibitors (PPIs), focusing on long-term use of PPIs for three common indications: gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), and non-steroidal anti-inflammatory drug (NSAID) bleeding prophylaxis. METHODS: The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed, EMbase, and the Cochrane library (through July 2016)...
March 2017: Gastroenterology
https://www.readbyqxmd.com/read/28248794/intestinal-metaplasia-of-the-esophagus-in-children-with-esophageal-atresia
#10
Helen Hsieh, Adam Frenette, Laurent Michaud, Usha Krishnan, Dorothée B Dal-Soglio, Frederic Gottrand, Christophe Faure
OBJECTIVES: Patients with esophageal atresia/tracheoesophageal fistula (EA-TEF) can develop Barrett esophagus as a long-term consequence of their condition. Intestinal metaplasia (IM), a risk factor for developing adenocarcinoma of the esophagus, has not been well characterized in the pediatric population. METHODS: Retrospective review of patients with EA-TEF followed at 3 academic pediatric centers between the years 1997 and 2014. RESULTS: Among 542 children and adolescents, 1...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28195178/recurrence-of-barrett-s-esophagus-is-rare-following-endoscopic-eradication-therapy-coupled-with-effective-reflux-control
#11
Srinadh Komanduri, Peter J Kahrilas, Kumar Krishnan, Tim McGorisk, Kiran Bidari, David Grande, Laurie Keefer, John Pandolfino
OBJECTIVES: Recent data suggest that effective control of gastroesophageal reflux improves outcomes associated with endoscopic eradication therapy (EET) for Barrett's esophagus (BE). However, the impact of reflux control on preventing recurrent intestinal metaplasia and/or dysplasia is unclear. The aims of the study were: (a) to determine the effectiveness and durability of EET under a structured reflux management protocol and (b) to determine the impact of optimizing anti-reflux therapy on achieving complete eradication of intestinal metaplasia (CE-IM)...
April 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28188977/lack-of-incremental-effect-of-histamine-receptor-antagonists-over-proton-pump-inhibitors-on-the-risk-of-neoplastic-progression-in-patients-with-barrett-s-esophagus-a-cohort-study
#12
Prashanthi N Thota, Kaveh Hajifathalian, Tanmayee Benjamin, Ashok Runkana, Rocio Lopez, Madhusudhan R Sanaka
AIMS: Long-term acid suppression lowers the risk of progression to esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus (BE). With the recent reports about harmful effects of chronic proton pump inhibitor (PPI) use, there is renewed interest about alternative methods of acid suppression. Hence, our aim was to study the effect of H2 receptor antagonists (H2RA) on the risk of progression to neoplasia in our BE cohort. METHODS: This is a retrospective analysis of prospectively collected data of patients in our BE Registry from 2002 to 2015...
February 11, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28089434/gastroesophageal-reflux-disease-and-barrett-s-esophagus-after-laparoscopic-sleeve-gastrectomy-a-possible-underestimated-long-term-complication
#13
Alfredo Genco, Emanuele Soricelli, Giovanni Casella, Roberta Maselli, Lidia Castagneto-Gissey, Nicola Di Lorenzo, Nicola Basso
BACKGROUND: Morbidly obese patients are affected by gastroesophageal reflux disease (GERD) and hiatal hernia (HH) more frequently than lean patients. Because of conflicting results, the indication to sleeve gastrectomy (SG) in patients with GERD is still debated. OBJECTIVES: To evaluate the incidence of GERD on the basis of clinical, endoscopic, and histologic data in patients undergoing SG. SETTINGS: University hospital, Rome, Italy. METHODS: From July 2007 to January 2010, 162 patients underwent primary SG...
April 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27492354/a-combined-nissen-plus-hill-hybrid-repair-for-paraesophageal-hernia-improves-clinical-outcomes-and-reduces-long-term-recurrences-compared-with-laparoscopic-nissen-alone
#14
Gal Levy, Ralph W Aye, Alexander S Farivar, Brian E Louie
INTRODUCTION: We compared clinical and objective outcomes of combined Nissen-Hill hybrid (HYB) to Nissen fundoplication (LNF) for repair of paraesophageal hernia (PEH). METHODS: This study is a single-institution retrospective chart review of prospectively collected data for consecutive patients undergoing PEH repair from 2006 to 2015 with at least 6 months of follow-up. Quality of life metrics (QOLRAD, HRQL, and dysphagia), manometry, radiographic imaging, and pH testing were administered pre- and postoperatively...
January 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27448962/gastrin-stimulates-a-cholecystokinin-2-receptor-expressing-cardia-progenitor-cell-and-promotes-progression-of-barrett-s-like-esophagus
#15
Yoomi Lee, Aleksandra M Urbanska, Yoku Hayakawa, Hongshan Wang, Andrew S Au, Aesis M Luna, Wenju Chang, Guangchun Jin, Govind Bhagat, Julian A Abrams, Richard A Friedman, Andrea Varro, Kenneth K Wang, Malcolm Boyce, Anil K Rustgi, Antonia R Sepulveda, Michael Quante, Timothy C Wang
OBJECTIVE: The incidence of esophageal adenocarcinoma (EAC) is increasing, but factors contributing to malignant progression of its precursor lesion, Barrett's esophagus (BE), have not been defined. Hypergastrinemia caused by long-term use of proton pump inhibitors (PPIs), has been suggested as one possible risk factor. The gastrin receptor, CCK2R, is expressed in the cardia and upregulated in BE, suggesting the involvement of the gastrin-CCK2R pathway in progression. In the L2-IL-1β mouse model, Barrett's-like esophagus arises from the gastric cardia...
January 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/27373671/radiofrequency-ablation-of-symptomatic-cervical-inlet-patch-using-a-through-the-scope-device-a-pilot-study
#16
Jason Mark Dunn, Guiping Sui, Angela Anggiansah, Terence Wong
BACKGROUND AND AIMS: The cervical inlet patch (CIP) is an area of heterotopic gastric mucosa at the proximal esophagus, which can secrete both acid and mucus. Attributable symptoms include chronic globus sensation and sore throat. Previous studies have demonstrated improvement in symptoms after ablation using argon plasma coagulation. Our aim was to assess a through-the-scope radiofrequency ablation (RFA) catheter for ablation of symptomatic CIP. METHODS: Ten patients with endoscopically and histologically proven CIP and symptoms of globus or sore throat were included in the study...
December 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27325300/evidence-based-clinical-practice-guidelines-for-gastroesophageal-reflux-disease-2015
#17
REVIEW
Katsuhiko Iwakiri, Yoshikazu Kinoshita, Yasuki Habu, Tadayuki Oshima, Noriaki Manabe, Yasuhiro Fujiwara, Akihito Nagahara, Osamu Kawamura, Ryuichi Iwakiri, Soji Ozawa, Kiyoshi Ashida, Shuichi Ohara, Hideyuki Kashiwagi, Kyoichi Adachi, Kazuhide Higuchi, Hiroto Miwa, Kazuma Fujimoto, Motoyasu Kusano, Yoshio Hoshihara, Tatsuyuki Kawano, Ken Haruma, Michio Hongo, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015...
August 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/26945777/radiofrequency-ablation-coupled-with-roux-en-y-gastric-bypass-a-treatment-option-for-morbidly-obese-patients-with-barrett-s-esophagus
#18
Keyur Parikh, Leena Khaitan
Barrett's esophagus (BE) is a premalignant condition that is associated with the development of esophageal adenocarcinoma. Risk factors that have been associated with the development of BE include male gender, Caucasian race, chronic gastroesophageal reflux disease, smoking, age >50 and obesity. The current management of BE is dependent on underlying pathological changes and treatment can range from surveillance endoscopy with daily proton pump inhibitor (PPI) therapy in the setting of intestinal metaplasia or low-grade dysplasia (LGD) to radiofrequency ablation (RFA), endoscopic mucosal resection or surgical resection in the setting of high-grade dysplasia...
2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/26926861/peptic-esophageal-stricture-in-an-adolescent-with-barrett-s-esophagus
#19
Sandeep Lamoria, Arka De, Somya Agarwal, Brinder Mohan Singh Lamba, Vishal Sharma
Barrett's esophagus (BE) is characterized by the replacement of distal esophageal stratified squamous epithelium by columnar epithelium. It is rare in children and the risk factors may include mental retardation, cerebral palsy, esophageal atresia, etc. Apart from corrosive ingestion, peptic stricture is the other leading cause of esophageal strictures in children. However, BE has not been well characterized in the pediatric population and in children presenting with esophageal strictures. A 16-year-old Indian boy presented with a history of gradually progressive dysphagia to solids (but not liquids) for 12 years along with heartburn and poor weight gain...
February 27, 2016: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/26772891/rates-and-predictors-of-progression-to-esophageal-carcinoma-in-a-large-population-based-barrett-s-esophagus-cohort
#20
Rajesh Krishnamoorthi, Bijan Borah, Herbert Heien, Ananya Das, Amitabh Chak, Prasad G Iyer
BACKGROUND AND AIMS: Rates of progression to esophageal adenocarcinoma in subjects with Barrett's esophagus (BE) are lower than previously estimated. Identification of predictors of progression will enable risk stratification of BE subjects, potentially making current surveillance programs more efficient. We aimed to assess the potential of demographic and lifestyle factors, obesity, and medications in predicting progression in BE. METHODS: BE subjects were identified from the General Practice Research Database using validated diagnostic codes...
July 2016: Gastrointestinal Endoscopy
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