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Duodenogastroesophageal reflux

Hiroaki Usui, Masahide Fukaya, Keita Itatsu, Kazushi Miyata, Ryoji Miyahara, Kohei Funasaka, Masato Nagino
BACKGROUND: The aim of this study was to evaluate the impact of the location of esophagogastrostomy on acid and duodenogastroesophageal reflux (DGER) in patients undergoing gastric tube reconstruction and intrathoracic esophagogastrostomy. METHODS: Thirty patients receiving transthoracic esophagectomy without cervical lymph node dissection and gastric tube reconstruction by intrathoracic anastomosis were enrolled. All patients underwent 24-h pH and bilirubin monitoring and gastrointestinal endoscopy one year after surgery...
August 14, 2017: World Journal of Surgery
G S Dzhulay, E V Sekareva
AIM: To estimate esophageal and gastric pH values on an empty stomach and after stimulation of gastric secretion and gastric and duodenal motor-evacuatory activity in patients with gastroesophageal reflux disease (GERD) associated with pathological refluxes, such as gastroesophageal reflux (GER) and duodenogastroesophageal reflux (DGER). SUBJECTS AND METHODS: The observational cross-sectional study was conducted to investigate and compare the parameters of intraesophageal and intragastric pH metry and peripheral electrogastroenterography in 103 GERD patients with endoscopically positive distal reflux esophagitis in GER and DGER...
2016: Terapevticheskiĭ Arkhiv
J-D Wang, S-Y Zhu, Y-J Lu, L-Y Gao
OBJECTIVE: Reflux is the principal complication for patients after esophagectomy with gastric reconstruction. The aim of this study was to investigate the effect of the modified Nissen fundoplication after resection of adenocarcinoma from the esophagogastric junction (AEG) on controlling the reflux and the role of duodenogastroesophageal reflux (DGER) and cyclooxygenase-2 (COX-2) expression level in the remnant esophagus. PATIENTS AND METHODS: Sixty patients with AEG were randomly divided into two groups: (i) the conventional anastomosis group and (ii) the anti-reflux anastomosis group...
2016: European Review for Medical and Pharmacological Sciences
Roberta Maselli, Haruhiro Inoue, Haruo Ikeda, Manabu Onimaru, Akira Yoshida, Esperanza Grace Santi, Hiroki Sato, Nikolas Eleftheriadis, Shin-Ei Kudo
Background. Bile juice plays a major role in duodenogastroesophageal reflux (DGERD). Several devices to directly measure the bile concentration have been proposed. We aimed to ex-vivo evaluate the bile concentration by narrow band imaging (NBI). Method. From six surgical cholecystectomies, the content of the gallbladders was aspirated and the total biliary acid (TBA) concentration was evaluated. 2 mL was employed for serial twofold dilutions. Each dilution was scoped. Images on white light (WL) and NBI were captured and grouped accordingly to NBI-appearance and TBA-concentration...
2015: Gastroenterology Research and Practice
T V K Herregods, A J Bredenoord, A J P M Smout
BACKGROUND: The prevalence of gastroesophageal reflux disease (GERD) has increased in the last decades and it is now one of the most common chronic diseases. Throughout time our insight in the pathophysiology of GERD has been characterized by remarkable back and forth swings, often prompted by new investigational techniques. Even today, the pathophysiology of GERD is not fully understood but it is now recognized to be a multifactorial disease. Among the factors that have been shown to be involved in the provocation or increase of reflux, are sliding hiatus hernia, low lower esophageal sphincter pressure, transient lower esophageal sphincter relaxation, the acid pocket, obesity, increased distensibility of the esophagogastric junction, prolonged esophageal clearance, and delayed gastric emptying...
September 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Patrick Yachimski, Sabba Maqbool, Yasser M Bhat, Joel E Richter, Gary W Falk, Michael F Vaezi
OBJECTIVES: Symptom eradication in patients with Barrett's esophagus (BE) does not guarantee control of acid or duodenogastroesophageal reflux (DGER). Continued reflux of acid and/or DGER may increase risk of neoplastic progression and may decrease the likelihood of columnar mucosa eradication after ablative therapy. To date, no study has addressed whether both complete acid and DGER control is possible in patients with BE. This prospective study was designed to assess the effect of escalating-dose proton pump inhibitor (PPI) therapy on esophageal acid and DGER...
August 2015: American Journal of Gastroenterology
G S Dzhulaĭ, E V Sekareva, T E Dzhulaĭ
AIM: To investigate the phenotypic and visceral signs of connective tissue dysplasia (CTD) and comorbid diseases of the digestive system in gastroesophageal reflux disease (GERD) patients with different types of esophageal reflux as the predictors of its variants. MATERIAL AND METHODS: In 124 patients with GERD the clinical features, phenotypic and visceral signs of undifferentiated CTD were studied in details. RESULTS: In 82.0% of patients with GERD associated with gastroesophageal type of reflux (GER) phenotypic and especially visceral signs of STD were detected, mainly in the form of cardiochalasia and hiatal hernia...
2014: Experimental & Clinical Gastroenterology
Karl Hermann Fuchs, Benjamin Babic, Wolfram Breithaupt, Bernard Dallemagne, Abe Fingerhut, Edgar Furnee, Frank Granderath, Peter Horvath, Peter Kardos, Rudolph Pointner, Edoardo Savarino, Maud Van Herwaarden-Lindeboom, Giovanni Zaninotto
BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most frequent benign disorders of the upper gastrointestinal tract. Management of GERD has always been controversial since modern medical therapy is very effective, but laparoscopic fundoplication is one of the few procedures that were quickly adapted to the minimal access technique. The purpose of this project was to analyze the current knowledge on GERD in regard to its pathophysiology, diagnostic assessment, medical therapy, and surgical therapy, and special circumstances such as GERD in children, Barrett's esophagus, and enteroesophageal and duodenogastroesophageal reflux...
June 2014: Surgical Endoscopy
G S Dzhulai, E V Sekareva, V M Chervinets, E S Mikhailova, T E Dzhulai
AIM: To study the specific features of the clinical course of gastroesophageal reflux disease (GERD) associated with duodenogastroesophageal reflux (DGER) in patients with chronic acalculous cholecystitis (CAC) and cholelithiasis (CL), as well as qualitative and quantitative characteristics. SUBJECTS AND METHODS: The clinical, morphological, motor tonic characteristics of the esophagogastroduodenal area, mucosal microbial biocenosis in the esophagus, stomach, and duodenum were studied in detail in 83 patients with GERD that was associated with DGER and ran concurrently with CAC or CL...
2014: Terapevticheskiĭ Arkhiv
Nicola H Green, Zoe Nicholls, Paul R Heath, Jonathan Cooper-Knock, Bernard M Corfe, Sheila MacNeil, Jonathan P Bury
Oesophageal exposure to duodenogastroesophageal refluxate is implicated in the development of Barrett's metaplasia (BM), with increased risk of progression to oesophageal adenocarcinoma. The literature proposes that reflux exposure activates NF-κB, driving the aberrant expression of intestine-specific caudal-related homeobox (CDX) genes. However, early events in the pathogenesis of BM from normal epithelium are poorly understood. To investigate this, our study subjected a 3D model of the normal human oesophageal mucosa to repeated, pulsatile exposure to specific bile components and examined changes in gene expression...
June 2014: International Journal of Experimental Pathology
Takashi Fujimura, Katsunobu Oyama, Shozo Sasaki, Koji Nishijima, Tomoharu Miyashita, Tetsuo Ohta, Koichi Miwa, Takanori Hattori
Development from chronic inflammation to Barrett's adenocarcinoma is known as one of the inflammation-related carcinogenesis routes. Gastroesophageal reflux disease induces regurgitant esophagitis, and esophageal mucosa is usually regenerated by squamous epithelium, but sometimes and somewhere replaced with metaplastic columnar epithelium. Specialized columnar epithelium, so-called Barrett's epithelium (BE), is a risk factor for dysplasia and adenocarcinoma in esophagus. Several experiments using rodent model inducing duodenogastroesophageal reflux or duodenoesophageal reflux revealed that columnar epithelium, first emerging at the proliferative zone, progresses to dysplasia and finally adenocarcinoma, and exogenous carcinogen is not necessary for cancer development...
2011: Cancers
G S Dzhulaĭ, E V Sekareva, V M Kuritsyn, T E Dzhulaĭ
AIM: To study the clinical and pathogenetic types of gastroesophageal reflux disease (GERD) in terms of different types of reflux into the esophagus, their risk factors and predictors. MATERIALS AND METHODS: The clinical, morphological, motor tonic characteristics of the esophagogastroduodenal area, the phenotypic and visceral signs of existing undifferentiated connective tissue dysplasias (UDCTD), and the suprasegmental and segmental autonomic apparatus were studied in detail in 124 patients with GERD...
2013: Terapevticheskiĭ Arkhiv
Peng Cheng, Jian-Sheng Li, Lian-Feng Zhang, Yong-Zhong Chen, Jun Gong
AIM: To determine the effects of gastric juice on the development of esophageal adenocarcinoma (EAC). METHODS: A animal model of duodenogastroesophageal reflux was established in Sprague-Dawley rats undergoing esophagoduodenostomy. The development of EAC and forestomach adenocarcinoma was investigated 40 wk after the treatment. Intraluminal pH and bile of the forestomach were measured. RESULTS: There were no significant differences in pH (t = 0...
April 21, 2013: World Journal of Gastroenterology: WJG
Nima Abbassi-Ghadi, Sacheen Kumar, Billy Cheung, Anne McDermott, Alison Knaggs, Emmanouil Zacharakis, Krishna Moorthy, Martin Carby, George B Hanna
BACKGROUND: The aim of this study was to determine the safety of anti-reflux surgery for lung transplant recipients and assess its effect on lung function. METHODS: We retrospectively collected and analyzed data from all lung transplant recipients who underwent anti-reflux surgery at St Mary's Hospital London from July 2005 to May 2012. The indications for surgery were histologic evidence of gastroesophageal reflux aspiration on bronchoscopy biopsy specimens or a positive impedance study with symptomatic reflux or a consistent decline/fluctuating forced expiratory volume in 1 second (FEV(1))...
June 2013: Journal of Heart and Lung Transplantation
S Kunsch, A Neesse, T Linhart, C Nell, T M Gress, V Ellenrieder
BACKGROUND: Duodenogastroesophageal reflux (DGER) is considered an independent risk factor for complicated reflux disease (gastroesophageal reflux disease; GERD). However, the role of DGER in GERD patients refractory to proton pump inhibitors (PPI) remains poorly understood. METHODS: 85 patients with clinical reflux symptoms and a history of ineffective response to PPIs were enrolled in the study. Patients with elevated reflux measurement (pH and/or Bilitec measurement; n = 47) received pantoprazole 80 mg for 8 weeks...
2012: Digestion
Yoshio Araki, Ken-Ichi Mukaisho, Yoshihide Fujiyama, Takanori Hattori, Hiroyuki Sugihara
Anti-secretory drugs, particularly proton pump inhibitors (PPIs), are the preferred treatment agents for patients with gastroesophageal reflux disease (GERD). However, refractory GERD, which may manifest as an incomplete or lack of response to PPI therapy, is common. Despite the administration of PPIs for symptomatic control, duodenogastroesophageal reflux (DGER) containing bile is successfully controlled in only one-third of patients. It has previously been reported that the traditional Japanese herbal medicine rikkunshito, which has a prokinetic action on gastric emptying, exhibits clinically therapeutic effects against GERD and DGER that does not respond to PPIs...
April 2012: Experimental and Therapeutic Medicine
Han-Chen Tsai, Fang-Chi Lin, Yi-Chu Chen, Shi-Chuan Chang
PURPOSE: The aim of this study was to investigate the role of inflammatory biomarkers and total bile acid (TBA) in oral secretions in the development of ventilator-associated pneumonia (VAP). MATERIALS: This prospective study was conducted in an intensive care unit. Oral secretions were collected from mechanically ventilated patients who met the selection criteria for VAP prevention protocol. The levels of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor α, soluble intercellular adhesion molecule-1, monocyte chemoattractant protein-1, C-reactive protein, surfactant protein D, and TBA in oral secretions were measured and compared between the patients with and those without VAP...
October 2012: Journal of Critical Care
Takahiro Yamada, Yusuke Ishida, Yukiko Nakamura, Shoichi Shimada
In patients with gastroesophageal reflux disease (GERD), esophageal exposure to both acid and duodenogastroesophageal reflux are more common than to acid reflux alone, suggesting that acidic bile acid in duodenal juice may contribute to the pathophysiology and severity of GERD. However, the mechanism whereby esophageal mucosal epithelial cells react to bile acid remains unclear. We visually examined the real-time response of mouse esophageal epithelial cells to bile acids using calcium (Ca(2+))-imaging methods...
November 4, 2011: Biochemical and Biophysical Research Communications
K Nishimura, T Tanaka, T Tsubuku, S Matono, T Nagano, K Murata, Y Aoyama, T Yanagawa, K Shirouzu, H Fujita
Reflux esophagitis (RE) is a known complication disturbing patients' quality of life after esophageal resection. It is generally recognized that bile reflux as well as acid reflux cause RE. However, the clinical influence of acid and bile reflux, and Helicobacter pylori (H. pylori) infection on RE in the cervical esophagus after esophagectomy is not yet clarified. Sixty patients who underwent cervical esophagogastrostomy following esophagectomy were enrolled in this study. They underwent examination for H. pylori infection, endoscopic examination, and continuous 24-hour pH and bilirubin monitoring, at 1 month after surgery...
July 2012: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Peng Cheng, Jian-Sheng Li, Jun Gong, Lian-Feng Zhang, Rong-Zhong Chen
AIM: To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC). METHODS: An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED). The development of EAC was investigated in rats exposed to duodenogastric juice of different pH. The rats were divided into three groups: low-pH group (group A), high-pH group (group B) and a sham-operated group as a control (group C) (n = 30 rats in each group)...
July 7, 2011: World Journal of Gastroenterology: WJG
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