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https://www.readbyqxmd.com/read/29913281/most-patients-with-gastroesophageal-reflux-disease-who-failed-proton-pump-inhibitor-therapy-also-have-functional-esophageal-disorders
#1
Jason Abdallah, Nina George, Takahisa Yamasaki, Stephen Ganocy, Ronnie Fass
BACKGROUND & AIMS: As many as 45% of patients with gastroesophageal reflux disease (GERD) still have symptoms after receiving once-daily proton pump inhibitor (PPI) therapy. We aimed to compare reflux characteristics and patterns between responders and non-responders to once-daily PPI therapy using combined impedance-pH monitoring. METHODS: Patients who reported heartburn and/or regurgitation at least twice per week for 3 months while receiving standard-dose PPI therapy were assigned to the PPI failure group (n=16)...
June 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29905784/blind-esophageal-brushing-offers-a-safe-and-accurate-method-to-monitor-inflammation-in-children-and-young-adults-with-eosinophilic-esophagitis
#2
Y Smadi, C Deb, J Bornstein, S Safder, K Horvath, D Mehta
Patients with eosinophilic esophagitis (EoE) require frequent evaluation of mucosal inflammation via endoscopy. Instead of endoscopy, mucosal evaluation in adults with esophageal cancer and candidiasis is achieved using a cytology brush inserted through a nasogastric tube (NGT). We conducted a prospective cross-sectional study in children and young adults scheduled for routine esophagogastroduodenoscopy (EGD) where in Phase 1, we performed esophageal brushing through the endoscope under direct visualization and in Phase 2, we inserted the brush through a Cortrak® NGT prior to endoscopy...
June 14, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29902643/a-rare-case-of-hyperplastic-proximal-esophageal-polyps-with-foveolar-dysplasia
#3
Maham Hayat, Sultan Mahmood, John T Maple
A 62-year-old male with long-standing esophageal reflux underwent endoscopy at an outside institution that reported multiple polypoid lesions in upper esophagus and a small focal area of nodular mucosa at the gastroesophageal junction(GEJ). Biopsies of the proximal esophageal polyps demonstrated hyperplastic mucosa with ulceration, reactive epithelial changes, and focal intestinal metaplasia. Biopsies from the nodular GEJ mucosa were described as Barrett's esophagus with low grade dysplasia. An upper endoscopy performed at our medical center found multiple semi-pedunculated esophageal polyps between 18-24 cm from the incisors (Figure A)...
June 11, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29899438/complications-of-antireflux-surgery
#4
REVIEW
Rena Yadlapati, Eric S Hungness, John E Pandolfino
Antireflux surgery anatomically restores the antireflux barrier and is a therapeutic option for proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease or PPI intolerance. Laparoscopic fundoplication is the standard antireflux surgery, though its popularity has declined due to concerns regarding wrap durability and adverse events. As the esophagogastric junction is an anatomically complex and dynamic area subject to mechanical stress, wraps are susceptible to disruption, herniation or slippage...
June 14, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29894215/utility-of-water-siphon-maneuver-for-eliciting-gastroesophageal-reflux-during-barium-esophagography-correlation-with-histologic-findings
#5
B Dane, A Doshi, A Khan, A Megibow
OBJECTIVE: The objective of this study is to evaluate whether the water siphon maneuver improves detection of gastroesophageal (GE) reflux during barium esophagography compared with observation for spontaneous reflux only. Histopathologic analysis is the reference standard. MATERIALS AND METHODS: This retrospective study assessed 87 outpatients who underwent both barium esophagography and upper endoscopy-guided biopsy within a 30-day interval. The water siphon maneuver was routinely performed when spontaneous GE reflux was not observed during the fluoroscopic study...
June 12, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29892570/management-of-gastroesophageal-reflux-disease-in-adults-a-pharmacist-s-perspective
#6
REVIEW
Brett MacFarlane
Gastroesophageal reflux disease (GERD) is a common gastrointestinal diagnosis, a leading reason for endoscopy and cause of potentially serious complications, resulting in significant individual and system-wide health burden. Approximately one quarter of people living in western countries have experienced GERD, and the prevalence appears to be on the rise. Risk factors for GERD include hiatus hernia, obesity, high-fat diet, tobacco smoking, alcohol consumption, pregnancy, genetics, and some medications. The cardinal symptoms of GERD are troublesome heartburn and regurgitation...
2018: Integrated Pharmacy Research and Practice
https://www.readbyqxmd.com/read/29888240/before-and-after-esophageal-surgery-which-information-is-needed-from-the-functional-laboratory
#7
REVIEW
Ines Gockel, Sebastian Murad Rabe, Stefan Niebisch
Background: Indications for benign esophageal surgery and postoperative follow-up need to be highly elaborated with differentiated and structured algorithms, based on objective functional workup in the esophageal laboratory. Functional outcome is of utmost interest and has to be driven by the need for comprehensive but purposeful diagnostic methods. Methods: Preoperative diagnostic workup procedures by the functional laboratory include 24-h pH-monitoring, impedance testing, and high-resolution manometry (HRM) - in addition to upper gastrointestinal endoscopy and barium swallow/timed barium esophagogram...
April 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29888237/diagnostic-investigations-of-gastroesophageal-reflux-disease-who-and-when-to-refer-and-for-what-test
#8
REVIEW
Arne Kandulski, Lukas Moleda, Martina Müller-Schilling
Background: Due to the high prevalence and incidence of patients with gastroesophageal reflux disease (GERD), the diagnostic workup of patients with symptoms of GERD needs to be balanced between empiric antisecretory therapy and further functional assessment including endoscopy and reflux monitoring. Methods: This article is based on a literature review (PubMed, Medline) using the terms 'gastroesophageal reflux disease' or 'GERD' and 'diagnosis', 'therapy', or 'PPI' with special and critical analysis of the current 'Porto' consensus report...
April 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29886566/mucosal-impedance-a-new-approach-to-diagnosing-gastroesophageal-reflux-disease-and-eosinophilic-esophagitis
#9
REVIEW
Caroline Barrett, Yash Choksi, Michael F Vaezi
PURPOSE OF REVIEW: In this review, we discuss current diagnostic testing modalities for both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) and then introduce mucosal impedance (MI), a novel technology that measures epithelial integrity in real time during endoscopy. We describe the advantages and disadvantages of MI as compared with traditional diagnostic testing. RECENT FINDINGS: We review studies that demonstrate that GERD and EoE have distinct MI patterns, and that physicians can accurately diagnose and distinguish the two during endoscopy with minimal time added to the procedure...
June 9, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29876624/eosinophilic-esophagitis-an-underdiagnosed-cause-of-dysphagia-and-food-impaction-to-be-recognized-by-otolaryngologists
#10
REVIEW
C Górriz Gil, V Matallana Royo, Ó Álvarez Montero, A Rodríguez Valiente, C Fernández Manzano, B Conde García, J R García-Berrocal
Eosinophilic esophagitis (EoE) is a recently recognised pathologic entity whose prevalence has risen significantly since first being described in 1993. Defined as a chronic, local immune-mediated disease with predominant eosinophil infiltration, it is nowadays the leading cause of dysphagia and food bolus impaction in children and young adults. Genetic and environmental risk factors, and especially food antigens, trigger the disease and are in the focus of investigation as avoidance can cure three quarters of patients...
June 6, 2018: HNO
https://www.readbyqxmd.com/read/29849599/vegetal-and-animal-food-proteins-have-a-different-impact-in-the-first-postprandial-hour-of-impedance-ph-analysis-in-patients-with-heartburn
#11
Irene Martinucci, Giada Guidi, Edoardo V Savarino, Marzio Frazzoni, Salvatore Tolone, Leonardo Frazzoni, Lorenzo Fuccio, Lorenzo Bertani, Giorgia Bodini, Linda Ceccarelli, Vincenzo Savarino, Santino Marchi, Nicola de Bortoli
Background and Aims: By means of 24 h impedance-pH monitoring, we aimed to evaluate the effect of two different meals with a bromatological balanced composition: one with a prevailing component of animal proteins and the other with vegetable proteins. Patients and Methods: We enrolled 165 patients with heartburn and negative endoscopy, who underwent impedance-pH monitoring off therapy. Patients were allocated to receive a Mediterranean diet with a total caloric intake of about 1694 kcal, divided into two meals: one with a prevailing component of animal proteins and the other with vegetable proteins...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29848163/factors-predictive-of-gastroesophageal-reflux-disease-and-esophageal-motility-disorders-in-patients-with-non-cardiac-chest-pain
#12
Juan Gomez Cifuentes, Rocio Lopez, Prashanthi N Thota
BACKGROUND: Patients with non-cardiac chest pain (NCCP) are referred for esophageal motility testing and pH monitoring since gastroesophageal reflux disease (GERD) and esophageal motility disorders are frequently encountered in these patients. Our aim was to determine the prevalence and distribution of these disorders and to identify predictors of abnormal esophageal function testing. METHODS: We performed a retrospective study of NCCP patients who presented after a negative cardiac evaluation and underwent esophageal manometry, esophageal pH monitoring and upper endoscopy from January 2010 to January 2017...
May 30, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29846260/the-role-of-esophageal-ph-impedance-testing-in-clinical-practice
#13
Paul Hobbs, C Prakash Gyawali
PURPOSE OF REVIEW: Ambulatory reflux monitoring is typically performed when esophageal symptoms do not respond to usual antireflux medications, or prior to invasive antireflux therapy. Although pH-based metrics have been the standard in defining esophageal reflux burden, novel impedance parameters have been introduced in recent years that can either be extracted from pH-impedance monitoring or obtained directly from esophageal mucosa. This review evaluates the clinical role of esophageal pH-impedance monitoring in clinical practice in the present day...
July 2018: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29846258/how-to-use-rome-iv-criteria-in-the-evaluation-of-esophageal-disorders
#14
Max Schmulson
PURPOSE OF REVIEW: In 2016, the Rome IV process and criteria were published. They provide a system to standardize patient diagnostic requirements for clinical studies and pharmaceutical trials on functional gastrointestinal disorders (FGIDs), which are now called disorders of gut-brain interaction (DGBI). Although the Rome criteria have limitations in clinical practice, an understanding of the criteria can help clinicians to manage symptoms in patients with DGBI, and with organic diseases as well...
July 2018: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29774149/the-rome-iv-versus-rome-iii-criteria-for-heartburn-diagnosis-a-comparative-study
#15
Mengyu Zhang, Minhu Chen, Sui Peng, Yinglian Xiao
Background: The phenotypes of heartburn patients are heterogeneous. Objective: The objective of this study was to investigate the proportion of heartburn phenotypes in a Chinese population and to compare the Rome IV and III criteria for heartburn diagnosis. Methods: A retrospective study was performed among heartburn patients referred for upper endoscopy and esophageal function tests in a tertiary hospital. Their symptoms fulfilled Rome IV and III criteria...
April 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29766301/randomized-clinical-trial-comparing-laparoscopic-hiatal-hernia-repair-using-sutures-versus-sutures-reinforced-with-non-absorbable-mesh
#16
Jelmer E Oor, David J Roks, Jan H Koetje, Joris A Broeders, Henderik L van Westreenen, Vincent B Nieuwenhuijs, Eric J Hazebroek
BACKGROUND: Current literature is characterized by a discrepancy between reported symptomatic and radiological recurrent hiatal hernia's following primary repair. Crural augmentation using mesh is suggested to reduce recurrence rates. The aim of this trial is to analyze 1-year outcome of laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh. METHODS: Between 2013 and 2016, 72 patients with an objectified hiatal hernia were randomized for primary repair using non-absorbable sutures and sutures reinforced with non-absorbable mesh...
May 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29761528/nonerosive-reflux-disease-clinical-concepts
#17
REVIEW
C Prakash Gyawali, Dan E Azagury, Walter W Chan, Servarayan M Chandramohan, John O Clarke, Nicola de Bortoli, Edgar Figueredo, Mark Fox, Daniela Jodorkovsky, Adriana Lazarescu, Peter Malfertheiner, Jan Martinek, Kenric M Murayama, Roberto Penagini, Edoardo Savarino, Katerina P Shetler, Ellen Stein, Roger P Tatum, Justin Wu
Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH-impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux-symptom association...
May 15, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29754440/indications-and-interpretation-of-esophageal-function-testing
#18
REVIEW
C Prakash Gyawali, Nicola de Bortoli, John Clarke, Carla Marinelli, Salvatore Tolone, Sabine Roman, Edoardo Savarino
Esophageal symptoms are common, and can arise from mucosal, motor, functional, and neoplastic processes, among others. Judicious use of diagnostic testing can help define the etiology of symptoms and can direct management. Endoscopy, esophageal high-resolution manometry (HRM), ambulatory pH or pH-impedance manometry, and barium radiography are commonly used for esophageal function testing; functional lumen imaging probe is an emerging option. Recent consensus guidelines have provided direction in using test findings toward defining mechanisms of esophageal symptoms...
May 12, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29728987/gastrogastric-fistula-an-unusual-cause-for-severe-bile-reflux-following-conversion-of-sleeve-gastrectomy-to-one-anastomosis-gastric-bypass
#19
Ashraf Haddad, Ahmad Bashir, Abdelrahman Nimeri
INTRODUCTION: One anastomosis gastric bypass/mini-gastric bypass (OAGB/MGB) was first described in 2001 as a safe and effective procedure. It has been gaining popularity worldwide. Multiple authors have reported the need to re-operate on patients for bile reflux. We report a patient with severe bile reflux after laparoscopic conversion of sleeve gastrectomy (LSG) to OAGB/MGB. METHODS: A 33-year-old patient underwent a LSG in 2014. Postoperatively, she developed severe gastroesophageal acid reflux...
May 4, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29713739/barium-upper-gi-series-in-adults-a-surgeon-s-perspective
#20
Daniel T Dempsey
Barium upper GI series performed by an interested and competent radiologist is still a very useful study to evaluate a variety of esophagogastric disorders. It usually provides information complementary to upper endoscopy and other foregut studies. Barium upper GI series is an important part of the diagnostic workup for gastroesophageal reflux disease, hiatal hernia, and esophageal motility disorders including achalasia. It is also an important part of the follow-up after operation for these common problems and after other operations such as resection or bariatric surgery...
April 30, 2018: Abdominal Radiology
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