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https://www.readbyqxmd.com/read/29454796/endoscopic-myotomy-for-foregut-motility-disorders
#1
Mouen A Khashab, Petros C Benias, Lee L Swanstrom
Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure classically performed for the treatment of achalasia. The procedure is based on principles of submucosal endoscopy and is comprised of a mucosal incision, submucosal tunneling, myotomy and mucosal closure. Multiple published studies that collectively include more than 6000 patients reported clinical success in more than 80-90% of patients. Recent literature also suggested durability of response over a medium-term follow-up. POEM is associated with a low rate of adverse events when performed by experienced operators...
February 15, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29451037/esophageal-hiatal-hernia-risk-diagnosis-and-management
#2
Hai-Xiang Yu, Chun-Shan Han, Jin-Ru Xue, Zhi-Feng Han, Hua Xin
Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations...
February 16, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29437910/modern-diagnosis-of-gerd-the-lyon-consensus
#3
REVIEW
C Prakash Gyawali, Peter J Kahrilas, Edoardo Savarino, Frank Zerbib, Francois Mion, André J P M Smout, Michael Vaezi, Daniel Sifrim, Mark R Fox, Marcelo F Vela, Radu Tutuian, Jan Tack, Albert J Bredenoord, John Pandolfino, Sabine Roman
Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET <4% and <40 reflux episodes on pH-impedance monitoring off proton pump inhibitors...
February 3, 2018: Gut
https://www.readbyqxmd.com/read/29435819/expanding-role-of-third-space-endoscopy-in-the-management-of-esophageal-diseases
#4
REVIEW
Dennis Yang, Peter V Draganov
OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders...
February 12, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29435755/surgical-management-of-gastroesophageal-reflux-disease-in-patients-with-systemic-sclerosis
#5
Jingliang Yan, Andrew T Strong, Gautam Sharma, Scott Gabbard, Prashanti Thota, John Rodriguez, Matthew Kroh
BACKGROUND: Systemic sclerosis (scleroderma) is frequently associated with both gastroesophageal reflux disease (GERD) and simultaneous esophageal dysmotility. Anti-reflux procedures in this patient population must account for the existing physiology of each patient and likely disease progression. We aim to compare perioperative and intermediate outcomes of fundoplication versus gastric bypass for the treatment of GERD. METHODS: After IRB approval, patients with systemic sclerosis undergoing fundoplication or gastric bypass for the treatment of GERD from 2004 to 2016 were identified...
February 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29435273/efficacy-of-vonoprazan-for-24-week-maintenance-therapy-of-patients-with-healed-reflux-esophagitis-refractory-to-proton-pump-inhibitors
#6
Hideki Mizuno, Kazutoshi Yamada, Keiji Minouchi, Shinji Kamiyamamoto, Yoshinobu Hinoue
The aim of the present study was to evaluate the efficacy of a potassium-competitive acid blocker (P-CAB), vonoprazan, for the maintenance therapy of healed reflux esophagitis (RE). A total of 60 patients were enrolled in this open-label, single-center, prospective study. All patients were diagnosed with RE with a frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) total score ≥8 following treatment with standard proton pump inhibitors (PPIs) for a minimum of 8 weeks. Standard PPI treatment was switched to vonoprazan 20 mg once daily for 4 weeks...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29423552/laparoscopic-management-of-large-hiatal-hernia-mesh-method-with-the-use-of-progrip-mesh-versus-standard-crural-repair
#7
V V Ilyashenko, Viktor V Grubnyk, V V Grubnik
BACKGROUND: Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh can lead to a reduce of recurrence rate. Despite this reduction, the type of mesh used and the placement technique are controversial. In our study, we used a new type of non-absorbable, self-fixating mesh to reinforce the cruroplasty. The aim of the present study was to compare the long-term results of laparoscopic treatment of large hiatal hernia with mesh reinforcement versus simple crura repair...
February 8, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29399800/double-blind-placebo-controlled-study-with-alginate-suspension-for-laryngopharyngeal-reflux-disease
#8
Wen-Hsuan Tseng, Ping-Huei Tseng, Jia-Feng Wu, Ya-Chin Hsu, Ting-Yi Lee, Yen-Hsuan Ni, Hsiu-Po Wang, Tzu-Yu Hsiao, Wei-Chung Hsu
OBJECTIVE: Treatment for laryngopharyngeal reflux disease (LPRD) is challenging because of delays in recognition and poor responsiveness to proton-pump inhibitor therapy. The aim of this study was to determine the efficacy and safety of liquid alginate suspension for treating LPRD. METHODS: A double-blind, placebo-controlled, prospective study comparing 8 weeks of treatment with Alginos Oral Suspension (TTY Biopharm Co. Ltd., Taipei, Taiwan) (sodium alginate 1,000 mg three times daily) with a placebo was conducted on patients who fulfilled the criteria of at least one symptom consistent with LPRD, a total reflux symptom index (RSI) score of > 10, and a total reflux finding score (RFS) of > 5...
February 5, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29394215/practice-differences-in-the-diagnosis-and-management-of-eosinophilic-esophagitis-among-adult-and-pediatric-gastroenterologists-in-israel
#9
Eyal Zifman, Hagar Banai, Raanan Shamir, Tamar Ringel-Kulka, Noam Zevit
OBJECTIVES: Eosinophilic esophagitis (EoE) guidelines call for similar practices in adults and children with EoE. We compared the diagnostic and management practices of gastroenterologists treating adult and pediatric patients suspected of having, or diagnosed with, EoE. METHODS: A 19 question multiple choice questionnaire was given to gastroenterologists treating either adults or children. Questions explored four areas of interest: Physician demographics, diagnosis and tissue sampling practices, management, and the need for societal publications on EoE...
February 1, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29393167/evaluation-of-esophageal-mucosal-integrity-in-patients-with-gastroesophageal-reflux-disease
#10
Tomoaki Matsumura, Makoto Arai, Hideaki Ishigami, Mai Fujie, Kentaro Ishikawa, Naoki Akizue, Takashi Taida, Yuki Ohta, Shinsaku Hamanaka, Kenichiro Okimoto, Keiko Saito, Daisuke Maruoka, Tomoo Nakagawa, Naoya Kato
BACKGROUND: Impaired esophageal mucosal integrity plays a role in causing symptoms of gastroesophageal reflux disease (GERD). Recently, the assessment of esophageal baseline impedance (BI) using the multichannel intraluminal impedance-pH (MII-pH) test was suggested as a surrogate technique for the study of esophageal mucosal integrity and was reported to be useful in distinguishing GERD from non-GERD. However, measuring BI requires a 24-h testing period, is complicated, and causes considerable patient discomfort...
February 1, 2018: Digestion
https://www.readbyqxmd.com/read/29386767/abdominoperineal-pull-through-with-simultaneous-extravesical-detrussoraphy-an-alternative-surgical-technique-for-congenital-pouch-colon-with-high-grade-vesicoureteric-reflux
#11
Monika Bawa, Ravi Kumar Garg, Vedarth Dash, Prema Menon, K L N Rao
Congenital pouch colon (CPC) is frequently associated with vesicoureteric reflux (VUR). These patients require long-term antibiotic prophylaxis and/or an additional surgical intervention for the management of the refluxing system. We propose a single-stage alternative approach in these patients. Two patients diagnosed to have CPC underwent pouch excision and an end colostomy at birth. Further evaluation revealed high-grade reflux in both the patients. At 6 months of age, definitive abdominoperineal pull-through (APPT) surgery along with extravesical detrusorrhaphy was performed...
January 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29384872/the-psychological-results-of-438-patients-with-persisting-gerd-symptoms-by-symptom-checklist-90-revised-scl-90-r-questionnaire
#12
Ping Li, Fei Wang, Guo-Zhong Ji, Lin Miao, Sihong You, Xia Chen
Persisting gastroesophageal reflux disease (GERD) symptoms affect mental state and social activities and mental disorders likewise play a crucial role on GERD symptoms. The aim of this study was to analyze the data of Symptom Checklist by 90-Revised (SCL-90-R) questionnaire in patients with persisting GERD symptom and to explore the impact of psychological factors on them.The patients accepted SCL-90-R questionnaire survey, following endoscopy, high-resolution manometry (HRM) and ambulatory impedance-pH monitoring...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29383301/association-between-minimal-change-esophagitis-and-gastric-dysmotility-a-single-center-electrogastrography-and-endoscopy-study-in-children
#13
Kyung In Lim, Sung Bo Shim, Hann Tchah, Eell Ryoo
Purpose: Minimal change esophagitis (MCE) is a reflux disease without mucosal breaks, known to be partially associated with abnormal gastric motor function. Electrogastrography (EGG) is commonly applied to assess gastric motor function in a noninvasive fashion. We aimed to determine the relationship between MCE and gastric myoelectrical activity (GME) recorded on EGG in children. Methods: We retrospectively assessed the records of 157 children without underlying disease who underwent both EGG and upper gastrointestinal endoscopy at Gachon University Gil Medical Center between January 2010 and June 2015...
January 2018: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/29379535/diagnostic-yield-of-esophagogastroduodenoscopy-in-children-with-chronic-abdominal-pain
#14
Ulas Emre Akbulut, Hamdi Cihan Emeksiz, Fatma Gulgun Kocak, Ayten Livaoglu
Introduction: Chronic abdominal pain (CAP) is one of the most common indications of esophagogastroduodenoscopy (EGD) in the pediatric population. However, there is not enough information about the diagnostic yield of EGD in children with CAP. We aimed to evaluate the diagnostic yield of EGD in children with CAP in the Eastern Black Sea region of Turkey. Material and methods: The study included children (n = 372) who underwent EGD for the primary indication of chronic abdominal pain during an 18-month period...
January 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29372566/symptom-associated-probability-does-not-reliably-distinguish-functional-heartburn-from-reflux-hypersensitivity
#15
Y Choksi, J C Slaughter, R Sharda, T Higginbotham, P Lal, M F Vaezi
BACKGROUND: Symptom association probability (SAP) is thought to distinguish reflux hypersensitivity from functional disorders. A diagnosis of hypersensitive oesophagus (SAP-positive) indicates that gastro-oesophageal reflux disease (GERD) is the cause of continued symptoms. AIM: To conduct an analysis of pH and symptom criteria that lead to a diagnosis of SAP-positivity METHODS: We calculated SAP for 205 patients with GERD symptoms refractory to proton pump inhibitor (PPI) therapy who underwent endoscopy with wireless pH monitoring from 2007 to 2014...
January 26, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29368532/image-enhanced-endoscopy-is-specific-for-the-diagnosis-of-non-erosive-gastroesophageal-reflux-disease
#16
Neil D Parikh, Artur V Viana, Saloni Shah, Loren Laine
OBJECTIVES: We assessed the performance characteristics of image-enhanced endoscopy with i-Scan or narrow band imaging (NBI) in patients with non-erosive gastroesophageal reflux disease (GERD) compared to controls without heartburn. MATERIAL AND METHODS: Image-enhanced endoscopic findings of vascularity at the squamocolumnar junction, distal esophageal micro-erosions, and non-round pit pattern at the squamocolumnar junction were assessed in cases (heartburn not responsive to PPIs, positive results on validated GERD questionnaire, no esophageal erosions, esophageal biopsies with histologic evidence of GERD (basal cell hyperplasia, elongation of papillae and dilation of intercellular spaces all required)) and in controls (no GERD symptoms or esophageal erosions)...
January 25, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29365373/-evaluation-and-treatment-of-children-s-laryngeal-clefts
#17
C Chen, L T Tan, Z M Xu
Objectives: To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC). Methods: A retrospective case study was conducted at an academic children's hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow...
January 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29340828/hiatal-hernia-recurrence-following-magnetic-sphincter-augmentation-and-posterior-cruroplasty-intermediate-term-outcomes
#18
Kais A Rona, James M Tatum, Joerg Zehetner, Katrin Schwameis, Carol Chow, Kamran Samakar, Adrian Dobrowolsky, Caitlin C Houghton, Nikolai Bildzukewicz, John C Lipham
BACKGROUND: We have previously reported short-term outcomes after hiatal hernia repair (HHR) at the time of magnetic sphincter augmentation (MSA) for gastroesophageal reflux disease (GERD). Here we report intermediate-term outcomes and hernia recurrence rate after concomitant MSA and HHR. METHODS: This is a retrospective cohort study of patients who underwent repair of a hiatal hernia 3 cm or larger at the time of MSA implantation between May 2009 and December 2015...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340546/pre-and-postoperative-ph-monitoring-and-weight-loss-analysis-in-patients-undergoing-gastric-plication-in-association-with-fundoplication
#19
Flávio Heuta Ivano, Luciana Pereira Mesquita, Cristiane Megumi Simamura, Gustavo Massaki Kuwaki, Julielli Taques Colman, Guilherme Mussi Campos
BACKGROUND: Obese patients with gastroesophageal reflux disease with pathological pH monitoring result may benefit from surgical treatment which is based on the fundoplication technique in association with laparoscopic gastric plication. The Nissen surgery is the gold standard for surgical treatment of gastroesophageal reflux disease, whereas laparoscopic gastric plication is a restrictive surgery that consists of the invagination of the greater curvature, resulting in weight loss. AIM: To compare pre and postoperative pHmetry results and to evaluate weight loss in patients submitted to gastroplasty with fundoplication...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29339948/update-on-functional-heartburn
#20
Takahisa Yamasaki, Jessica O'Neil, Ronnie Fass
The definition of functional heartburn has been refined over the years. It is currently described, based upon Rome IV criteria, as typical heartburn symptoms in the presence of normal upper endoscopy findings (including normal biopsies), normal esophageal pH testing, and a negative association between symptoms and reflux events. Functional heartburn is very common, affecting women more than men, and with reflux hypersensitivity makes up the majority of heartburn patients who fail twice-daily proton pump inhibitor therapy...
December 2017: Gastroenterology & Hepatology
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