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https://www.readbyqxmd.com/read/28317452/recent-advances-in-diagnostic-testing-for-gastroesophageal-reflux-disease
#1
Rishi D Naik, Michael F Vaezi
Gastroesophageal reflux disease (GERD) has a large economic burden with important complications that include esophagitis, Barrett's esophagus, and adenocarcinoma. Despite endoscopy, validated patient questionnaires, and traditional ambulatory pH monitoring, the diagnosis of GERD continues to be challenging. Areas covered: This review will explore the difficulties in diagnosing GERD with a focus on new developments, ranging from basic fundamental changes (histology and immunohistochemistry) to direct patient care (narrow-band imaging, impedance, and response to anti-reflux surgery)...
March 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28303290/relationship-between-functional%C3%A2-endoscopy%C3%A2-and-impedance-ph%C3%A2-measurement
#2
F Michel, T Stroh, R Fritsche, P Ahrens
Classic gastroenterological diagnostic tools have proven to be insufficient in identifying the causal relationship between extra-esophageal symptoms and presumed pathological reflux activity. Some new methodological approaches, such as functional endoscopy (video panendoscopy, VPE), are considered to be helpful. However, there are currently no data objectively verifying the success of this method. In a previous study, we found a good correlation between the reflux symptom index (RSI) according to Belafsky and endoscopic findings...
March 16, 2017: HNO
https://www.readbyqxmd.com/read/28302442/symptoms-endoscopic-findings-and-reflux-monitoring-results-in-candidates-for-bariatric-surgery
#3
Benjamin Heimgartner, Marcus Herzig, Yves Borbély, Dino Kröll, Philipp Nett, Radu Tutuian
BACKGROUND: Gastroesophageal reflux disease (GERD) is common in patients with obesity. Diagnosing GERD is important as bariatric operations have different influence on GERD. We assessed reflux symptoms and objective findings prior to surgery. METHODS: Work-up included esophageal symptoms quantification by VAS-scores, esophagogastroduodenoscopy (EGD) and 24-h impedance-pH (imp-pH) monitoring off PPI therapy. Imp-pH was classified as abnormal if either %time pH<4 was abnormal, total number of reflux episodes was elevated or symptom index (SI) was positive...
February 3, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28289859/diagnosis-of-swallowing-disorders-how-we-interpret-pharyngeal-manometry
#4
REVIEW
Charles Cock, Taher Omari
PURPOSE OF REVIEW: We provide an overview of the clinical application of novel pharyngeal high-resolution impedance manometry (HRIM) with pressure flow analysis (PFA) in our hands with example cases. RECENT FINDINGS: In our Centre, we base our interpretation of HRIM recordings upon a qualitative assessment of pressure-impedance waveforms during individual swallows, as well as a quantitative assessment of averaged PFA swallow function variables. We provide a description of two global swallowing efficacy measures, the swallow risk index (SRI), reflecting global swallowing dysfunction (higher SRI = greater aspiration risk) and the post-swallow impedance ratio (PSIR) detecting significant post-swallow bolus residue...
March 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28272380/complexity-and-diversity-of-gerd-phenotypes
#5
Patrizia Zentilin, Elisa Marabotto, Gaia Pellegatta, Claudia Coppo, Manuele Furnari, Edoardo Savarino, Vincenzo Savarino
Gastroesophageal reflux disease (GERD) is defined as a condition which develops when the reflux of gastric contents causes troublesome symptoms, impairs quality of life, or leads to mucosal damage or complications. There are two main phenotypic presentations of GERD, the erosive (ERD) and non-erosive reflux disease (NERD), with the latter one representing up to 70% of GERD spectrum. Moreover, patients with GERD can be clinically subdivided into two distinct syndromes: patinets with esophageal and extraesophageal symptoms...
March 7, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28265971/application-of-the-functional-lumen-imaging-probe-to-esophageal-disorders
#6
REVIEW
Dustin A Carlson, Ikuo Hirano
The functional luminal imaging probe (FLIP) provides a novel method to evaluate esophageal physiology and function in both health and disease. FLIP enables assessment of a previously underexplored component of esophageal function, distensibility, by utilizing high-resolution impedance planimetry to evaluate the relationship of the esophageal luminal geometry with pressure during controlled volumetric distension. Recent studies have described the potential utility of FLIP to evaluate the severity and effectiveness of therapy for esophageal diseases including achalasia, gastroesophageal reflux disease, and eosinophilic esophagitis...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28260353/is-there-a-role-for-high-resolution-manometry-in-gerd-diagnosis
#7
Salvatore Tolone, Edoardo Savarino, Ludovico Docimo
Gastroesophageal reflux disease (GERD) is a condition, which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. In patients with alarm symptoms or signs or in those refractory to antiacid therapy, it is indicated to perform instrumental tests to correctly diagnose GERD presence. Esophageal manometry is currently considered the gold standard test for the diagnosis of esophageal dysmotility. However, it has shown limited capability in diagnosing GERD. With the advent of high resolution manometry (HRM), more accurate evaluations of esophageal motility are now possible...
March 3, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28260352/extra-esophageal-presentation-of-gerd-new-understanding-in-a-new-era
#8
Irene Martinucci, Eleonora Albano, Santino Marchi, Corrado Blandizzi
Associations of gastroesophageal reflux disease (GERD) with extraesophageal manifestations, such as chronic cough, asthma, and laryngitis, are reported frequently, and there is a strong evidence of biological plausibility in support of this relationship. On the other hand, extraesophageal reflux disease (EERD) is usually multifactorial in nature with reflux being just one of the several potential contributing cofactors. Moreover, the accuracy of currently available diagnostic tests for EERD is suboptimal, and therefore the causal relationship between GERD and EERD remains far from being conclusively proven...
March 3, 2017: Minerva Gastroenterologica e Dietologica
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/28235713/gastroesophageal-reflux-is-not-associated-with-short-term-variability-of-parasympathetic-activity-in-children
#10
Jan Krzysztof Nowak, Agata Łaźniak, Aleksandra Lisowska, Zdzisława Kycler, Waldemar Bobkowski, Jarosław Walkowiak
PURPOSE: A lower parasympathetic activity was described in patients with the gastroesophageal reflux disease. We aimed to determine whether gastroesophageal reflux (GER) episodes are associated with a short-term parasympathetic tone variability in children. METHODS: In order to address this question we performed simultaneous 24-h esophageal multichannel intraluminal impedance-pH and electrocardiographic monitoring in 16 children (age range 6-18 years), including 8 with asthma and 2 with gastroesophageal reflux disease...
February 21, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28220362/the-role-of-impedance-planimetry-in-the-evaluation-of-esophageal-disorders
#11
REVIEW
Nitin K Ahuja, John O Clarke
PURPOSE OF REVIEW: Impedance planimetry measures tissue wall distensibility as a function of pressure and cross-sectional area. Recent interest in this technique's relevance to the gastrointestinal tract has been accelerated by the availability of the functional lumen imaging probe, a catheter-based system that dynamically quantitates these biomechanical properties. Herein, we review the device's particular utility in the setting of esophageal pathology, including processes affecting the esophageal body as well as the upper and lower esophageal sphincters...
February 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28215067/epidemiology-and-natural-history-of-gastro-esophageal-reflux-disease
#12
Edoardo Savarino, Elisa Marabotto, Giorgia Bodini, Gaia Pellegatta, Claudia Coppo, Elisa Giambruno, Matteo Brunacci, Patrizia Zentilin, Vincenzo Savarino
Gastroesophageal reflux disease (GERD) is highly prevalent in Western countries, particularly when considering its most classic symptom, that is heartburn. This symptom is very frequent in the community and ranges from 10% to more than 30%, according to the various population-based studies. This disease is much more represented in Europe and US than in Asiatic countries. It has been shown that GERD prevalence increases in parallel with the remarkable growth of obesity, as this condition is able to favor all the pathogenetic mechanisms leading to it...
February 17, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28212050/volume-controlled-ventilation-does-not-prevent-injurious-inflation-during-spontaneous-effort
#13
Takeshi Yoshida, Susumu Nakahashi, Maria Aparecida Miyuki Nakamura, Yukiko Koyama, Rollin Roldan, Vinicius Torsani, Roberta R De Santis, Susimeire Gomes, Akinori Uchiyama, Marcelo B P Amato, Brian P Kavanagh, Yuji Fujino
RATIONALE: Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and tidal volume, and worsens lung injury. Intuitively, controlling tidal volume and transpulmonary pressure might limit injury from added spontaneous effort. OBJECTIVES: To test the hypothesis that during spontaneous effort in injured lungs, tidal volume and transpulmonary pressure limitation by volume-controlled ventilation results in less injurious patterns of inflation...
February 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28191707/mechanisms-underlying-reflux-symptoms-and-dysphagia-in-patients-with-joint-hypermobility-syndrome-with-and-without-postural-tachycardia-syndrome
#14
A Fikree, Q Aziz, D Sifrim
BACKGROUND: The joint hypermobility syndrome (JHS) is a common non-inflammatory connective tissue disorder which frequently co-exists with postural tachycardia syndrome (PoTS), a form of orthostatic intolerance. Gastrointestinal symptoms and dysmotility have been reported in PoTS. Dysphagia and reflux are common symptoms in JHS, yet no studies have examined the physiological mechanism for these, subdivided by PoTS status. METHODS: Thirty patients (28 female, ages: 18-62) with JHS and symptoms of reflux (n=28) ± dysphagia (n=25), underwent high-resolution manometry and 24 hour pH-impedance monitoring after questionnaire-based symptom assessment...
February 12, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28163259/effects-of-age-on-esophageal-motility-use-of-high-resolution-esophageal-impedance-manometry
#15
Young Kwang Shim, Nayoung Kim, Yo Han Park, Jong-Chan Lee, Jihee Sung, Yoon Jin Choi, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee
Background/Aims: Disturbances of esophageal motility have been reported to be more frequent in aged population. However, the physiology of disturbances in esophageal motility during aging is unclear. The aim of this study was to evaluate the effects of age on the esophageal motility using high-resolution esophageal impedance manometry (HRIM). Methods: Esophageal motor function of 268 subjects were measured using HRIM in 3 age groups, < 40 years (n = 32), 40-65 years (n = 185), and > 65 years (n = 62)...
February 5, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/28161707/pathogenesis-of-double-dose-proton-pump-inhibitor-resistant-non-erosive-reflux-disease-and-mechanism-of-reflux-symptoms-and-gastric-acid-secretion-suppressive-effect-in-the-presence-or-absence-of-helicobacter-pylori-infection
#16
Noriyuki Kawami, Nana Takenouchi, Mariko Umezawa, Shintaro Hoshino, Yuriko Hanada, Yoshimasa Hoshikawa, Hirohito Sano, Yoshio Hoshihara, Tsutomu Nomura, Eiji Uchida, Katsuhiko Iwakiri
BACKGROUND: Various mechanisms have been suggested to be responsible for contributing to the occurrence of proton pump inhibitor (PPI)-resistant non-erosive reflux disease (NERD). The aims of this study were to clarify the pathogenesis of PPI-resistant NERD. METHODS: Fifty-three patients with NERD, who had persistent reflux symptoms despite taking double-dose PPI, were included in this study. After excluding eosinophilic esophagitis (EoE) and primary esophageal motility disorder, esophageal impedance-pH monitoring was carried out...
2017: Digestion
https://www.readbyqxmd.com/read/28151867/an-analysis-of-342-patients-with-refractory-gastroesophageal-reflux-disease-symptoms-using-questionnaires-high-resolution-manometry-and-impedance-ph-monitoring
#17
Fei Wang, Ping Li, Guo-Zhong Ji, Lin Miao, Zhining Fan, Sihong You, Xueqin Pan, Xia Chen
Symptoms of refractory gastroesophageal reflux disease (GERD) are commonly encountered in clinical practice. The aim of this study was to analyze the data obtained from questionnaires, high-resolution manometry (HRM), and ambulatory impedance-pH monitoring in patients with persisting GERD symptoms and to explore the possible underlying causes for this clinical presentation. After completing the questionnaires, the selected patients underwent endoscopy, HRM, and ambulatory impedance-pH monitoring. Based on the results of these investigations, we divided the patients into 4 groups: reflux esophagitis (RE), hypersensitive esophagus (HE), functional heartburn (FH), and nonerosive gastroesophageal reflux disease (NERD)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28150011/-relationship-between-functional-endoscopy-and-impedance-ph-measurement-german-version
#18
F Michel, T Stroh, R Fritsche, P Ahrens
Classic gastroenterological diagnostic tools are proving increasingly insufficient for analyzing the complex causal relationship between extra-esophageal symptoms and presumed pathological reflux activity. Some new methodological approaches, such as functional endoscopy (videopanendoscopy, VPE), are considered to be helpful. However, there are currently no data objectively verifying the usefulness of this method. In a pilot study, a good correlation between the reflux symptom index (RSI) and endoscopic findings was shown...
February 1, 2017: HNO
https://www.readbyqxmd.com/read/28144844/surveillance-in-patients-with-esophageal-atresia-tracheoesophageal-fistula
#19
REVIEW
Arunjot Singh, William Middlesworth, Julie Khlevner
PURPOSE OF REVIEW: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a congenital aerodigestive anomaly with high survival rates after surgical repair. Care should now be focused on prevention of long-term complications using appropriate surveillance techniques. RECENT FINDINGS: The incidence of gastroesophageal reflux disease (GERD) is high in patients with EA/TEF. Consequences of untreated GERD include esophagitis, strictures, and Barrett esophagus. Subjective symptoms are an unreliable indicator of presence or severity of GERD, and therefore, diagnostic testing is needed to assess esophageal heath and monitor the effectiveness of anti-reflux treatment...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28133879/normal-values-of-esophageal-pressure-responses-to-a-rapid-drink-challenge-test-in-healthy-subjects-results-of-a-multicenter-study
#20
I Marin, D Cisternas, L Abrao, E Lemme, C Bilder, A Ditaranto, R Coello, A Hani, A M Leguizamo, A Meixueiro, J Remes-Troche, M A Zavala, A Ruiz de León, J Perez de la Serna, M A Valdovinos, J Serra
BACKGROUND: Multiple water swallow is increasingly used as a complementary challenge test in patients undergoing high-resolution manometry (HRM). Our aim was to establish the range of normal pressure responses during the rapid drink challenge test in a large population of healthy subjects. METHODS: Pressure responses to a rapid drink challenge test (100 or 200 mL of water) were prospectively analyzed in 105 healthy subjects studied in nine different hospitals from different countries...
January 29, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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