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gastroesophageal reflex disease

Yue Zhang, Shenhong Wu
Gastric cancer (GC) is a common lethal malignancy. Gastroesophageal junction and gastric cardia tumors are the fastest rising malignancies due to increasing prevalence of obesity and acid reflex in the United States. Traditional chemotherapy remains the main treatment with trastuzumab targeting human epidermal growth factor receptor 2 positive disease. The median overall survival (OS) is less than one year for advanced GC patients; thus, there is an urgent unmet need to develop novel therapy for GC. Although multiple targeted agents were studied, only the vascular endothelial growth factor receptor inhibitor ramucirumab was approved recently by the United States Food and Drug Administration because of its 1...
November 15, 2015: World Journal of Gastrointestinal Oncology
Arash Babaei, Mukund Venu, Sohrab Rahimi Naini, Jason Gonzaga, Ivan M Lang, Benson T Massey, Sudarshan Jadcherla, Reza Shaker
BACKGROUND & AIMS: Normal responses of the upper esophageal sphincter (UES) and esophageal body to liquid reflux events prevent esophagopharyngeal reflux and its complications, however, abnormal responses have not been characterized. We investigated whether patients with supraesophageal reflux disease (SERD) have impaired UES and esophageal body responses to simulated reflux events. METHODS: We performed a prospective study of 25 patients with SERD (age, 19-82 y; 13 women) and complaints of regurgitation and supraesophageal manifestations of reflux...
November 2015: Gastroenterology
Branislav Milovanovic, Branka Filipovic, Slavica Mutavdzin, Marija Zdravkovic, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic
AIM: To investigate autonomic nervous function in patients with a diagnosis of gastroesophageal reflux disease (GERD). METHODS: The investigation was performed on 29 patients (14 men), aged 18-80 years (51.14 ± 18.34), who were referred to our Neurocardiology Laboratory at the Clinical and Hospital Center "Bezanijska Kosa" with a diagnosis of GERD. One hundred sixteen healthy volunteers matched in age and sex with the examinees served as the control group. The study protocol included the evaluation of autonomic function and hemodynamic status, short-term heart rate variability (HRV) analysis, 24 h ambulatory ECG monitoring with long-term HRV analysis and 24 h ambulatory blood pressure monitoring...
June 14, 2015: World Journal of Gastroenterology: WJG
Bi-Yu Liu, Yu-Jung Lin, Hung-Fu Lee, Ching-Yin Ho, Ting Ruan, Yu Ru Kou
Patients with gastroesophageal reflux disease (GERD) display enhanced laryngeal reflex reactivity to stimuli that may be due to sensitization of the laryngeal C-fibers by acid and pepsin. Menthol, a ligand of transient receptor potential melastatin-8 (TRPM8), relieves throat irritation. However, the possibility that GERD induces laryngeal C-fiber hypersensitivity to cigarette smoke (CS) and that menthol suppresses this event has not been investigated. We delivered CS into functionally isolated larynxes of 160 anesthetized rats...
March 1, 2015: Journal of Applied Physiology
M Proesmans, M Vreys, E Huenaerts, E Haest, S Coremans, F Vermeulen, H Feys
BACKGROUND: 'Profound intellectual and multiple disability' (PIMD) is defined as a profound cognitive disability with severe sensory and motor impairments. The aim of this study was to evaluate the respiratory morbidity in children with PIMD and investigate possible risk factors. METHODS: In 10 specialized facilities for daily care of patients with PIMD, children underwent a standardized clinical assessment evaluating respiratory and motor function. Additional medical information was obtained...
October 2015: Pediatric Pulmonology
Boudewijn F Kessing, Albert J Bredenoord, André J P M Smout
Excessive belching is a commonly observed complaint in clinical practice that can occur not only as an isolated symptom but also as a concomitant symptom in patients with gastroesophageal reflux disease (GERD) or functional dyspepsia. Impedance monitoring has revealed that there are two mechanisms through which belching can occur: the gastric belch and the supragastric belch. The gastric belch is the result of a vagally mediated reflex leading to relaxation of the lower esophageal sphincter and venting of gastric air...
August 2014: American Journal of Gastroenterology
P V Dicpinigaitis, A H Morice, S S Birring, L McGarvey, J A Smith, B J Canning, C P Page
Cough remains a serious unmet clinical problem, both as a symptom of a range of other conditions such as asthma, chronic obstructive pulmonary disease, gastroesophageal reflux, and as a problem in its own right in patients with chronic cough of unknown origin. This article reviews our current understanding of the pathogenesis of cough and the hypertussive state characterizing a number of diseases as well as reviewing the evidence for the different classes of antitussive drug currently in clinical use. For completeness, the review also discusses a number of major drug classes often clinically used to treat cough but that are not generally classified as antitussive drugs...
2014: Pharmacological Reviews
Tomasz Skoczylas, Harathi Yandrapu, Cezary Poplawski, Mazen Asadi, Grzegorz Wallner, Jerzy Sarosiek
BACKGROUND: It has been previously demonstrated that the exposure of the lower esophageal mucosa to acid and pepsin results in significant increase in salivary protective factors secretion, mediated by the esophago-salivary reflex. The impact of the upper esophageal mucosal exposure to acid and pepsin on salivary secretory response remains unknown. AIMS: To investigate the rate of salivary protective factors secretion during the upper esophageal mucosal exposure to acid and pepsin and to compare with the corresponding results recorded during the lower esophageal mucosal exposure, in the same group of asymptomatic volunteers...
October 2014: Digestive Diseases and Sciences
Mei-Chi Lin, Chia-Lin Lee, Chea-Ying Chen, Ruey-Horng Rau
Due to smaller incisions, fewer wound injuries, and a shorter time of recovery, laparoscopic procedures are becoming increasingly popular in pediatric surgery, but the safety of their application in low-body-weight or premature infants should be a major concern. Here we present a case report of a 3-month-old premature infant, who developed a sudden change of hemodynamic instability while undergoing a laparoscopic Nissen's fundoplication for gastroesophageal reflex disease. This was thought to result from an accidental passage of massive insufflation of carbon dioxide gas across the diaphragm, leading to pneumomediastinum...
December 2013: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Rayid Abdulqawi, Lesley A Houghton, Jaclyn A Smith
Gastro-oesophageal reflux, either singly or in association with postnasal drip and/or asthma is considered to be a cause of chronic cough. The amount and nature of gastro-oesophageal reflux however is often normal with acid suppression having very little, if any therapeutic effect in these patients. This review examines the challenges posed when exploring the reflux-cough link, and discusses the merits and limitations of the proposed mechanisms of reflux leading to cough.
May 2013: Journal of the Association of Physicians of India
Yasumitsu Hirano, Noriyuki Inaki, Norihiko Ishikawa, Go Watanabe
Radius surgical system (RSS) is a manual manipulator to enhance the surgeon's dexterity and ergonomy achieving more degrees of freedom, and it enables us easy to perform intracorporeal suturing in laparoscopic surgery. We successfully performed laparoscopic treatment including intracorporeal suturing in cases of esophageal achalasia and gastroesophageal reflux disease using RSS. RSS may facilitate of intracorporeal suturing and knotting in complex laparoscopic procedures.
June 2013: Indian Journal of Surgery
Payman Dabirmoghaddam, Amin Amali, Maziar Motiee Langroudi, Mohammad Reza Samavati Fard, Mona Hejazi, Masoud Sharifian Razavi
Laryngopharyngeal reflux (LPR) is a variant of gastroesophageal reflux disease (GERD) in which the stomach contents go up into the pharynx and then down into the larynx. LPR causes a wide spectrum of manifestations mainly related to the upper and the lower respiratory system such as laryngitis, asthma, chronic obstructive pulmonary disease, cough, hoarseness, postnasal drip disease, sinusitis, otitis media, recurrent pneumonia, laryngeal cancer and etc. The object of this study was to examine the effect of N-acetyl Cysteine (NAC) with and without Omeprazole on laryngitis and LPR...
2013: Acta Medica Iranica
Peter G Gibson, Jodie L Simpson, Nicole M Ryan, Anne E Vertigan
PURPOSE OF REVIEW: To review recent developments in the mechanisms of chronic cough. RECENT FINDINGS: Although cough prevalence is similar across the world, there are significant regional differences in the diseases associated with cough. This may represent regional differences in diet, environmental exposure, and diagnostic assessment and labelling. Cough can be reliably measured using several validated questionnaires and objective tools that monitor cough frequency and cough reflex sensitivity...
February 2014: Current Opinion in Allergy and Clinical Immunology
M Couto, A de Diego, M Perpiñi, L Delgado, A Moreira
A high parasympathetic tone leading to bronchoconstriction and neurogenic inflammation is thought to have a major role in the pathogenesis of asthma. Transient receptor potential vanilloid 1 (TRPV1) is the hub of almost all neuronal inflammatory signaling pathways. A critical determinant of neurogenic inflammation, TRPV1 functions as a sensor for detecting irritants in the lung by transmitting noxious stimuli to the central nervous system and inducing the release of a variety of proinflammatory neuropeptides at the peripheral terminals...
2013: Journal of Investigational Allergology & Clinical Immunology
Peter J Kahrilas, Jaclyn A Smith, Peter V Dicpinigaitis
Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies of chronic cough. Indeed, cough management guidelines published by numerous respiratory societies worldwide recommend evaluation and treatment of GERD as an integral component of the diagnostic/therapeutic algorithm for the management of chronic cough. However, a significant number of patients with chronic cough presumed due to GERD do not report improvement despite aggressive acid-suppressive therapy...
February 2014: Lung
Megan M Cornere
PURPOSE OF REVIEW: This article reviews the common causes and investigation of chronic cough and explores unexplained cough and its relationship to cough hypersensitivity. RECENT FINDINGS: Cough plays a critical role in airway protection and clearance of secretions. Chronic cough, however, is a debilitating symptom that can significantly interfere with quality of life. Despite their limitations cough guidelines have raised the awareness of chronic cough as an important problem and provided a framework for a logical care pathway...
December 2013: Current Opinion in Otolaryngology & Head and Neck Surgery
Susan M Harding, Jacqui E Allen, Joel H Blumin, Elizabeth A Warner, Carlos A Pellegrini, Walter W Chan
Gastroesophageal reflux disease (GERD) is highly associated with a range of respiratory symptoms, arising from a variety of etiologies. The following commentaries on respiratory manifestations of GERD address evidence for a role of a vagally mediated bronchoconstriction reflex in the development of asthma; the direct effects of airway obstruction on lower esophageal sphincter (LES) pressure and reflux episodes; the mechanisms by which reflux may play roles in chronic cough and airway stenosis; the limited efficacy of laparoscopic antireflux surgery (LARS) in improving GERD-related respiratory symptoms; the search for a marker for microaspiration and reflux-induced airway disease; and the potential of proton pump inhibitor (PPI) treatment for patients presenting with asthma and GERD...
October 2013: Annals of the New York Academy of Sciences
Miguel Ângelo Nobre e Souza, Maria Josire Vitorino Lima, Giovanni Bezerra Martins, Rivianny Arrais Nobre, Marcellus Henrique Loiola Ponte Souza, Ricardo Brandt de Oliveira, Armênio Aguiar dos Santos
The crural diaphragm (CD) is an essential component of the esophagogastric junction (EGJ), and inspiratory exercises may modify its function. This study's goal is to verify if inspiratory muscle training (IMT) improves EGJ motility and gastroesophageal reflux (GER). Twelve GER disease [GERD; 7 males, 20-47 yr, 9 esophagitis, and 3 nonerosive reflex disease (NERD)] and 7 healthy volunteers (3 males, 20-41 yr) performed esophageal pH monitoring, manometry, and heart rate variability (HRV) studies. A 6-cm sleeve catheter measured average EGJ pressure during resting, peak inspiratory EGJ pressures during sinus arrhythmia maneuver (SAM) and inhalations under 17-, 35-, and 70-cmH2O loads (TH maneuvers), and along 1 h after a meal...
December 2013: American Journal of Physiology. Gastrointestinal and Liver Physiology
Vivek N Iyer, Kaiser G Lim
Cough persisting beyond 8 weeks (ie, chronic cough) is one of the most common reasons for an outpatient visit. A protracted cough can negatively affect one's quality of life by causing anxiety, physical discomfort, social isolation, and personal embarrassment. Herein, the anatomy and physiology of the cough reflex are reviewed. Upper airway cough syndrome, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease account for most chronic cough after excluding smoking, angiotensin-converting enzyme inhibitor use, and chronic bronchitis...
October 2013: Mayo Clinic Proceedings
Ahmad Kantar, Roberto Bernardini, Francesco Paravati, Domenico Minasi, Oliviero Sacco
Cough may be the first overt sign of disease of the airways or lungs when it represents more than a defense mechanism, and may by its persistence become a helpful pointer of potential disease for both patient and physician. On the other hand, impairment or absence of the coughing mechanism can be harmful and even fatal; this is why cough suppression is rarely indicated in childhood. Pediatricians are concerned more with the etiology of the cough and making the right diagnosis. Whereas chronic cough in adults has been universally defined as a cough that lasts more than 8 weeks, in childhood, different timing has been reported...
October 2013: Early Human Development
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