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Refractory reflux disease

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https://www.readbyqxmd.com/read/29447372/small-fiber-polyneuropathy-is-prevalent-in-patients-experiencing-complex-chronic-pelvic-pain
#1
Annie Chen, Elise De, Charles Argoff
Objective: To demonstrate the prevalence of small fiber polyneuropathy (SFPN) in patients with refractory chronic pelvic pain (CPP). Design: Retrospective study of prospective database. Subjects: Participants were complex CPP patients recruited from subspecity referral clinics defined as those who were refractory to initial treatment and/or exhibited comorbid pain syndromes at initial presentation. Methods: Comprehensive treatment history for CPP was obtained, and participants referred as above; 3-mm punch biopsies were obtained of the lower extremity and sent to diagnostic reference labs to evaluate for SFPN...
February 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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
#2
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/29405886/the-tempo-trial-at-5-years-transoral-fundoplication-tif-2-0-is-safe-durable-and-cost-effective
#3
Karim S Trad, William E Barnes, Elizabeth R Prevou, Gilbert Simoni, Jennifer A Steffen, Ahmad B Shughoury, Mamoon Raza, Jeffrey A Heise, Mark A Fox, Peter G Mavrelis
BACKGROUND: Questions remain about the therapeutic durability of transoral incisionless fundoplication (TIF). In this study, clinical outcomes were evaluated at 5 years post-TIF 2.0. METHODS: A total of 63 chronic gastroesophageal reflux disease (GERD) sufferers with troublesome symptoms refractory to proton pump inhibitor (PPI) therapy, absent or ≤2 cm hiatal hernia, and abnormal esophageal acid exposure were randomized to the TIF group or PPI group. Following the 6-month evaluation, all patients in the PPI group elected for crossover to TIF; therefore, all 63 patients underwent TIF 2...
February 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29372566/symptom-associated-probability-does-not-reliably-distinguish-functional-heartburn-from-reflux-hypersensitivity
#4
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/29352757/refractory-heartburn-a-challenging-problem-in-clinical-practice
#5
REVIEW
Gerson Domingues, Joaquim Prado P Moraes-Filho, Ronnie Fass
Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Heartburn and regurgitation are the typical symptoms of GERD. The treatment of GERD encompasses lifestyle modifications, pharmacological, endoscopic, and surgical therapy. The majority of the patients respond to 4-8 weeks of proton-pump inhibitors therapy, but 20-42% will demonstrate partial or complete lack of response to treatment. While these patients have been considered as having refractory heartburn, a subset of them does not have GERD or have not been adequately treated...
January 20, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29346118/mycobacterium-avium-complex-pulmonary-disease-new-epidemiology-and-management-concepts
#6
Leah Lande, Jason George, Theodore Plush
PURPOSE OF REVIEW: The prevalence of Mycobacterium avium complex (MAC)-related pulmonary disease has been increasing because of environmental factors, changes in organism virulence, and evolving host susceptibility. Treatment is often complicated by adverse effects, development of drug resistance, and refractory disease, with recurrence rates as high as 25-45%. RECENT FINDINGS: Aerosolization of water, soil, or dusts are the likely sources of MAC-related pulmonary disease in susceptible individuals...
January 15, 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29340828/hiatal-hernia-recurrence-following-magnetic-sphincter-augmentation-and-posterior-cruroplasty-intermediate-term-outcomes
#7
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/29282192/mast-cell-activation-syndrome
#8
Owen N Kramer, Marla S Barkoff, Claudia Hernandez
A 51-year-old woman with a history of asthma and Hashimoto's thyroiditis presented to the dermatology service with a chief complaint of "itchy bumpy rashes" that persisted beyond 24 hours. She noted that, 3 days prior to the onset of urticaria, a pyrroloquinoline quinone supplement had been started. The urticaria was accompanied by variable episodes of transient facial swelling and difficulty breathing. The patient noted that exposure to fish, nuts, and nonsteroidal anti-inflammatory drugs triggered facial swelling...
2017: Skinmed
https://www.readbyqxmd.com/read/29275582/-effect-analysis-on-deanxit-combined-with-shuganjieyu-capsule-in-the-treatment-of-refractory-gastroesophageal-reflux-disease
#9
X Y Yang, C Y Guo, X Zhang, Y Q Zhong, C Tian
Objective: To investigate the curative effect of Deanxit combined with Shuganjieyu capsule on the treatment of refractory gastroesophageal reflux disease. Methods: A total of 125 patients with refractory gastroesophageal reflux disease who had failed in standard lansolazole capsule treatment in the Department of Gastroenterology, First People's Hospital of Neijiang were selected. According to the symptom scores and mood scores of gastroesophageal reflux disease, patients were randomly and double-blindly divided into five groups...
November 28, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29234939/the-role-of-preoperative-high-resolution-manometry-in-predicting-dysphagia-after-laparoscopic-nissen-fundoplication
#10
Sonam Kapadia, Turner Osler, Allen Lee, Edward Borrazzo
BACKGROUND: Laparoscopic fundoplication is an accepted surgical management of refractory gastro-esophageal reflux disease (GERD). The use of high resolution esophageal manometry (HRM) in preoperative evaluation is often applied to determine the degree of fundoplication to optimize reflux control while minimizing adverse sequela of postoperative dysphagia. OBJECTIVE: Assess the role of preoperative HRM in predicting surgical outcomes, specifically risk assessment of postoperative dysphagia and quality of life, among patients receiving laparoscopic Nissen fundoplication for GERD with immediate postoperative (< 4 weeks clinic), short-term (3-month clinic), and long-term (34 ± 10...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29209919/association-between-cyp2c19-extensive-metabolizer-phenotype-and-childhood-anti-reflux-surgery-following-failed-proton-pump-inhibitor-medication-treatment
#11
James P Franciosi, Edward B Mougey, Andre Williams, Roberto A Gomez Suarez, Cameron Thomas, Christa L Creech, Katherine George, Diana Corao, John J Lima
When pediatric gastroesophageal reflux disease (GERD) that is refractory to proton pump inhibitor (PPI) medication treatment is identified in clinical practice and anti-reflux surgery (ARS) is being considered, genetic factors related to PPI metabolism by the CYP2C19 enzyme are currently not part of the clinical decision-making process. Our objective was to test the hypothesis that the distribution of the extensive metabolizer (EM) phenotypes among children undergoing ARS after failing PPI therapy would differ compared to controls (children with no history of ARS)...
January 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29201809/long-esophageal-stricture-in-a-brittle-diabetic
#12
Stella C Pak, Umar Darr, Yaseen Alastal, Youngsook Yoon
Aim: We report a case of atypical esophageal stricture in a young diabetic woman. Background: Diabetes mellitus and gastroesophageal reflux disease (GERD) are two common disorders in modern society. Case report: A young diabetic woman developed a 6-cm-long esophageal stricture. This stricture was refractory to multiple esophageal dilation procedures. She underwent subtotal esophagectomy and had excellent treatment outcome. Conclusion: Gastroesophageal reflux disease can cause severe long esophageal stricture in a brittle diabetic...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29199161/indications-of-24-h-esophageal-ph-monitoring-capsule-ph-monitoring-combined-ph-monitoring-with-multichannel-impedance-esophageal-manometry-radiology-and-scintigraphy-in-gastroesophageal-reflux-disease
#13
Rukiye Vardar, Muharrem Keskin
Ambulatory esophageal pH monitoring is an essential method in patients exhibiting signs of non-erosive reflux disease (NERD) to make an objective diagnosis. Intra-esophageal pH monitoring is important in patients who are non-responsive to medications and in those with extraesophageal symptoms, particularly in NERD, before surgical interventions. With the help of the wireless capsule pH monitoring, measurements can be made under more physiological conditions as well as longer recordings can be performed because the investigation can be better tolerated by patients...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29193785/contribution-of-hiatal-hernia-to-asthma-in-patients-with-gastroesophageal-reflux-disease
#14
Zhi-Tong Li, Feng Ji, Xin-Wei Han, Lin-Xia Gu, Li Wang, Yong-Qiang Yue, Zhong-Gao Wang
BACKGROUND: To determine the correlation between asthma and hiatal hernia (HH) in patients with gastroesophageal reflux disease (GERD)-related asthma requiring laparoscopic anti-reflux surgery. METHODS: One hundred and thirty-six GERD patients with medically refractory asthma with (80 patients) or without HH (56 patients) were enrolled. Gastroesophageal reflux disease was assessed by endoscopy, esophageal manometry, reflux monitoring and symptom questionnaires, and treated with laparoscopic Nissen fundoplication (LNF) or LNF with concomitant hiatal hernia repair (LNF-HHR)...
November 28, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29110162/recent-advances-in-the-pharmacological-management-of-gastroesophageal-reflux-disease
#15
REVIEW
Yu-Min Kung, Wen-Hung Hsu, Meng-Chieh Wu, Jiunn-Wei Wang, Chung-Jung Liu, Yu-Chung Su, Chao-Hung Kuo, Fu-Chen Kuo, Deng-Chyang Wu, Yao-Kuang Wang
The management of proton pump inhibitor-refractory GERD (rGERD) is a challenge in clinical practice. Since up to one-third of patients with typical GERD symptoms (heartburn and/or acid regurgitation) are not satisfied with proton pump inhibitor (PPI) therapy, new drug development targeting different pathophysiologies of GERD is imperative. At present, no other drugs serve as a more potent acid suppression agent than PPIs. As an add-on therapy, histamine type-2 receptor antagonists, alginates, prokinetics and transient lower esophageal sphincter relaxation inhibitors have some impact on the subgroups of rGERD, but greater effectiveness and fewer adverse effects for widespread use are required...
December 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29109876/debut-of-gastroesophageal-reflux-concomitant-with-administration-of-sublingual-immunotherapy
#16
Jacob Juel
Gastroesophageal reflux disease (GORD) is an often debilitating condition characterised by retrograde flow of content from stomach into the oesophagus, where the low pH of the stomach acid irritates the mucosa of the oesophagus. The most dominant symptoms in GORD are pyrosis, regurgitation, and dysphagia. Sublingual immunotherapy (SLIT) was first described in 1986. Following this description, the use has greatly increased in the treatment of allergic rhinitis, as an alternative to subcutaneously administered immunotherapy...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29104130/diaphragmatic-breathing-reduces-belching-and-proton-pump-inhibitor-refractory-gastroesophageal-reflux-symptoms
#17
Andrew Ming-Liang Ong, Laura Teng-Teng Chua, Christopher Jen-Lock Khor, Ravishankar Asokkumar, Vikneswaran S/O Namasivayam, Yu-Tien Wang
BACKGROUND & AIMS: In patients with gastroesophageal reflux disease (GERD) and excessive belching, most belches are supragastric, and can induce reflux episodes and worsen GERD. Supragastric belching (SGB) might be reduced with diaphragmatic breathing exercises. We investigated whether diaphragmatic breathing therapy is effective in reducing belching and proton pump inhibitor (PPI)-refractory gastroesophageal reflux symptoms. METHODS: We performed a prospective study of 36 consecutive patients with GERD refractory to PPI therapy and a belching visual analogue scale (VAS) score of 6 or more, seen at a gastroenterology clinic at a tertiary hospital in Singapore from April 2015 through October 2016...
December 22, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29094873/chronic-cough-evaluation-and-management
#18
REVIEW
Charlie Michaudet, John Malaty
Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic bronchitis. Patients should be evaluated clinically (with spirometry, if indicated), and empiric treatment should be initiated. Other potential causes include angiotensin-converting enzyme inhibitor use, environmental triggers, tobacco use, chronic obstructive pulmonary disease, and obstructive sleep apnea...
November 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29071486/fragments-of-e-cadherin-as-biomarkers-of-non-erosive-reflux-disease
#19
Biljana Jovov, Craig C Reed, Nicholas J Shaheen, Amy Pruitt, Kathleen Ferrell, Geraldine S Orlando, Zorka Djukic, Roy C Orlando
BACKGROUND: Approximately, 20% of patients with heartburn and normal endoscopic findings do not symptomatically improve on proton pump inhibitor (PPI) therapy making diagnosis and treatment uncertain. A biomarker distinguishing PPI-responsive from PPI-refractory heartburn is desirable. AIMS: We performed a pilot study assessing whether carboxy(C)-terminal fragments (CTFs) of e-cadherin in esophageal biopsies or amino(N)-terminal fragments (NTFs) of e-cadherin in serum could serve this purpose...
October 25, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29060954/-the-additional-role-of-symptom-reflux-association-analysis-of-diagnosis-of-gastroesophageal-reflux-disease-using-bravo-capsule-ph-test
#20
Kyoungwon Jung, Moo In Park, Seun Ja Park, Won Moon, Sung Eun Kim, Jae Hyun Kim
Background/Aims: Since the development of ambulatory esophageal pH monitoring test to diagnose gastroesophageal reflux disease (GERD), several parameters have been introduced. The aim of this study was to assess whether using the symptom index (SI), symptom sensitivity index (SSI), and symptom association probability (SAP), in addition to the DeMeester score (DS), would be useful for interpreting the Bravo pH monitoring test. Methods: A retrospective study, which included 68 patients with reflux symptoms refractory to proton pump inhibitor (PPI) therapy who underwent a Bravo capsule pH test between October 2006 and May 2015, was carried out...
October 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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