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Refractory reflux disease

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https://www.readbyqxmd.com/read/28088386/trypsin-induces-biphasic-muscle-contraction-and-relaxation-via-transient-receptor-potential-vanilloid-1-and-neurokinin-receptors-1-2-in-porcine-esophageal-body
#1
Bai Xiaopeng, Yoshimasa Tanaka, Eikichi Ihara, Katsuya Hirano, Kayoko Nakano, Mayumi Hirano, Yoshinao Oda, Kazuhiko Nakamura
Duodenal reflux of fluids containing trypsin relates to refractory gastroesophageal reflux disease (GERD). Esophageal peristalsis and clearance are important factors in GERD pathogenesis. However, the function of trypsin in esophageal body contractility is not fully understood. In this study, effects of trypsin on circular smooth muscle (CSM) and longitudinal smooth muscle (LSM) of the porcine esophageal body were examined. Trypsin elicited a concentration dependent biphasic response, a major contraction and a subsequent relaxation only in CSM...
January 11, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28039654/radiofrequency-energy-delivery-to-the-lower-esophageal-sphincter-improves-gastroesophageal-reflux-patient-reported-outcomes-in-failed-laparoscopic-nissen-fundoplication-cohort
#2
Mark Noar, Patrick Squires, Sulman Khan
BACKGROUND: Patients with uncontrollable gastroesophageal reflux disease (GERD) often undergo laparoscopic Nissen fundoplication (LNF); however, long-term there are often recurring symptoms and need for continuous medication use. Refractory LNF patients may receive radiofrequency energy delivery to the lower esophageal sphincter (Stretta) to ameliorate symptoms and medication requirements. The aim was to assess and compare long-term patient-reported outcomes of Stretta in refractory patients with and without previous LNF...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27981382/linx-%C3%A2-magnetic-esophageal-sphincter-augmentation-versus-nissen-fundoplication-for-gastroesophageal-reflux-disease-a-systematic-review-and-meta-analysis
#3
Daniel Skubleny, Noah J Switzer, Jerry Dang, Richdeep S Gill, Xinzhe Shi, Christopher de Gara, Daniel W Birch, Clarence Wong, Matthew M Hutter, Shahzeer Karmali
BACKGROUND: The LINX(®) magnetic sphincter augmentation system (MSA) is a surgical technique with short-term evidence demonstrating efficacy in the treatment of medically refractory or chronic gastroesophageal reflux disease (GERD). Currently, the Nissen fundoplication is the gold-standard surgical treatment for GERD. We are the first to systematically review the literature and perform a meta-analysis comparing MSA to the Nissen fundoplication. METHODS: A comprehensive search of electronic databases (e...
December 15, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27977904/adenosine-triphosphate-induces-p2y2-activation-and-il-8-release-in-human-esophageal-epithelial-cells
#4
Liping Wu, Tadayuki Oshima, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
BACKGROUND AND AIM: Immune-mediated mucosal inflammation characterized by the release of IL-8 is associated with gastroesophageal reflux disease (GERD). ATP released by human esophageal epithelial cells mediates the release of cytokines through P2 nucleotide receptors that are present on various cells, including human esophageal epithelial cells. This study characterized and identified human esophageal epithelial P2 receptors that are responsible for ATP-mediated release of IL-8 by using a human esophageal stratified squamous epithelial model...
December 15, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27933133/pre-operative-clinical-and-instrumental-factors-as-antireflux-surgery-outcome-predictors
#5
REVIEW
Salvatore Tolone, Giorgia Gualtieri, Edoardo Savarino, Marzio Frazzoni, Nicola de Bortoli, Manuele Furnari, Giuseppina Casalino, Simona Parisi, Vincenzo Savarino, Ludovico Docimo
Gastroesophageal reflux disease (GERD) is nowadays a highly prevalent, chronic condition, with 10% to 30% of Western populations affected by weekly symptoms. Many patients with mild reflux symptoms are treated adequately with lifestyle modifications, dietary changes, and low-dose proton pump inhibitors (PPIs). For those with refractory GERD poorly controlled with daily PPIs, numerous treatment options exist. Fundoplication is currently the most commonly performed antireflux operation for management of GERD...
November 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27922988/minimally-invasive-fundoplication-is-safe-and-effective-in-patients-with-severe-esophageal-hypomotility
#6
Michael B Goldberg, Abbas El-Sayed Abbas, Michael S Smith, Henry P Parkman, Ron Schey, Daniel T Dempsey
OBJECTIVE: Fundoplication is used to treat refractory gastroesophageal reflux disease (GERD). A subset of patients has coexisting esophageal dysmotility, including aperistalsis or hypoperistalsis. These patients may be at increased risk of dysphagia after fundoplication. To evaluate the outcomes of minimally invasive fundoplication (MIF) in patients with GERD and esophageal hypomotility. METHODS: Retrospective review of all patients who underwent MIF and had severe esophageal hypomotility from January 2003 to June 2013...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27908388/the-unknown-association-of-ppis-with-chest-pain-in-patients-with-known-treated-coronary-artery-disease-a-diagnostic-dilemma
#7
Fahad Javed, Stephen Ramee
Patients with coronary artery disease (CAD) are destined to lifelong antiplatelet therapy in form of aspirin (acetylsalicylic acid) alone, or in combination with other P2Y2 inhibitors. Proton pump inhibitors (PPIs) are the preferred agents for the treatment and prophylaxis of gastrointestinal injury associated with nonsteroidal anti-inflammatory drug or acetylsalicylic acid or both,(1) but recent data has raised questions about their association with negative cardiovascular events. We report 2 cases of patients with known CAD presented with chest pain mimicking angina pectoris that successfully resolved on discontinuation of the PPIs...
July 2016: Current Problems in Cardiology
https://www.readbyqxmd.com/read/27896821/clinical-symptom-tool-that-raises-the-index-of-suspicion-for-eosinophilic-oesophagitis-in-adults-and-drives-earlier-biopsy-for-definitive-diagnosis
#8
U von Arnim, F-W Röhl, S Miehlke, D Jechorek, D Reinhold, T Wex, P Malfertheiner
BACKGROUND: Eosinophilic oesophagitis (EoE) and gastro-oesophageal reflux disease (GERD) present with overlapping symptomatology and it is challenging to distinguish EoE from GERD clinically before endoscopy. AIM: To investigate the prognostic value of a set of clinical symptoms and laboratory values in patients with EoE and GERD. METHODS: In this prospective, single-centre, observational study, we compared clinical and laboratory data from 202 patients with EoE or GERD (10 relevant characteristics)...
February 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27888864/oesophageal-disease-gastroesophageal-reflux-disease-barrett-s-oesophagus-achalasia-and-eosinophilic-oesophagitis
#9
Xavier Calvet
The most interesting conclusions and/or advances presented at Digestive Disease Week 2016 were the following: a) gastroesophageal reflux disease: proton pump inhibitor-refractory reflux disease is frequently associated with poor treatment adherence, psychiatric comorbidities and functional gastrointestinal disorders. These possible entities should be investigated in all cases of proton pump inhibitor-refractory reflux disease; b) Barrett's oesophagus: the efficacy of screening remains unclear; however, new minimally-invasive techniques such as the cytosponge allow more effective detection, both of Barrett's oesophagus and Barrett's oesophagus-associated dysplasia or neoplasia; c) achalasia: evidence indicates that peroral endoscopic myotomy is as effective as surgery and is a safer alternative; d) eosinophilic oesophagitis: high-dose proton pump inhibitors are required to rule out proton pump inhibitor-responsive eosinophilic oesophagitis; montelukast is not clearly effective in the treatment of eosinophilic oesophagitis, although moderate efficacy cannot be ruled out...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27825371/effective-and-safe-proton-pump-inhibitor-therapy-in-acid-related-diseases-a-position-paper-addressing-benefits-and-potential-harms-of-acid-suppression
#10
EDITORIAL
Carmelo Scarpignato, Luigi Gatta, Angelo Zullo, Corrado Blandizzi
BACKGROUND: The introduction of proton pump inhibitors (PPIs) into clinical practice has revolutionized the management of acid-related diseases. Studies in primary care and emergency settings suggest that PPIs are frequently prescribed for inappropriate indications or for indications where their use offers little benefit. Inappropriate PPI use is a matter of great concern, especially in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions...
November 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27796767/endoluminal-therapy-for-gastroesophageal-reflux-disease-in-between-the-pill-and-the-knife
#11
REVIEW
Tony S Brar, Peter V Draganov, Dennis Yang
Gastroesophageal reflux disease (GERD) is a chronic disease characterized by symptoms of heartburn and acid regurgitation. Uncontrolled GERD can significantly impact quality of life, can lead to complications, and increases the risk of esophageal cancer. Over the past few decades, there has been an increasing prevalence of GERD among adults in Western populations. The use of proton pump inhibitors (PPI) in conjunction with lifestyle modifications remains the mainstay therapy. However, the efficacy of this intervention is often hampered by adherence, costs, and the risks of long-term PPI use...
January 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27766409/laser-tracheobronchoplasty-a-novel-technique-for-the-treatment-of-symptomatic-tracheobronchomalacia
#12
Paul Castellanos, Manjunath Mk, Ihab Atallah
The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years...
October 20, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27736035/role-of-non-acid-gastro-esophageal-reflux-in-children-with-respiratory-symptoms
#13
Letizia Zenzeri, Paolo Quitadamo, Renato Tambucci, Dario Ummarino, Antonio Poziello, Erasmo Miele, Annamaria Staiano
OBJECTIVES: Respiratory symptoms are a possible atypical clinical picture of gastro-esophageal reflux disease (GERD). However, a significant number of patients with GERD-related respiratory symptoms do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of non-acid or weakly acidic reflux. The aim of our study is to assess the pH-impedance features of GER inducing airway symptoms, compared with GER inducing typical gastro-intestinal (GI) symptoms...
October 13, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27683794/from-complex-evolving-to-simple-current-revisional-and-endoscopic-procedures-following-bariatric-surgery
#14
Ricardo Zorron, Manoel Passos Galvão-Neto, Josemberg Campos, Alcides José Branco, José Sampaio, Tido Junghans, Claudia Bothe, Christian Benzing, Felix Krenzien
Background: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27648103/effects-of-transcutaneous-electrical-acustimulation-on-refractory-gastroesophageal-reflux-disease
#15
Li-Na Meng, Shanshan Chen, Jiande D Z Chen, Hai-Feng Jin, Bin Lu
Objective. To investigate effects and possible mechanisms of transcutaneous electrical acustimulation (TEA) performed by a wearable watch-size stimulator for refractory gastroesophageal reflux disease (RGERD). Methods. Twenty patients diagnosed as RGERD were enrolled in the study and randomly divided into four groups: esomeprazole group (Group A), esomeprazole combined with TEA group (Group B), esomeprazole combined with sham-TEA group (Group C), and esomeprazole combined with domperidone group (Group D). HRM and 24 h pH-impedance monitoring and GerdQ score were used to measure related indexes before and after treatment...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/27646580/-current-status-of-translational-research-on-gastroesophageal-reflux-disease
#16
REVIEW
In Du Jeong, Moo In Park
The prevalence of gastroesophageal reflux disease (GERD) and the incidence of some of its complications have risen strikingly over the last few decades. With the increase in our understanding of the pathophysiology of GERD along with the development of proton pump inhibitors, the diagnostic and therapeutic approaches to GERD have changed dramatically over the past decade. However, GERD still poses a problem to many clinicians since the spectrum of the disease has evolved to encompass more challenging presentations such as refractory GERD and extra-esophageal manifestations...
September 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27644924/-complications-and-reoperations-following-laparoscopic-antireflux-surgery
#17
Örs Péter Horváth, Gábor Varga, Zsanett Biró, András Papp, Laura Bognár, András Vereczkei
Laparoscopic antireflux surgery is an effective treatment for patients with gastro-esophageal reflux disease, when it is refractory to conservative management. In experienced centers the procedure is safe, although complications may develop either during surgery or in the early or late postoperative period, which may necessitate revisional surgery. Between 1998 and 2015 a total of 407 patients underwent laparoscopic antireflux surgery at the Department of Surgery, University of Pécs. This interval was divided into two periods...
September 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27644563/efficacy-of-proton-pump-inhibitor-in-combination-with-rikkunshito-in-patients-complaining-of-globus-pharyngeus
#18
Sei-Ichi Nakano, Hidetaka Iwasaki, Eiji Kondo, Katsushi Miyazaki, Haruhiko Shizuku, Sei-Ichiro Kamimura, Junya Fukuda, Ryo Kanamura, Noriaki Takeda
OBJECTIVE: Globus pharyngeus (GP) is a common symptom of laryngopharyngeal reflux disease (LPRD), and proton pump inhibitor (PPI) and rikkunshito, a traditional Japanese medicine having prokinetic effect improve LPRD symptoms. In the present study, we examined the efficacy of high-dose PPI in combination with rikkunshito in patients complaining of GP. METHODS: 106 patients complaining of GP without any organic endoscopic findings were enrolled. RESULTS: Patients were first administrated with high-dose PPI alone for 4 to 8 weeks and the symptom was improved in 65 patients...
2016: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/27620303/the-added-diagnostic-value-of-postreflux-swallow-induced-peristaltic-wave-index-and-nocturnal-baseline-impedance-in-refractory-reflux-disease-studied-with-on-therapy-impedance-ph-monitoring
#19
M Frazzoni, N de Bortoli, L Frazzoni, S Tolone, M Furnari, I Martinucci, V G Mirante, S Marchi, V Savarino, E Savarino
BACKGROUND: On-therapy impedance-pH monitoring in proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) yielded conflicting results. We aimed to assess the diagnostic value of postreflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) in PPI-refractory heartburn. METHODS: On-therapy impedance-pH tracings from 189 consecutive patients with PPI-refractory heartburn were blindly reviewed. Patients were subdivided into refractory reflux esophagitis (RRE), healed reflux esophagitis (HRE), non-erosive reflux disease (NERD), and functional heartburn (FH) according to endoscopic and conventional impedance-pH findings...
September 12, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27599539/esophageal-body-motility-for-clinical-assessment-in-patients-with-refractory-gastroesophageal-reflux-symptoms
#20
Liuqin Jiang, Bixing Ye, Ying Wang, Meifeng Wang, Lin Lin
Background/Aims: Little data exists about esophageal body dysmotility and reflux patterns in refractory gastroesophageal reflux disease (RGERD) patients off therapy. We aimed to evaluate effects of esophageal body dysmotility on reflux parameters in RGERD patients by combining impedance-pH monitoring and high-resolution manometry (HRM). Methods: We retrospectively reviewed the impedance-pH data and HRM metrics in patients with refractory gastroesophageal reflux symptoms...
January 30, 2017: Journal of Neurogastroenterology and Motility
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