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Refractory reflux disease

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https://www.readbyqxmd.com/read/28821410/laparoscopic-redo-anti-reflux-surgery-case-series-of-different-presentations-varied-management-and-their-outcomes
#1
Hari Nageswaran, Ali Haque, Mohammed Zia, Ahmed Hassn
BACKGROUND: A minority of patients undergoing surgery for refractory gastroesophageal reflux disease (GORD) will require revision antireflux surgery ("redo-ARS") for persistent symptoms or complications. Although a repeat minimally invasive procedure for revision may be technically challenging due to post-operative changes, studies are beginning to show favourable data for the laparoscopic approach. METHOD: From a single institution 41 consecutive cases of laparoscopic redo-ARS performed by the same surgeon were classified by mode of presentation to analyse their intra-operative findings, management and post-operative outcomes...
August 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28768356/-singultus-diagnostic-workup-and-therapy
#2
Ohlrich Marcus, Georg Royl
A hiccup is a reflex movement with diffusely distributed afferents and efferents in the thorax; its functional relevance is controversial. In its physiological form, it is mostly a minor complaint that stops spontaneously and rarely leads to medical consultation. However, prolonged agonizing hiccups represent serious deterioration of quality of life. Chronic hiccups by definition last for more than 48 h, with gastroesophageal reflux being the frequent underlying disease. Various other causes affect multiple organ systems, some with serious underlying diseases...
July 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28761578/esophageal-motility-and-rikkunshito-treatment-for-proton-pump-inhibitor-refractory-nonerosive-reflux-disease-a-prospective-uncontrolled-open-label-pilot-study-trial
#3
Takeo Odaka, Shigeru Yamato, Osamu Yokosuka
BACKGROUND: Only a few reports focused on esophageal motility in patients with proton pump inhibitor (PPI)-refractory nonerosive reflux disease (NERD) and there has been no established strategy for treatment. OBJECTIVE: To clarify the characteristics of esophageal motility in patients with PPI-refractory NERD, we evaluated esophageal function using combined multichannel intraluminal impedance and esophageal manometry (MII-EM). In addition, we evaluated the efficacy of rikkunshito (RKT), which is a gastrointestinal prokinetic agent...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/28754071/a-review-of-pharmacotherapy-for-treating-gastroesophageal-reflux-disease-gerd
#4
Edoardo Savarino, Patrizia Zentilin, Elisa Marabotto, Giorgia Bodini, Marco Della Coletta, Marzio Frazzoni, Nicola de Bortoli, Irene Martinucci, Salvatore Tolone, Gaia Pellegatta, Vincenzo Savarino
Medical therapy of gastroesophageal reflux disease (GERD) is based on the use of proton pump inhibitors (PPIs) as first choice treatment. Despite their effectiveness, about 20-30% of patients report an inadequate response and alternative drugs are required. Areas covered: This review provides an overview of current pharmacotherapy for treating GERD by showing the results of PPIs, reflux inhibitors, antidepressants and mucosa protective medications. Expert opinion: Medical therapy of GERD does not definitely cure the disease, because even PPIs are not able to change the key factors responsible for it...
August 7, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28737451/long-term-quality-of-life-outcomes-following-nissen-versus-toupet-fundoplication-in-patients-with-gastroesophageal-reflux-disease
#5
Rebecca L Gunter, Amber L Shada, Luke M Funk, Xing Wang, Jacob A Greenberg, Anne O Lidor
INTRODUCTION: Laparoscopic fundoplication is the gold standard treatment for gastroesophageal reflux disease (GERD) refractory to medical management. Although many studies have compared Nissen fundoplication (NF) to Toupet fundoplication (TF), it is unclear which operation provides the best long-term reflux control. The objective of this study was to evaluate long-term quality-of-life (QoL) outcomes after NF versus TF. METHODS: Clinical data from our single academic institutional foregut database were used to identify patients who underwent NF or TF (June 2010 to May 2016)...
July 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28630017/vesicoureteral-reflux-is-a-phenotype-not-a-disease-a-population-centered-approach-to-pediatric-urinary-tract-infection
#6
REVIEW
Jathin Bandari, Steven G Docimo
We performed a review of the recent literature concerning urinary tract infection (UTI) evaluation and management. In modeling options for management, one overriding conclusion became apparent: in most affected children, the presence of vesicoureteral reflux (VUR) is inconsequential since it has no bearing on optimal management or outcome. In fact, knowing that a child does not have reflux might bias the provider to withhold potentially helpful therapeutic modalities to decrease UTI morbidity, such as antibiotic prophylaxis...
May 22, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28623447/new-approaches-to-gastroesophageal-reflux-disease
#7
William Kethman, Mary Hawn
BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disorder of the esophagus. It is a chronic, progressive disorder that presents most typically with heartburn and regurgitation and atypically with chest pain, dysphagia, chronic cough, globus, or sore throat. The mainstay for diagnosis and characterization of the disorder is esophagoduodenoscopy (EGD), high-resolution esophageal manometry, and symptom-associated ambulatory esophageal pH impedance monitoring...
June 16, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28569739/endoscopic-guided-measurement-of-mucosal-admittance-can-discriminate-gastroesophageal-reflux-disease-from-functional-heartburn
#8
Tomoaki Matsumura, Hideaki Ishigami, Mai Fujie, Takashi Taida, Shingo Kasamatsu, Kenichiro Okimoto, Keiko Saito, Daisuke Maruoka, Tomoo Nakagawa, Takeshi Suzuki, Tatsuro Katsuno, Makoto Arai
OBJECTIVES: A novel catheter that can measure mucosal admittance (MA), the inverse of impedance, was developed recently. In this pilot study, we aimed to clarify the usefulness of measuring MA for diagnosing gastroesophageal reflux disease (GERD). METHODS: We conducted two prospective studies. In the first study, esophageal MA was evaluated in 120 participants (24 with erosive esophagitis, 82 with heartburn but non-erosive esophagitis, and 14 healthy volunteers) and compared with the endoscopic findings...
June 1, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28557566/psychosocial-factors-are-associated-with-quality-of-life-after-laparoscopic-antireflux-surgery
#9
Alexa K Statz, Andrea M Stroud, Sally A Jolles, Jacob A Greenberg, Anne O Lidor, Amber L Shada, Xing Wang, Luke M Funk
BACKGROUND: Laparoscopic antireflux surgery (LARS) is the gold standard treatment for refractory gastroesophageal reflux disease (GERD). Traditional surgical outcomes following LARS are well described, but limited data exist regarding patient-reported outcomes. We aimed to identify preoperative characteristics that were independently associated with a high GERD health-related quality of life (GERD-HRQL) following LARS. METHODS: Clinical data from our single institution foregut surgery database were used to identify all patients with GERD who underwent primary LARS from June 2010 to November 2015...
August 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28502925/therapeutic-response-to-twice-daily-rabeprazole-on-health-related-quality-of-life-and-symptoms-in-patients-with-refractory-reflux-esophagitis-a-multicenter-observational-study
#10
Yoshikazu Kinoshita, Michio Hongo, Motoyasu Kusano, Yoshinori Furuhata, Hideaki Miyagishi, Satoshi Ikeuchi
Objective To investigate the effect of twice-daily rabeprazole doses on health-related quality of life in refractory patients. Methods and Patients Reflux esophagitis patients with an insufficient response to once-daily proton pump inhibitor therapy (Los Angeles Classification grade A-D) received rabeprazole 10 mg or 20 mg twice daily for 8 weeks. The health-related quality of life (SF-8™) and symptoms, using the Frequency Scale for the Symptoms of Gastroesophageal reflux disease, were evaluated before treatment and at weeks 4 and 8...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28501868/factors-associated-with-potassium-competitive-acid-blocker-non-response-in-patients-with-proton-pump-inhibitor-refractory-gastroesophageal-reflux-disease
#11
Masatsugu Okuyama, Kenichi Nakahara, Narika Iwakura, Tomoki Hasegawa, Maizumi Oyama, Ayumi Inoue, Hirotaka Ishizu, Hiroshi Satoh, Yasuhiro Fujiwara
BACKGROUND/AIMS: Approximately 20-40% of patients with gastroesophageal reflux disease (GERD) are refractory to proton pump inhibitor (PPI) treatment. The acid-inhibitory effect of vonoprazan, a novel potassium-competitive acid blocker (P-CAB), is significantly greater when compared to the effect of PPIs. We investigated the efficacy of vonoprazan treatment for PPI-refractory GERD and factors associated with P-CAB non-response. METHODS: We enrolled 277 GERD patients receiving continuous PPI therapy...
2017: Digestion
https://www.readbyqxmd.com/read/28427116/current-trends-in-the-management-of-gastroesophageal-reflux-disease
#12
REVIEW
Dalbir S Sandhu, Ronnie Fass
Gastroesophageal reflux disease (GERD) characterized by heartburn and/or regurgitation symptoms is one of the most common gastrointestinal disorders managed by gastroenterologists and primary care physicians. There has been an increase in GERD prevalence, particularly in North America and East Asia. Over the past three decades proton pump inhibitors (PPIs) have been the mainstay of medical therapy for GERD. However, recently there has been an increasing awareness amongst physicians and patients regarding the side effects of the PPI class of drugs...
April 24, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28405322/specific-dyspeptic-symptoms-are-associated-with-poor-response-to-therapy-in-patients-with-gastroesophageal-reflux-disease
#13
A D'Alessandro, F P Zito, M Pesce, P Andreozzi, E Efficie, M Cargiolli, F Maione, G D De Palma, R Cuomo, G Sarnelli
INTRODUCTION: In patients with gastroesophageal reflux disease (GORD), co-existence of functional dyspepsia (FD) is known to be associated with poor response to proton pump inhibitors (PPIs), but the contribution of specific dyspepsia symptoms has not yet been systematically investigated. OBJECTIVE: We aimed to characterize the impact of dyspepsia symptoms on response to PPIs in patients with GORD. METHODS: The enrolled subjects were consecutive patients with a diagnosis of GORD...
February 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28393826/-possibilities-of-ph-impedance-and-high-resolution-manometry-in-managing-patients-with-refractory-gastroesophageal-reflux-disease
#14
REVIEW
I V Maev, E V Barkalova, M A Ovsepyan, Yu A Kucheryavyi, D N Andreev
Gastroesophageal reflux disease (GERD) is a common condition that has a substantial impact on quality of life in patients and is a leading risk factor for esophageal adenocarcinoma. Now therapy with proton pump inhibitors (PPIs) is a basic method in the treatment of patients with GERD; however, one third of the patients do not respond to the therapy used. The causes of refractory GERD are a fairly large group of heterogeneous factors contributing to the inefficacy of PPIs in adequate dosage. Among these factors, there is low compliance by patients to the prescribed treatment regimen; nocturnal acid breakthrough; СУР2С19 gene polymorphism; chiasm syndrome with functional diseases of the gastrointestinal tract; non-acidic refluxes in a patient; thoracic esophageal motility disorders; the increased number and duration of transient lower esophageal sphincter relaxation periods; hiatus hernia; and misdiagnosis...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28387090/-how-to-approach-a-chronic-cough
#15
R Louis
Cough is the most common symptom for which patients seek medical attention. Chronic cough is defined when the symptom lasts for more than 8 weeks. It significantly alters quality of life. Chronic cough may be the dominant symptom which reveals a large number of diseases, not only respiratory. It is classic to distinguish chronic cough according to the chest X Ray results. In case of normal chest X ray, which is the most frequent condition, the diagnosis of tobacco-associated chronic bronchitis, drug induced cough, asthma, oesophageal reflux and rhinosinusitis should be considered...
February 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28367330/factors-predicting-renal-function-outcome-after-augmentation-cystoplasty
#16
Shahbaz Mehmood, Raouf Seyam, Sadia Firdous, Waleed Mohammad Altaweel
We determined the cause of renal deterioration after augmentation cystoplasty (AC). Twenty-nine adult patients with refractory bladder dysfunction and who underwent ileocystoplasty from 2004 to 2015 were studied. Patients with a decline in glomerular filtration rate (GFR) after augmentation were reviewed. The primary outcome was to determine the factors that might lead to deterioration of estimated GFR. Median follow-up was 7.0 ± 2.6 years. Significant bladder capacity, end filling pressure, and bladder compliance were achieved from median 114 ± 53...
2017: International Journal of Nephrology
https://www.readbyqxmd.com/read/28366995/effects-of-rikkunshito-on-quality-of-life-in-patients-with-gastroesophageal-reflux-disease-refractory-to-proton-pump-inhibitor-therapy
#17
Takashi Kawai, Yoji Hirayama, Aiko Oguchi, Fumi Ishii, Masanao Matushita, Naoya Kitayama, Shinji Morishita, Noboru Hiratsuka, Ken Ohata, Hiroyuki Konishi, Maiko Kishino, Shinichi Nakamura
We investigated the effects of rikkunshito, in combination with a proton pump inhibitor, on symptoms and quality of life in patients with proton pump inhibitor-refractory gastroesophageal reflux disease. The subjects were 47 patients with gastroesophageal reflux disease with residual symptoms such as heartburn following 8 weeks of proton pump inhibitor therapy. We administered these subjects rikkunshito in combination with a proton pump inhibitor for 6-8 weeks. We scored their symptoms of heartburn, fullness, abdominal discomfort, and abdominal pain, and surveyed their quality of life using the Reflux Esophagitis Symptom Questionnaire, comprising questions concerning daily activities, meals (changes in amount and favorite foods), and sleep (getting to sleep and early morning waking)...
March 2017: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/28363401/neutrophilic-steroid-refractory-recurrent-wheeze-and-eosinophilic-steroid-refractory-asthma-in-children
#18
Tamazoust Guiddir, Philippe Saint-Pierre, Elsa Purenne-Denis, Nathalie Lambert, Yacine Laoudi, Rémy Couderc, Rahelé Gouvis-Echraghi, Flore Amat, Jocelyne Just
BACKGROUND: Little is known about inflammatory pathways of severe recurrent wheeze in preschool children and severe asthma in children. OBJECTIVES: The aim of the Severe Asthma Molecular Phenotype cohort was to characterize phenotypes of severe recurrent wheeze and severe asthma during childhood in terms of triggers (allergic or not), involved cells (eosinophil or neutrophil), and corticoid responsiveness. METHODS: Children with moderate-to-severe asthma and preschool children with moderate-to-severe recurrent wheeze were enrolled prospectively...
March 28, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28336550/the-effect-of-intravenous-corticotropin-releasing-hormone-administration-on-esophageal-sensitivity-and-motility-in-health
#19
Charlotte Broers, Chloé Melchior, Lukas Van Oudenhove, Tim Vanuytsel, Brecht Van Houtte, Charlotte Scheerens, Nathalie Rommel, Jan Tack, Ans Pauwels
Esophageal hypersensitivity is important in gastroesophageal reflux disease (GERD) patients who are refractory to acid-suppressive therapy. Stress affects visceral sensitivity and exacerbates heartburn in GERD. Peripheral CRH is a key mediator of the gut stress response. We hypothesize that CRH increases esophageal sensitivity and alters esophageal motility in health. Esophageal sensitivity to thermal, mechanical, electrical, and chemical stimuli was assessed in 14 healthy subjects after administration of placebo or CRH (100 μg iv)...
May 1, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28294958/seventeen-year-outcome-of-a-randomized-clinical-trial-comparing-laparoscopic-and-conventional-nissen-fundoplication-a-plea-for-patient-counseling-and-clarification
#20
Jelmer E Oor, David J Roks, Joris A Broeders, Eric J Hazebroek, Hein G Gooszen
OBJECTIVE: To analyze long-term outcome of a randomized clinical trial comparing laparoscopic Nissen fundoplication (LNF) and conventional Nissen fundoplication (CNF) for the treatment of gastroesophageal reflux disease (GERD). BACKGROUND: LNF has replaced CNF, based on positive short and mid-term outcome. Studies with a follow-up of over 15 years are scarce, but are desperately needed for patient counselling. METHODS: Between 1997 and 1999, 177 patients with proton pump inhibitor (PPI)-refractory GERD were randomized to CNF or LNF...
July 2017: Annals of Surgery
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