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Refractory reflux disease

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https://www.readbyqxmd.com/read/29032661/a-prospective-study-of-eosinophilic-esophagitis-and-the-expression-of-tight-junction-proteins-in-patients-with-gastroesophageal-reflux-disease-symptoms
#1
Kenichiro Okimoto, Makoto Arai, Hideaki Ishigami, Keiko Saito, Shoko Minemura, Daisuke Maruoka, Tomoaki Matsumura, Tomoo Nakagawa, Tatsuro Katsuno, Masaki Suzuki, Yukio Nakatani, Osamu Yokosuka
Background/Aims: Eosinophilic esophagitis (EoE) is often erroneously diagnosed as gastroesophageal reflex disease (GERD). The aim of this study is to investigate the prevalence of EoE and the expression of tight junction (TJ) proteins in patients with GERD symptoms. Methods: One hundred patients with GERD symptoms and 10 healthy controls were prospectively studied. Sixty-two patients had symptoms refractory to proton pump inhibitors (PPI). All patients underwent esophageal biopsy...
October 17, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28895583/psychosocial-distress-and-quality-of-life-impairment-are-associated-with-symptom-severity-in-ppi-non-responders-with-normal-impedance-ph-profiles
#2
Rena Yadlapati, Michael Tye, Laurie Keefer, Peter J Kahrilas, John E Pandolfino
OBJECTIVES: Up to 50% of patients with reflux symptoms do not manifest a satisfactory symptom response to proton pump inhibitor (PPI) therapy. Our primary aim in this study was to identify factors associated with symptom perception among PPI non-responder phenotypes. METHODS: This prospective observational cohort study was performed from September 2014 to January 2017 at a single academic medical center and included PPI non-responders who underwent 24-h impedance-pH monitoring and completed a questionnaire set measuring patient-reported symptom severity, quality of life (QOL), and psychosocial distress...
September 12, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28894571/vonoprazan-10-mg-daily-is-effective-for-the-treatment-of-patients-with-proton-pump-inhibitor-resistant-gastroesophageal-reflux-disease
#3
Satoshi Shinozaki, Hiroyuki Osawa, Yoshikazu Hayashi, Hirotsugu Sakamoto, Yasutoshi Kobayashi, Alan Kawarai Lefor, Hironori Yamamoto
Gastroesophageal reflux disease (GERD) is commonly treated by primary care physicians. Although proton pump inhibitors (PPI) have been the mainstay of GERD treatment for two decades, in some patients GERD is refractory to standard dose PPI for more than eight weeks and is referred to as PPI-resistant GERD. Vonoprazan, a novel competitive acid blocker, became available in Japan for the treatment of patients with GERD, and has greater acid inhibition than existing PPIs. The aim of the present study was to determine the effect of vonoprazan 10 mg daily on PPI-resistant GERD...
September 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28891136/helicobacter-pylori-infection-and-nonmalignant-diseases
#4
REVIEW
Olga Sjomina, Frederic Heluwaert, Driffa Moussata, Marcis Leja
A substantial decrease in Helicobacter pylori-associated peptic ulcer disease has been observed during the last decades. Drug-related ulcers as well as idiopathic ulcers are becoming predominant and are more refractory to treatment; however, H. pylori infection still plays an important role in ulcer bleeding and recurrence after therapy. The effect of H. pylori eradication upon functional dyspepsia symptoms has been reviewed in this article and generally confirms the results of previous meta-analyses. Additional evidence suggests a lack of impact upon the quality of life, in spite of improvement in symptoms...
September 2017: Helicobacter
https://www.readbyqxmd.com/read/28884817/association-between-cyp2c19-17-alleles-and-ph-probe-testing-outcomes-in-children-with-symptomatic-gastroesophageal-reflux
#5
James P Franciosi, Edward B Mougey, Andre Williams, Roberto A Gomez-Suarez, Cameron Thomas, Christa L Creech, Katherine George, Diana Corao, John J Lima
Esophageal pH monitoring remains a primary diagnostic tool for detecting gastroesophageal reflux disease (GERD). GERD that is refractory to proton pump inhibitor (PPI) medications may be related to CYP2C19 variants. Current PPI dosing practices in children do not take into account CYP2C19 allelic variants, which may lead to underdosing and subsequently to a misperception of PPI therapy failure. We hypothesized that pH probe acid exposure outcomes associate with CYP2C19*17 alleles among children with clinical concern for GERD...
September 8, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28880273/tailored-therapy-guided-by-multichannel-intraluminal-impedance-ph-monitoring-for-refractory-non-erosive-reflux-disease
#6
Nunzio Ranaldo, Giuseppe Losurdo, Andrea Iannone, Mariabeatrice Principi, Michele Barone, Massimo De Carne, Enzo Ierardi, Alfredo Di Leo
A relevant percentage of non-erosive reflux disease (NERD) is refractory to proton pump inhibitors (PPIs) treatment. Multichannel intraluminal impedance pH (MII-pH) monitoring should give useful pathophysiological information about refractoriness. Therefore, our aim was to assess whether this technique could be useful to guide a 'tailored' therapy in refractory NERD. We retrospectively recruited NERD patients undergoing MII-pH monitoring for unsuccessful treatment. All patients had undergone upper endoscopy, and those with erosive esophagitis were excluded...
September 7, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28827001/laparoscopic-nissen-fundoplication-controls-reflux-symptoms-and-improves-disease-specific-quality-of-life-in-patients-with-class-i-and-ii-obesity
#7
Sara E Martin Del Campo, Umer I Chaudhry, Aliyah Kanji, Andrew J Suzo, Kyle A Perry
BACKGROUND: Patients with class I obesity and refractory gastroesophageal reflux disease may not qualify for bariatric surgery, and the effectiveness of laparoscopic Nissen fundoplication remains controversial. This study evaluates the early efficacy of laparoscopic Nissen fundoplication in patients with class I and II obesity. METHODS: Data for patients who underwent laparoscopic Nissen fundoplication between 2009 and 2014 were collected prospectively. Cohorts were stratified based on body mass index at the time of surgery: Nonobese (body mass index <30 kg/m(2)), class I obese (body mass index 30-34...
August 18, 2017: Surgery
https://www.readbyqxmd.com/read/28821410/laparoscopic-redo-anti-reflux-surgery-case-series-of-different-presentations-varied-management-and-their-outcomes
#8
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
#9
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
#10
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
#11
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...
September 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
#12
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)...
September 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
#13
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...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28623447/new-approaches-to-gastroesophageal-reflux-disease
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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