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Refractory reflux disease

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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
#1
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...
December 6, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28270118/a-case-of-type-1-multiple-endocrine-neoplasia-with-esophageal-stricture-successfully-treated-with-endoscopic-balloon-dilation-and-local-steroid-injection-combined-with-surgical-resection-of-gastrinomas
#2
Hiroyuki Matsubayashi, Noboru Kawata, Naomi Kakushima, Masaki Tanaka, Kohei Takizawa, Yoshimi Kiyozumi, Yasue Horiuchi, Keiko Sasaki, Teiichi Sugiura, Katsuhiko Uesaka, Hiroyuki Ono
BACKGROUND: In type 1 multiple endocrine neoplasia (MEN1), esophageal diseases association with excessive gastrin secretion in Zollinger-Ellison syndrome (ZES) sometimes develop. Here, we reported a case of MEN1/ZES, who developed dysphagia due to reflux esophagitis with severe esophageal stricture. Treatment for his esophageal stricture and ZES was discussed. CASE PRESENTATION: A 43-year-old man with progressive dysphagia and diarrhea was referred to the teaching hospital...
March 7, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28260353/is-there-a-role-for-high-resolution-manometry-in-gerd-diagnosis
#3
Salvatore Tolone, Edoardo Savarino, Ludovico Docimo
Gastroesophageal reflux disease (GERD) is a condition, which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. In patients with alarm symptoms or signs or in those refractory to antiacid therapy, it is indicated to perform instrumental tests to correctly diagnose GERD presence. Esophageal manometry is currently considered the gold standard test for the diagnosis of esophageal dysmotility. However, it has shown limited capability in diagnosing GERD. With the advent of high resolution manometry (HRM), more accurate evaluations of esophageal motility are now possible...
March 3, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28260352/extra-esophageal-presentation-of-gerd-new-understanding-in-a-new-era
#4
Irene Martinucci, Eleonora Albano, Santino Marchi, Corrado Blandizzi
Associations of gastroesophageal reflux disease (GERD) with extraesophageal manifestations, such as chronic cough, asthma, and laryngitis, are reported frequently, and there is a strong evidence of biological plausibility in support of this relationship. On the other hand, extraesophageal reflux disease (EERD) is usually multifactorial in nature with reflux being just one of the several potential contributing cofactors. Moreover, the accuracy of currently available diagnostic tests for EERD is suboptimal, and therefore the causal relationship between GERD and EERD remains far from being conclusively proven...
March 3, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28251845/ppi-refractory-gerd-current-diagnosis-and-management
#5
Leonardo Frazzoni, Lorenzo Fuccio, Marzio Frazzoni
Proton pump inhibitor (PPI) therapy is the mainstay of treatment for gastroesophageal reflux disease (GERD). However, up to 30% of patients with reflux symptoms report inadequate symptom control with PPI therapy. PPI-refractory GERD should be suspected when troublesome reflux symptoms persist after 4-week standard dosage and 8-week high-dosage PPI therapy. Impedance-pH monitoring represents the gold standard for investigating the mechanism(s) of PPI refractoriness and for distinguishing patients with reflux-related from those with reflux- unrelated PPI-refractory syndromes...
March 1, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28239077/a-review-of-diagnosis-of-gerd
#6
REVIEW
In Du Jeong
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 accumulation in our understanding on the pathophysiology of GERD along with the development of proton pump inhibitors, the diagnostic and therapeutic approaches to the GERD have changed dramatically over the past decade. However, The 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 extraesophageal manifestations...
February 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28197221/factors-leading-to-refractory-asthma-in-patients-from-saudi-arabia
#7
Amal M Al-Moamary, Mohamed S Al-Hajjaj, Mohamed S Al Moamary
AIM: The aim of this study was to study the clinical characteristic of patient with refractory asthma (RA) from Saudi Arabia. METHODS: This paper prospectively studied in a university hospital factors leading to RA in a cohort of patients who have inadequately controlled asthma or with frequent exacerbations despite optimum controller therapy. It also studied patients with asthma that requires extended periods of oral steroids to control. RESULTS: The mean age was 45...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28151867/an-analysis-of-342-patients-with-refractory-gastroesophageal-reflux-disease-symptoms-using-questionnaires-high-resolution-manometry-and-impedance-ph-monitoring
#8
Fei Wang, Ping Li, Guo-Zhong Ji, Lin Miao, Zhining Fan, Sihong You, Xueqin Pan, Xia Chen
Symptoms of refractory gastroesophageal reflux disease (GERD) are commonly encountered in clinical practice. The aim of this study was to analyze the data obtained from questionnaires, high-resolution manometry (HRM), and ambulatory impedance-pH monitoring in patients with persisting GERD symptoms and to explore the possible underlying causes for this clinical presentation. After completing the questionnaires, the selected patients underwent endoscopy, HRM, and ambulatory impedance-pH monitoring. Based on the results of these investigations, we divided the patients into 4 groups: reflux esophagitis (RE), hypersensitive esophagus (HE), functional heartburn (FH), and nonerosive gastroesophageal reflux disease (NERD)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28135121/robotic-assisted-minimally-invasive-total-esophagogastric-dissociation-for-children-with-severe-neurodisability
#9
Girolamo Mattioli, Francesco Molinaro, Irene Paraboschi, Lorenzo Leonelli, Cinzia Mazzola, Serena Arrigo, Margherita Mancardi, Alessio Pini Prato, Rossella Angotti, Mario Messina, Adrian Bianchi
BACKGROUND: Around 70% of children with neurodisability (ND) present pharyngeal neuromuscular incoordination and severe gastroesophageal reflux disease (GORD). METHODS: This is a pilot study with the Robotic-assisted minimally invasive total esophagogastric dissociation (TOGD). RESULTS: We included 4 patients, 2 males and 2 females, with ND and severe GORD refractory to medical treatment. CONCLUSIONS: Pharmacological management of GORD is often unsuccessful and antireflux surgery is common, but it has a high failure rate with symptom recurrence, requiring re-do surgery...
January 30, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28124156/helicobacter-pylori-induced-changes-in-gastric-acid-secretion-and-upper-gastrointestinal-disease
#10
Adam J Smolka, Mitchell L Schubert
Appropriate management of Helicobacter pylori infection of the human stomach is evolving and remains a significant clinical challenge. Acute infection results in hypochlorhydria, whereas chronic infection results in either hypo- or hyperchlorhydria, depending upon the anatomic site of infection. Acute hypochlorhydria facilitates survival of the bacterium and its infection of the stomach. Interestingly, most patients chronically infected with H. pylori manifest a pangastritis with reduced acid secretion due to bacterial virulence factors, inflammatory cytokines, and various degrees of gastric atrophy...
2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28120127/a-novel-prostanoid-ep1-receptor-antagonist-ono-8539-reduces-acid-induced-heartburn-symptoms-in-healthy-male-volunteers-a-randomized-clinical-trial
#11
Takashi Kondo, Hiroo Sei, Takahisa Yamasaki, Toshihiko Tomita, Yoshio Ohda, Tadayuki Oshima, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
BACKGROUND: Patients with proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) have unmet clinical needs. Recently, we reported that esophageal prostaglandin E2 (PGE2) plays a crucial role in the generation of heartburn. In the present study, we focused on the PGE2 receptor, EP1, and investigated the effects of ONO-8539, a novel EP1 receptor antagonist, on heartburn symptoms in healthy male volunteers. METHODS: This prospective, double-blind, placebo-controlled, two-period crossover study was performed in 20 healthy male subjects...
January 24, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28116591/prism-a-patient-reported-outcome-instrument-accurately-measures-symptom-change-in-refractory-gastroesophageal-reflux-disease
#12
Garth Fuller, Roger Bolus, Cynthia Whitman, Jennifer Talley, M Haim Erder, Alain Joseph, Debra G Silberg, Brennan Spiegel
BACKGROUND: Most patients with gastroesophageal reflux disease (GERD) experience relief following treatment with proton pump inhibitors (PPIs) (Vakil et al. in Am J Gastroenterol 101:1900-1920, 2006; Everhart and Ruhl in Gastroenterology 136:376-386, 2009). As many as 17-44% of patients, however, exhibit only partial response to therapy. Most extant GERD patient-reported outcome (PRO) instruments fail to meet development best practices as described by the FDA (Talley and Wiklund in Qual Life Res 14:21-33, 2005; Van Pinxteren et al...
March 2017: Digestive Diseases and Sciences
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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