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Refractory reflux disease

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https://www.readbyqxmd.com/read/29906324/electroacupuncture-treatments-for-gut-motility-disorders
#1
REVIEW
J D Z Chen, M Ni, J Yin
Functional gastrointestinal (GI) diseases are common and there are patients who are refractory to medical therapies as not all treatments work in all patients. Consequently, a large number of patients with functional GI diseases use complementary and alternative medicine, such as acupuncture or electroacupuncture (EA). In this issue, Zheng et al. reported interesting results of a multi-center placebo-controlled clinical study on the use of EA for treating refractory functional dyspepsia; another study reported a multi-center clinical trial on EA for chronic functional constipation; Liang et al...
July 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29899438/complications-of-antireflux-surgery
#2
REVIEW
Rena Yadlapati, Eric S Hungness, John E Pandolfino
Antireflux surgery anatomically restores the antireflux barrier and is a therapeutic option for proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease or PPI intolerance. Laparoscopic fundoplication is the standard antireflux surgery, though its popularity has declined due to concerns regarding wrap durability and adverse events. As the esophagogastric junction is an anatomically complex and dynamic area subject to mechanical stress, wraps are susceptible to disruption, herniation or slippage...
June 14, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29888238/what-is-the-impact-of-high-resolution-manometry-in-the-functional-diagnostic-workup-of-gastroesophageal-reflux-disease
#3
REVIEW
Jutta Keller
International guidelines agree that high-resolution esophageal manometry (HRM) is an integral part of the diagnostic evaluation of patients with refractory reflux symptoms and should be performed before antireflux surgery. Its most important goal is to explore differential diagnoses, in particular major esophageal motility disturbances, that may be responsible for symptoms. HRM additionally provides insights into all relevant pathomechanisms of gastroesophageal reflux disease (GERD): It can reveal important information on the morphology and function of the esophagogastric junction (EGJ), the presence of a hiatus hernia, transient lower esophageal sphincter relaxations, and dysmotility of the esophageal body...
April 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29886565/the-proton-pump-inhibitor-nonresponder-a-behavioral-approach-to-improvement-and-wellness
#4
REVIEW
Megan E Riehl, Joan W Chen
PURPOSE OF REVIEW: Gastroesophageal reflux disease (GERD) is a difficult to treat medical condition, where nearly 40% of patients are refractory to standard medical intervention, which typically begins with a proton pump inhibitor (PPI). These PPI nonresponders represent a population of patients, where treatment planning must be individualized; multidisciplinary and psychiatric comorbidities should be considered. This review highlights treatment options that include neuromodulators, lifestyle, and psychological interventions for the PPI nonresponder...
June 9, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29784120/open-surgical-management-of-deep-venous-occlusive-disease
#5
Misaki M Kiguchi, Steven D Abramowitz
Endovascular techniques have revolutionized the management of deep venous occlusive disease. Open surgery, however, is still required for cases that prove refractory to endovascular interventions. The surgical management of deep venous occlusive disease typically involves venous bypass. Preoperative planning before open venous surgery relies upon dynamic imaging to clarify the location and severity of venous obstruction, the assessment of infrainguinal reflux, and the delineation of bypass origination and target vessels...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29770925/esophageal-magnetic-sphincter-augmentation-as-a-novel-approach-to-post-bariatric-surgery-gastroesophageal-reflux-disease
#6
John P Kuckelman, Cody J Phillips, Michael J Derickson, Byron J Faler, Matthew J Martin
BACKGROUND: We sought to evaluate the safety and effectiveness of magnetic sphincter augmentation (MSA) in patients with GERD after bariatric surgery. METHODS: Pre- and post-operative GERD quality of life (G-QOL) surveys were conducted. Standard indications (SI) group or the post-bariatric group (PB) created. Outcomes were compared between groups. RESULTS: Twenty-eight patients analyzed with no losses to follow-up. All patients had preoperative testing confirming normal motility and presence of GERD...
May 16, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29766521/current-and-future-perspectives-in-the-management-of-gastroesophageal-reflux-disease
#7
REVIEW
Junichi Akiyama, Shiko Kuribayashi, Myong Ki Baeg, Nicola de Bortoli, Elen Valitova, Edoardo V Savarino, Motoyasu Kusano, George Triadafilopoulos
Although the prevalence of gastroesophageal reflux disease (GERD) used to be lower in East Asia as compared to Western countries, it has recently been increasing, most likely due to the socioeconomic development in the East. The prevalence of both GERD and functional gastrointestinal disorders (FGIDs) ranges between 10% and 25% worldwide and there are distinct subgroups of patients with overlapping of GERD and FGIDs. However, the true prevalence of an overlap between GERD and FGIDs can be determined only when a formal pathophysiological evaluation has been performed...
May 16, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29733015/transoral-incisionless-fundoplication-tif-2-0-a-meta-analysis-of-three-randomized-controlled-clinical-trials
#8
Lauren Gerson, Bruce Stouch, Adrian Lobonţiu
The TIF procedure has emerged as an endoscopic treatment for patients with refractory gastro-esophageal reflux disease (GERD). Previous systematic reviews of the TIF procedure conflated findings from studies with modalities that do not reflect the current 2.0 procedure technique or refined data-backed patient selection criteria. A meta-analysis was conducted using data only from randomized studies that assessed the TIF 2.0 procedure compared to a control. The purpose of the meta-analysis was to determine the efficacy and long-term outcomes associated with performance of the TIF 2...
March 2018: Chirurgia
https://www.readbyqxmd.com/read/29704563/building-a-model-for-day-case-hiatal-surgery-lessons-learnt-over-a-10-year-period-in-a-high-volume-unit-a-case-series
#9
Pritesh Mistry, Shafquat Zaman, Iestyn Shapey, Markos Daskalakis, Rajwinder Nijjar, Martin Richardson, Paul Super, Rishi Singhal
BACKGROUND: Laparoscopic anti-reflux surgery has become the standard treatment for symptomatic gastro-oesophageal reflux disease refractory to medical therapy. Successful anti-reflux surgery involves safe, minimally invasive surgery, resulting in symptom resolution with minimal side effects. This study aims to assess the feasibility and safety of day case anti-reflux surgery focussing on peri- and post-operative outcomes as a measure of success. METHODS: Data was collected from the hospital database from 2003 to 2012...
April 25, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29697647/-the-role-of-gastroesophageal-reflux-disease-in-the-development-of-chronic-exudative-otitis-media-in-the-children-during-the-first-year-of-life
#10
I V Rakhmanova, Yu L Soldatsky, A G Matroskin, N S Marenich, V N Shelamova
The objective of the present study was the determination of the incidence of gastroesophageal reflux disease and the evaluation of its possible influence on the development and duration of chronic exudative otitis media in the children during the first year of life. A total of 141 infants at the age of 3 months presenting with exudative otitis media refractory to the conservative treatment throughout the first 1-1.5 months of life were available for the examination. The effectiveness of the anti-reflux therapy was estimated based on the middle ear condition (the presence or absence of exudate) within 3 and 6 months after the initiation of the treatment...
2018: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/29681623/lack-of-improvement-of-impaired-chemical-clearance-characterizes-ppi-refractory-reflux-related-heartburn
#11
Marzio Frazzoni, Leonardo Frazzoni, Salvatore Tolone, Nicola De Bortoli, Vincenzo Savarino, Edoardo Savarino
OBJECTIVE: Heartburn is the most specific symptom of reflux disease and is highly responsive to proton pump inhibitor (PPI) therapy. Some patients do not respond to PPIs, but mechanisms of refractoriness have not yet been fully elucidated. Impedance-pH monitoring, allowing comprehensive on-therapy assessment of reflux, represents a valuable test to investigate PPI refractoriness. METHODS: Prospective multicenter study comparing endoscopy-negative patients with PPI-refractory and PPI-responsive heartburn...
May 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29679337/revisional-bariatric-surgery-for-weight-regain-and-refractory-complications-in-a-single-mbsaqip-accredited-center-what-are-we-dealing-with
#12
Jeffrey Qiu, Peter W Lundberg, T Javier Birriel, Leonardo Claros, Jill Stoltzfus, Maher El Chaar
BACKGROUND: Revisional surgery is the fastest growing area in bariatric surgery, constituting 13.6% of all procedures performed as of 2015. This reflects a rising need to treat adverse sequelae of primary bariatric procedures. Despite the increase in revisions, their safety and efficacy remain controversial. The objective of this study is to review the experience of revisional bariatric surgery in our center and the relevant literature to date. METHODS: We performed an IRB-approved review of prospectively collected data from all patients undergoing revisional bariatric surgery between 2012 and 2015...
April 20, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29625507/efficacy-of-transoral-incisionless-fundoplication-for-refractory-gastroesophageal-reflux-disease-a-systematic-review-and-meta-analysis
#13
Thomas R McCarty, Michael Itidiare, Basile Njei, Tarun Rustagi
BACKGROUND:  Given poor symptomatic response rates and rising awareness of the adverse events associated with the long-term use of proton pump inhibitors (PPIs), endoscopic modalities for treatment of refractory gastroesophageal reflux disease (GERD) have become more prominent. The aim of this study was to perform a systematic review and meta-analysis to evaluate feasibility, efficacy, and tolerability of transoral incisionless fundoplication (TIF) for the treatment of refractory GERD...
April 6, 2018: Endoscopy
https://www.readbyqxmd.com/read/29606884/proton-pump-inhibitor-refractory-gastroesophageal-reflux-disease-challenges-and-solutions
#14
REVIEW
Joseph Mermelstein, Alanna Chait Mermelstein, Maxwell M Chait
A significant percentage of patients with gastroesophageal reflux disease (GERD) will not respond to proton pump inhibitor (PPI) therapy. The causes of PPI-refractory GERD are numerous and diverse, and include adherence, persistent acid, functional disorders, nonacid reflux, and PPI bioavailability. The evaluation should start with a symptom assessment and may progress to imaging, endoscopy, and monitoring of esophageal pH, impedance, and bilirubin. There are a variety of pharmacologic and procedural interventions that should be selected based on the underlying mechanism of PPI failure...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29567054/electrical-stimulation-of-the-lower-esophageal-sphincter-to-address-gastroesophageal-reflux-disease-after-sleeve-gastrectomy
#15
Yves Borbély, Nicole Bouvy, Henning G Schulz, Leonardo Antonio Rodriguez, Camilo Ortiz, Alejandro Nieponice
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) can result in de novo and worsen preexisting gastroesophageal reflux disease (GERD). Post-LSG patients with GERD refractory to proton pump inhibitors (PPI) usually undergo more invasive, anatomy-altering Roux-en-Y gastric bypass surgery. Lower esophageal sphincter (LES) electrical stimulation (ES) preserves the anatomy and has been shown to improve outcomes in GERD patients. OBJECTIVE: To evaluate the safety and efficacy of LES-ES in post-LSG patients with GERD not controlled with maximal PPI therapy...
May 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29509533/new-minimally-invasive-endoscopic-and-surgical-therapies-for-gastroesophageal-reflux-disease-gerd
#16
Alexandru Eugen Nicolau, Adrian Lobonţiu, Silviu Constantinoiu
GERD has become one of the most frequent pathology of the upper GI tract. It is a spectrum disease and is a progressive disease as well. Serious and severe complications are possible. The mainstream therapy in most of the patients is the medical therapy with PPI's. The most severe cases with an impaired LES (Lower Esophageal Sphincter) function as well as important anatomical disruptions are of surgical indication, the gold standard being laparoscopic fundoplication, an elective therapy with long term follow up outcomes at the expense of de novo symptoms associated with fundoplications in general...
January 2018: Chirurgia
https://www.readbyqxmd.com/read/29488430/endoscopic-management-of-refractory-gastroesophageal-reflux-disease
#17
Waseem M Seleem, Amr Shaaban Hanafy, Samir I Mohamed
OBJECTIVE: Despite the therapeutic and surgical interventions for the management of gastroesophageal reflux disease (GERD), yet the high cost and the post-operative complications had led to a significant socioeconomic burden. The aim was to evaluate the safety and efficacy of endoscopic band ligation (EBL) in the management of refractory GERD. METHODS: A total of 150 patients with refractory GERD were assigned to an EBL group (banding was done at four quadrants just at the gastroesophageal junction (GEJ) (n = 75) or to a control group (optimized dose of PPI, n = 75)...
April 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29447372/small-fiber-polyneuropathy-is-prevalent-in-patients-experiencing-complex-chronic-pelvic-pain
#18
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
#19
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
#20
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...
April 2018: Surgical Innovation
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