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Gastroenterology

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129 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28774844/assessing-old-and-new-diagnostic-tests-for-gastroesophageal-reflux-disease
#1
REVIEW
Michael F Vaezi, Daniel Sifrim
A detailed critique of objective measurements of gastroesophageal reflux disease (GERD) would improve management of patients suspecting of having reflux, leading to rational selection of treatment and better outcomes. Many diagnostic tests for GERD have been developed over the past decades. We analyze their development, positive- and negative-predictive values, and ability to predict response to treatment. These features are important for development of medical, surgical, and endoscopic therapies for GERD. We discuss the value of available diagnostic tests and review their role in management of patients with persistent reflux symptoms despite adequate medical or surgical treatment...
January 2018: Gastroenterology
https://www.readbyqxmd.com/read/29681623/lack-of-improvement-of-impaired-chemical-clearance-characterizes-ppi-refractory-reflux-related-heartburn
#2
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...
April 23, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29668562/the-association-between-proton-pump-inhibitor-use-with-acute-kidney-injury-and-chronic-kidney-disease
#3
Faisal Kamal, Muhammad A Khan, Miklos Z Molnar, Colin W Howden
Proton pump inhibitors (PPIs) are among the most commonly prescribed medicines and are the mainstay of treatment for gastroesophageal reflux disease. Recently, there has been an increase in the use of these medicines for unclear and inappropriate indications. Although generally well tolerated and considered to be safe, several observational studies have linked PPI use with a variety of conditions such as pneumonia, Clostridium difficile infection, fractures, hypomagnesemia, and dementia. The well-established association between PPIs and acute interstitial nephritis has raised questions about whether they may also cause acute kidney injury and chronic kidney disease...
April 17, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29161458/proton-pump-inhibitors-for-functional-dyspepsia
#4
REVIEW
Maria Ines Pinto-Sanchez, Yuhong Yuan, Ahmed Hassan, Premysl Bercik, Paul Moayyedi
BACKGROUND: Functional dyspepsia (FD or non-ulcer dyspepsia) is defined as continuous or frequently recurring epigastric pain or discomfort for which no organic cause can be found. Acid suppressive therapy, including proton pump inhibitors (PPIs), has been proposed as a therapeutic option in FD, but its efficacy remains controversial. While PPIs are generally considered safe and well tolerated, they have been associated with adverse events, especially in the long term. For this reason, decisions on whether to initiate or continue PPI therapy should be made based on an appropriate clinical indication...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29653941/guidelines-for-the-investigation-of-chronic-diarrhoea-in-adults-british-society-of-gastroenterology-3rd-edition
#5
Ramesh P Arasaradnam, Steven Brown, Alastair Forbes, Mark R Fox, Pali Hungin, Lawrence Kelman, Giles Major, Michelle O'Connor, Dave S Sanders, Rakesh Sinha, Stephen Charles Smith, Paul Thomas, Julian R F Walters
Chronic diarrhoea is a common problem, hence clear guidance on investigations is required. This is an updated guideline from 2003 for the investigations of chronic diarrhoea commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). This document has undergone significant revision in content through input by 13 members of the Guideline Development Group (GDG) representing various institutions. The GRADE system was used to appraise the quality of evidence and grading of recommendations...
April 13, 2018: Gut
https://www.readbyqxmd.com/read/29601902/rethinking-what-we-know-about-hemorrhoids
#6
REVIEW
Robert S Sandler, Anne F Peery
Although hemorrhoids are responsible for considerable economic cost and personal suffering, they have received surprisingly little research attention. In the United States, hemorrhoids are the third most common outpatient gastrointestinal diagnosis with nearly 4 million office and emergency department visits annually. The etiology of hemorrhoids is speculative. A low-fiber diet and constipation have historically been thought to increase the risk for hemorrhoids, but not proven. Symptoms commonly attributed to hemorrhoids include bleeding, pain, pruritus, fecal seepage, prolapse and mucus discharge...
March 27, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29510130/new-eosinophilic-esophagitis-concepts-call-for-change-in-proton-pump-inhibitor-management-before-diagnostic-endoscopy
#7
EDITORIAL
Eunice Odiase, Armond Schwartz, Rhonda F Souza, Jason Martin, Vani Konda, Stuart Jon Spechler
No abstract text is available yet for this article.
April 2018: Gastroenterology
https://www.readbyqxmd.com/read/29580179/the-iarc-perspective-on-colorectal-cancer-screening
#8
Béatrice Lauby-Secretan, Nadia Vilahur, Franca Bianchini, Neela Guha, Kurt Straif
New England Journal of Medicine, Volume 378, Issue 18, Page 1734-1740, May 2018.
March 26, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29510131/how-to-perform-a-high-quality-examination-in-patients-with-barrett-s-esophagus
#9
Martin A Everson, Krish Ragunath, Pradeep Bhandari, Laurence Lovat, Rehan Haidry
No abstract text is available yet for this article.
April 2018: Gastroenterology
https://www.readbyqxmd.com/read/29545633/chronic-nausea-and-vomiting-evaluation-and-treatment
#10
REVIEW
Brian E Lacy, Henry P Parkman, Michael Camilleri
Nausea is an uneasy feeling in the stomach while vomiting refers to the forceful expulsion of gastric contents. Chronic nausea and vomiting represent a diverse array of disorders defined by 4 weeks or more of symptoms. Chronic nausea and vomiting result from a variety of pathophysiological processes, involving gastrointestinal and non-gastrointestinal causes. The prevalence of chronic nausea and vomiting is unclear, although the epidemiology of specific conditions, such as gastroparesis and cyclic vomiting syndrome, is better understood...
March 15, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29380820/severity-and-outcomes-of-upper-gastrointestinal-bleeding-with-bloody-vs-coffee-grounds-hematemesis
#11
Loren Laine, Stig B Laursen, Liam Zakko, Harry R Dalton, Jing H Ngu, Michael Schultz, Adrian J Stanley
OBJECTIVES: Numerous reviews indicate bloody hematemesis signifies more severe bleeding than coffee-grounds hematemesis. We assessed severity and outcomes related to bleeding symptoms in a prospective study. METHODS: Consecutive patients presenting with hematemesis or melena were categorized as bloody emesis (N=1209), coffee-grounds emesis without bloody emesis (N=701), or melena without hematemesis (N=1069). We assessed bleeding severity (pulse, blood pressure) and predictors of outcome (hemoglobin, risk stratification scores) at presentation, and outcomes of bleeding episodes...
March 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28464343/randomised-clinical-trial-addition-of-alginate-antacid-gaviscon-double-action-to-proton-pump-inhibitor-therapy-in-patients-with-breakthrough-symptoms
#12
RANDOMIZED CONTROLLED TRIAL
C Coyle, G Crawford, J Wilkinson, S J Thomas, P Bytzer
BACKGROUND: Symptomatic breakthrough in proton pump inhibitor (PPI)-treated gastro-oesophageal reflux disease (GERD) patients is a common problem with a range of underlying causes. The nonsystemic, raft-forming action of alginates may help resolve symptoms. AIM: To assess alginate-antacid (Gaviscon Double Action, RB, Slough, UK) as add-on therapy to once-daily PPI for suppression of breakthrough reflux symptoms. METHODS: In two randomised, double-blind studies (exploratory, n=52; confirmatory, n=262), patients taking standard-dose PPI who had breakthrough symptoms, assessed by Heartburn Reflux Dyspepsia Questionnaire (HRDQ), were randomised to add-on Gaviscon or placebo (20 mL after meals and bedtime)...
June 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29501369/acute-pancreatitis-guideline
#13
Seth Crockett, Yngve Falck-Ytter, Sachin Wani, Timothy B Gardner
No abstract text is available yet for this article.
March 2018: Gastroenterology
https://www.readbyqxmd.com/read/28858946/facts-and-fantasies-on-extraesophageal-reflux-a-gastroenterologist-perspective
#14
Frank Zerbib, Charlotte Dulery
Gastroesophageal reflux disease encompasses a wide spectrum of disorders related to the reflux of gastric contents into the esophagus. Extraesophageal reflux (EER) may be suspected in patients with unexplained chronic cough, pharyngolaryngeal symptoms, and asthma. For physicians, suspected EER is challenging as there is currently no tool that can reliably make a definitive diagnosis. Endoscopic signs are not specific, pharyngeal and proximal reflux monitoring are not reliable, and if distal pH or pH-impedance monitoring can identify patients with abnormal reflux, they cannot predict the response to therapy...
October 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28930292/proton-pump-inhibitors-understanding-the-complications-and-risks
#15
REVIEW
Peter Malfertheiner, Arne Kandulski, Marino Venerito
Proton-pump inhibitors (PPIs) are the most effective therapy for the full spectrum of gastric-acid-related diseases. However, in the past decade, a steadily increasing list of complications following long-term use of PPIs has been reported. Their potent acid-suppressive action induces several structural and functional changes within the gastric mucosa, including fundic gland polyps, enterochromaffin-like cell hyperplasia and hypergastrinaemia, which can be exaggerated in the presence of Helicobacter pylori infection...
December 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29472295/association-between-proton-pump-inhibitors-use-and-risk-of-gastric-cancer-in-patients-with-gerd
#16
Yen-Chun Peng, Lam-Ru Huang, Cheng-Li Lin, Wan-Yun Hsu, Chi-Sen Chang, Hong-Zen Yeh, Chia-Hung Kao
No abstract text is available yet for this article.
February 22, 2018: Gut
https://www.readbyqxmd.com/read/29427733/extraesophageal-symptoms-and-diseases-attributed-to-gerd-where-is-the-pendulum-swinging-now
#17
Michael F Vaezi, David Katzka, Frank Zerbib
The purpose of this review is to outline the recent developments in the field of extraesophageal reflux disease and provide clinically relevant recommendations. The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: Best Practice Advice 1: The role of a gastroenterologist in patients referred for evaluation of suspected extra esophageal symptom is to assess for gastroesophageal etiologies that could contribute to the presenting symptoms...
February 7, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29406201/proton-pump-inhibitors-review-of-emerging-concerns
#18
REVIEW
Avinash K Nehra, Jeffrey A Alexander, Conor G Loftus, Vandana Nehra
First introduced in 1989, proton pump inhibitors (PPIs) are among the most widely utilized medications worldwide, both in the ambulatory and inpatient clinical settings. The PPIs are currently approved by the US Food and Drug Administration for the management of a variety of gastrointestinal disorders including symptomatic peptic ulcer disease, gastroesophageal reflux disease, and nonulcer dyspepsia as well as for prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. PPIs inhibit gastric acid secretion, and the most commonly associated adverse effects include abdominal pain, diarrhea, and headache...
February 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29352757/refractory-heartburn-a-challenging-problem-in-clinical-practice
#19
REVIEW
Gerson Domingues, Joaquim Prado P Moraes-Filho, Ronnie Fass
Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Heartburn and regurgitation are the typical symptoms of GERD. The treatment of GERD encompasses lifestyle modifications, pharmacological, endoscopic, and surgical therapy. The majority of the patients respond to 4-8 weeks of proton-pump inhibitors therapy, but 20-42% will demonstrate partial or complete lack of response to treatment. While these patients have been considered as having refractory heartburn, a subset of them does not have GERD or have not been adequately treated...
March 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28373773/factors-associated-with-residual-gastroesophageal-reflux-disease-symptoms-in-patients-receiving-proton-pump-inhibitor-maintenance-therapy
#20
Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsushi Uda, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Kazuhiko Yamashita, Takeshi Hirano, Midori Hirai, Takeshi Azuma
AIM: To elucidate the factors associated with residual gastroesophageal reflux disease (GERD) symptoms in patients receiving proton pump inhibitor (PPI) maintenance therapy in clinical practice. METHODS: The study included 39 GERD patients receiving maintenance PPI therapy. Residual symptoms were assessed using the Frequency Scale for Symptoms of GERD (FSSG) questionnaire and the Gastrointestinal Symptom Rating Scale (GSRS). The relationships between the FSSG score and patient background factors, including the CYP2C19 genotype, were analyzed...
March 21, 2017: World Journal of Gastroenterology: WJG
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