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Abhijeet Waghray, Nisheet Waghray, Adam T Perzynski, Mark Votruba, M Michael Wolfe
BACKGROUND: Proton pump inhibitors (PPIs) are potent inhibitors of acid secretion and are the mainstay of therapy for gastroesophageal reflux disease (GERD). Initially designed to be taken 30 min before the first daily meal, these agents are commonly used suboptimally, which adversely affects symptom relief. No study to date has assessed whether correcting dosing regimens would improve symptom control. The objective of this study was to determine whether patients with persistent GERD symptoms on suboptimal omeprazole dosing experience symptomatic improvement when randomized to commonly recommended dosing regimen and to evaluate the economic impact of suboptimal PPI dosing in GERD patients...
January 2019: Digestive Diseases and Sciences
Nipaporn Pichetshote, Mark Pimentel
Abdominal pain is a common reason for referral to a gastroenterologist. The workup of patients with chronic abdominal pain can be extremely challenging as clinicians are responsible for determining whether the patient can be observed or treated symptomatically or this abdominal pain heralds a more systemic disease. The differential is typically wide and given the innervation of the abdomen, localization of abdominal pain does not always provide clear insight into the etiology. This review attempts to help the gastroenterologist narrow down that broad differential and focus on key elements of the patient visit...
January 23, 2019: American Journal of Gastroenterology
Kimio Isshi, Nobuyuki Matsuhashi, Takashi Joh, Kazuhide Higuchi, Katsuhiko Iwakiri, Takeshi Kamiya, Noriaki Manabe, Maiko Ogawa, Seiji Arihiro, Ken Haruma, Koji Nakada
BACKGROUND AND AIM: Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are frequently overlapped. However, no treatment strategies have been established yet for such patients. This study compared the effects of proton pump inhibitor (PPI) treatment in patients with GERD-associated FD among three groups with varying severity levels of GERD symptoms. METHODS: The patients with GERD and FD symptoms received PPI treatment for 4 weeks after endoscopy, and the severity of the symptoms and responses to treatment were evaluated at before and after 4 weeks of treatment using the Gastroesophageal Reflux and Dyspepsia Therapeutic Efficacy and Satisfaction Test (GERD-TEST)...
January 23, 2019: Journal of Gastroenterology
Scott Klenzak, Igor Danelisen, Grace D Brannan, Melissa A Holland, Miranda Al van Tilburg
Gastroesophageal reflux disease (GERD) is a common upper esophageal condition and typical symptoms can include heartburn and sensation of regurgitation while atypical symptoms include chronic cough, asthma, hoarseness, dyspepsia and nausea. Typically, diagnosis is presumptive given the presence of typical and atypical symptoms and is an indication for empiric therapy. Treatment management can include lifestyle modifications and/or medication therapy with proton pump inhibitor (PPI) class being the preferred and most effective...
December 6, 2018: World Journal of Clinical Cases
Yeong Yeh Lee, Justin C Y Wu
No abstract text is available yet for this article.
June 2018: Gastroenterology
Eun Jeong Gong, Kee Wook Jung, Yang-Won Min, Kyoung Sup Hong, Hye-Kyung Jung, Hee Jung Son, Do Yeon Kim, Jungbok Lee, Oh Young Lee
Background/Aims: The Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed and validated as a tool for the diagnosis of gastroesophageal reflux disease (GERD) in patients with gastrointestinal symptoms. However, the GerdQ and the cutoff value for determining GERD has not been validated in Korea. Methods: Patients with symptoms suggestive of GERD were consecutively recruited. The Korean version of GerdQ was developed through a forward-backward translation process according to the cross-cultural adaptation method...
January 31, 2019: Journal of Neurogastroenterology and Motility
Lisa L Strate, Arden M Morris
Diverticulitis is a prevalent gastrointestinal disorder that is associated with significant morbidity and health care costs. Approximately 20% of patients with incident diverticulitis have at least 1 recurrence. Complications of diverticulitis, such as abdominal sepsis, are less likely to occur with subsequent events. Several risk factors, many of which are modifiable, have been identified including obesity, diet, and physical inactivity. Diet and lifestyle factors could affect risk of diverticulitis through their effects on the intestinal microbiome and inflammation...
January 17, 2019: Gastroenterology
Amanda J Cross, Kate Wooldrage, Emma C Robbins, Ines Kralj-Hans, Eilidh MacRae, Carolyn Piggott, Iain Stenson, Aaron Prendergast, Bhavita Patel, Kevin Pack, Rosemary Howe, Nicholas Swart, Julia Snowball, Stephen W Duffy, Stephen Morris, Christian von Wagner, Stephen P Halloran, Wendy S Atkin
OBJECTIVE: The English Bowel Cancer Screening Programme (BCSP) recommends 3 yearly colonoscopy surveillance for patients at intermediate risk of colorectal cancer (CRC) postpolypectomy (those with three to four small adenomas or one ≥10 mm). We investigated whether faecal immunochemical tests (FITs) could reduce surveillance burden on patients and endoscopy services. DESIGN: Intermediate-risk patients (60-72 years) recommended 3 yearly surveillance were recruited within the BCSP (January 2012-December 2013)...
December 11, 2018: Gut
Masaki Maeda
Older patients with gastro-esophageal reflux disease are prone to severe. Therefore, it is often required long-term treatment of proton pump inhibitors, attention is also required.
August 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Kunio Kasugai, Yasushi Funaki, Shinva Izawa, Naotaka Ogasawara, Makoto Sasaki
Non-erosive reflux disease (NERD) is characterized by the absence of esophageal mucosal damage during upper gastrointestinal endoscopy, despite the presence of typical symptoms of gastroesophageal reflux, such as heartburn and acid reflux. Almost 50 % of patients with NERD fail to respond to standard doses of proton pump inhibitors which are the first-line ther- apy for GERD. This means that acid reflux is only a minor effect on the pathophysiological mechanism of NERD and various mechanisms such as visceral hypersensitivity, esophageal motor abnormalities, weak or non-acid reflux and psychic effect have been estimated...
August 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Ingrid Toews, Aneesh Thomas George, John V Peter, Richard Kirubakaran, Luís Eduardo S Fontes, Jabez Paul Barnabas Ezekiel, Joerg J Meerpohl
BACKGROUND: Upper gastrointestinal (GI) bleeding due to stress ulcers contributes to increased morbidity and mortality in people admitted to intensive care units (ICUs). Stress ulceration refers to GI mucosal injury related to the stress of being critically ill. ICU patients with major bleeding as a result of stress ulceration might have mortality rates approaching 48.5% to 65%. However, the incidence of stress-induced GI bleeding in ICUs has decreased, and not all critically ill patients need prophylaxis...
June 4, 2018: Cochrane Database of Systematic Reviews
Prashanth Rawla, Tagore Sunkara, Andrew Ofosu, Vinaya Gaduputi
The modern lifestyle caters to an increase in the incidence of peptic ulcer disease, gastroesophageal reflux disease and several other acid-related conditions of the gut. The drugs to prevent these conditions work either through H2 receptor blockade or inhibition of the H+ , K+ ATPase enzyme. Although proton pump inhibitors have been proven to be efficacious, they have a slow onset of action with limited resolution of symptoms in most patients. Potassium-competitive acid blockers (P-CABs) are novel drugs that bind reversibly to K+ ions and block the H+ , K+ ATPase enzyme, thus preventing acid production...
December 13, 2018: World Journal of Gastrointestinal Pharmacology and Therapeutics
Robert T Kavitt, Anna M Lipowska, Adjoa Anyane-Yeboa, Ian M Gralnek
Peptic ulcer disease continues to be a source of significant morbidity and mortality worldwide. Approximately two-thirds of patients found to have peptic ulcer disease are asymptomatic. In symptomatic patients, the most common presenting symptom of peptic ulcer disease is epigastric pain, which may be associated with dyspepsia, bloating, abdominal fullness, nausea, and/or early satiety. Most cases of peptic ulcer disease are associated with H. pylori infection and/or the use of non-steroidal anti-inflammatory drugs (NSAIDs)...
January 3, 2019: American Journal of Medicine
Simon Brisebois, Albert Merati, John Paul Giliberto
Proton pump inhibitors (PPIs) are among the most prescribed classes of drugs in this day and age. These may be beneficial to treat many gastrointestinal conditions, such as gastroesophageal reflux or Barrett's esophagus as well as laryngopharyngeal reflux. However, many reports have emerged in the literature exposing the potential association of PPIs with various risks and complications such as bone fracture, infection, myocardial infarction, renal disease, and dementia. This review highlights many of these potential adverse side effects by exploring relevant publications and addressing the controversies associated with those findings...
December 2018: Laryngoscope Investigative Otolaryngology
Ramesh P Arasaradnam, Julian R F Walters
No abstract text is available yet for this article.
December 3, 2018: Gut
Daphne Ang, Qishi Zheng, Luming Shi, Jan Tack
Background: Patients with persistent gastroesophageal reflux disease symptoms despite proton pump inhibitors are increasingly encountered. It remains controversial if proton pump inhibitors should be stopped before functional oesophageal tests. Aim: This meta-analysis compares the positive yield of oesophageal studies performed off versus on proton pump inhibitors. Methods: Pubmed, Embase and the Cochrane Library were searched for eligible studies...
November 2018: United European Gastroenterology Journal
Stephanie Wong, Andrew Ruszkiewicz, Richard H Holloway, Nam Q Nguyen
Eosinophilic oesophagitis (EoE) and gastro-oesophageal reflux disease (GORD) are the most common causes of chronic oesophagitis and dysphagia associated with oesophageal mucosal eosinophilia. Distinguishing between the two is imperative but challenging due to overlapping clinical and histological features. A diagnosis of EoE requires clinical, histological and endoscopic correlation whereas a diagnosis of GORD is mainly clinical without the need for other investigations. Both entities may exhibit oesophageal eosinophilia at a similar level making a histological distinction between them difficult...
October 25, 2018: World Journal of Gastrointestinal Pathophysiology
Pruthvi C Revaiah, Rakesh Kochhar, Surinder V Rana, Neha Berry, Munish Ashat, Narendra Dhaka, Y Rami Reddy, Saroj K Sinha
Background and Aim: Intestinal dysmotility is considered a risk factor for small intestinal bacterial overgrowth (SIBO). Prokinetics improve intestinal motility and are often prescribed with proton pump inhibitors (PPIs) in patients with gastroesophageal reflux disease (GERD) and/or functional dyspepsia. The present study aimed to evaluate the prevalence of SIBO and the orocecal transit time (OCTT) in patients taking PPI compared with those taking PPI plus prokinetics. Methods: The study is a single-center, cross-sectional study...
April 2018: JGH open: an open access journal of gastroenterology and hepatology
U O Gustafsson, M J Scott, M Hubner, J Nygren, N Demartines, N Francis, T A Rockall, T M Young-Fadok, A G Hill, M Soop, H D de Boer, R D Urman, G J Chang, A Fichera, H Kessler, F Grass, E E Whang, W J Fawcett, F Carli, D N Lobo, K E Rollins, A Balfour, G Baldini, B Riedel, O Ljungqvist
BACKGROUND: This is the fourth updated Enhanced Recovery After Surgery (ERAS® ) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol. METHODS: A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system...
November 13, 2018: World Journal of Surgery
Andrea Corsonello, Fabrizia Lattanzio
The introduction of proton pump inhibitors (PPIs) has been a cornerstone in the treatment of acid-related disorders, such as gastroesophageal reflux and peptic ulcer, and their use has increased rapidly during the last decades. Being highly lipophilic drugs, they may potentially affect several pathophysiological pathways involved in cardiovascular and kidney morbidity, immune response and infections, absorption of selected nutrients, bone metabolism and cognitive function. Clinical epidemiology evidence coming from well-designed analyses of observational data consistently reported that long-term use of PPIs may increase the risk of cardiovascular events among patients treated with thienopyridines, tubular-interstitial nephritis and chronic kidney disease, hypomagnesemia, and fractures...
October 21, 2018: Trends in Cardiovascular Medicine
2018-11-26 06:13:09
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