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37 papers 0 to 25 followers questioning Medicine folder on GERD
By Joe Weatherly FM/Hospitalist-CoFounder of QuestioningMedicine and PCRAP contributor.
Megan E Riehl, Laurie Keefer
Hypnotherapy is an evidence based intervention for the treatment of functional bowel disorders, particularly irritable bowel syndrome. While similar in pathophysiology, less is known about the utility of hypnotherapy in the upper gastrointestinal tract. Esophageal disorders, most of which are functional in nature, cause painful and uncomfortable symptoms that impact patient quality of life and are difficult to treat from a medical perspective. After a thorough medical workup and a failed trial of proton pump inhibitor therapy, options for treatment are significantly limited...
July 2015: American Journal of Clinical Hypnosis
Robert A Ganz, Steven A Edmundowicz, Paul A Taiganides, John C Lipham, C Daniel Smith, Kenneth R DeVault, Santiago Horgan, Garth Jacobsen, James D Luketich, Christopher C Smith, Steven C Schlack-Haerer, Shanu N Kothari, Christy M Dunst, Thomas J Watson, Jeffrey Peters, Brant K Oelschlager, Kyle A Perry, Scott Melvin, Willem A Bemelman, André J P M Smout, Dan Dunn
BACKGROUND & AIMS: Based on results from year 2 of a 5-year trial, in 2012 the US Food and Drug Administration approved the use of a magnetic device to augment lower esophageal sphincter function in patients with gastroesophageal reflux disease (GERD). We report the final results of 5 years of follow-up evaluation of patients who received this device. METHODS: We performed a prospective study of the safety and efficacy of a magnetic device in 100 adults with GERD for 6 months or more, who were partially responsive to daily proton pump inhibitors (PPIs) and had evidence of pathologic esophageal acid exposure, at 14 centers in the United States and The Netherlands...
May 2016: Clinical Gastroenterology and Hepatology
Raul Badillo, Dawn Francis
Gastroesophageal reflux disease (GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms, these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations, further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms...
August 6, 2014: World Journal of Gastrointestinal Pharmacology and Therapeutics
Amanda Pinter Carvalheiro da Silva, Valdir Tercioti-Junior, Luiz Roberto Lopes, João de Souza Coelho-Neto, Laura Bertanha, Paulo Rodrigo de Faria Rodrigues, Nelson Adami Andreollo
BACKGROUND: Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. AIM: To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. METHODS: Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma...
April 2014: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
W T Liang, J N Wu, F Wang, Z W Hu, Z G Wang, T Ji, X L Zhan, C Zhang
AIM: Laparoscopic Nissen fundoplication (LNF) and Stretta radiofrequency (RF) are used as main alternative strategies to manage medication-refractory GERD. This study was therefore prospectively evaluated outcomes of patients with refractory GERD 5 years after LNF or Stretta RF. METHODS: A total of 215 consecutive patients with refractory GERD underwent LNF (N.=102) and Stretta RF (N.=113) in our department between 2007 and 2008. They were followed-up for 5 years, during which the outcome measures including symptom scores of regurgitation, heartburn, chest pain, belching, hiccup, cough and asthma as well as the proton pump inhibitor (PPI) use and complications...
August 2014: Minerva Chirurgica
Emad Hamdy, Ayman El Nakeeb, Hosam Hamed, Mohamed El Hemaly, Nabil Gad ElHak
BACKGROUND: Gastroesophageal reflux disease (GERD) is a common public health problem. Medical treatment remains the first line of treatment of GERD. Failure of medical treatment may occur in up to 45% of GERD patients. This study aims to evaluate the outcome of laparoscopic Nissen fundoplication (LNF) as a means of antireflux surgery in patients with poor response to anti-reflux medication. PATIENTS AND METHODS: This is a prospective study of patients who underwent LNF in the period between January 2000 and December 2010 in the Gastrointestinal Surgical Center, Mansoura University, Egypt...
September 2014: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Napapan Kangwan, Jong-Min Park, Eun-Hee Kim, Ki Baik Hahm
Gastric ulcer is a chronic disease featured with unexpected complications, including bleeding, stenosis and perforation, as well as a high incidence of recurrence. Clinical treatments for gastric ulcer have allowed the rapid development of potent anti-ulcer drugs during the last several decades. Gastric ulcer healing is successful with conventional treatments including H2-receptor antagonists, and proton pump inhibitors (PPIs) have been essential for ulcer healing and prevention of complications. Additionally, Helicobacter pylori eradication therapy is effective in reducing ulcer recurrence and leads to physiological changes in the gastric mucosa which affect the ulcer healing process...
February 15, 2014: World Journal of Gastrointestinal Pathophysiology
W Liang, J Wu, Z Hu, Z Wang, G Zhu, C Zhang
AIM: Chronic cough is the most common extra-esophageal manifestation of gastroesophageal reflux disease (GERD). This study aimed to retrospectively analyze outcomes in patients with GERD-related cough following laparoscopic Nissen fundoplication (LNF) and Stretta radiofrequency (RF) respectively. METHODS: Medical charts of 83 patients with GERD-related cough that underwent LNF or Stretta RF between 2007 and 2012 were retrieved. Symptom scores (heartburn, regurgitation and cough) and proton pump inhibitors (PPIs) usages were evaluated...
May 14, 2014: Minerva Chirurgica
Craig S Brown, Brittany Lapin, Chi Wang, Jay L Goldstein, John G Linn, Woody Denham, Stephen P Haggerty, Mark S Talamonti, John A Howington, Joann Carbray, Michael B Ujiki
INTRODUCTION: Barrett's esophagus (BE) is the most predictive risk factor for development of esophageal adenocarcinoma (EAC), a malignancy with the fastest increasing incidence in the US. The aim of this study was to investigate differences in exposures, demographics, and comorbidities between regressing and non-regressing patients. METHODS AND PROCEDURES: We retrospectively collected and analyzed data from a cohort of BE patients participating in a single-center study comprised of all patients diagnosed with BE over a 10-year period...
October 2014: Surgical Endoscopy
Karim S Trad, William E Barnes, Gilbert Simoni, Ahmad B Shughoury, Peter G Mavrelis, Mamoon Raza, Jeffrey A Heise, Daniel G Turgeon, Mark A Fox
BACKGROUND: Incomplete control of troublesome regurgitation and extraesophageal manifestations of chronic gastroesophageal reflux disease (GERD) is a known limitation of proton pump inhibitor (PPI) therapy. This multicenter randomized study compared the efficacy of transoral incisionless fundoplication (TIF) against PPIs in controlling these symptoms in patients with small hiatal hernias. METHODS: Between June and August 2012, 63 patients were randomized at 7 US community hospitals...
February 2015: Surgical Innovation
Gerson Domingues, Joaquim Prado P Moraes-Filho
The basis of pharmacological treatment of the gastroesophageal reflux disease is the use of proton pump inhibitors (PPIs) which provide effective gastric acid secretion blockade. However, PPI therapy failure may occur in up to 42% of patients. The main causes for therapeutic failure are non-acid or weakly acid reflux, genotypic differences, presence of comorbidities, wrong diagnosis and lack of treatment compliance. Noncompliance is an important issue and should be carefully observed. Several studies addressed patient compliance and 20-50% of patients may present lack of compliance to the PPI prescribed...
September 2014: Expert Review of Gastroenterology & Hepatology
R Dickman, C Maradey-Romero, R Fass
Pain modulators have been primarily used for the management of functional esophageal disorders. Recently, these drugs have also been used for the management of other esophageal disorders, such as non-erosive reflux disease, the hypersensitive esophagus, and heartburn that is not responsive to proton pump inhibitor treatment. Several etiologies have been identified in patients with functional esophageal disorders, and these include esophageal hypersensitivity due to peripheral and/or central sensitisation, altered central processing of peripheral stimuli, altered autonomic activity, and psychological comorbidity such as depression and anxiety...
May 2014: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Parth J Parekh, Edward C Oldfield, David A Johnson
INTRODUCTION: The prevalence of gastroesophageal reflux disease continues to increase with the aging population and the obesity epidemic. Therapeutic failures can have significant detrimental effects in patients. Recently, dexlansoprazole MR and esomeprazole strontium were introduced to the class of proton pump inhibitors (PPIs). AREAS COVERED: This article will review the pharmacodynamics and pharmacokinetics of dexlansoprazole MR and esomeprazole strontium. Using the keywords 'dexlansoprazole MR' and 'esomeprazole strontium' in the search engines of PubMed, Cochrane Reviews and Google, we were able to identify peer-reviewed publications, abstracts and presentations at national society educations meetings and present a balanced view of the available data...
June 2014: Expert Opinion on Pharmacotherapy
Nora I Schneider, Wolfgang Plieschnegger, Michael Geppert, Bernd Wigginghaus, Gabriele M Hoess, Andreas Eherer, Eva-Maria Wolf, Peter Rehak, Michael Vieth, Cord Langner
In patients with gastroesophageal reflux disease (GERD), histology is generally believed to be a tool of limited diagnostic value. Our study aimed to assess the prevalence of microscopic esophageal lesions as defined by the Esohisto consensus guidelines, which have proven high interobserver agreement in previous studies. In the prospective Central European multicenter histoGERD trial, we recruited 1071 individuals (576 females and 495 males; median age, 53 years; range, 15-93 years) undergoing gastroscopy for nonselected reasons...
May 2014: Human Pathology
Fehmi Ates, David O Francis, Michael F Vaezi
'Refractory gastroesophageal reflux disease' is one of the most common misnomers in the area of gastroesophageal reflux disease. The term implies reflux as the underlying etiology despite unresponsiveness to aggressive proton pump inhibitor therapy. The term should be replaced with 'refractory symptoms.' We must acknowledge that in many patients symptoms of reflux often overlap with non-GERD causes such as gastroparesis, dyspepsia, hypersensitive esophagus and functional disorders. Lack of response to aggressive acid suppressive therapy often leads to diagnostic testing...
August 2014: Expert Review of Gastroenterology & Hepatology
Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Bernhard Haller, Roland M Schmid, Alexander Meining, Monther Bajbouj
AIM: To identify objective and subjective predictors for the reliable diagnosis of gastroesophageal reflux disease (GERD) and the response to proton pump inhibitor (PPI) therapy. METHODS: Retrospectively, 683 consecutive patients suspected for GERD who underwent pH-metry/impedance measurement (pH/MII) were analyzed. All patients had previously undergone standard PPI treatment (e.g., pantoprazole 40 mg/d or comparable). Four hundred sixty patients were at least 10 d off PPIs (group A), whereas 223 patients were analyzed during their ongoing PPI therapy (group B)...
April 14, 2014: World Journal of Gastroenterology: WJG
Frédéric Borie, Alban Zarzavadjian le Bian, Bertrand Millat
PURPOSE: In patients presenting with uncomplicated gastroesophageal reflux disease, nonresponders to medical treatment are not viewed as good candidates for surgical treatment. Considering preoperative response to medical treatment and quality of life, this study aimed to predict outcome following laparoscopic Nissen fundoplication. MATERIALS AND METHODS: In an academic center, 35 consecutive patients presenting with a gastroesophageal reflux disease requiring a laparoscopic Nissen fundoplication were prospectively included; 16 patients were nonresponders...
August 2014: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Clara Loots, Stamatiki Kritas, Michiel van Wijk, Lisa McCall, Laura Peeters, Peter Lewindon, Rob Bijlmer, Ross Haslam, Jacinta Tobin, Marc Benninga, Geoffrey Davidson, Taher Omari
OBJECTIVE: Proton-pump inhibitors (PPIs) reduce acid gastroesophageal reflux (GER) and esophageal acid exposure in infants; however, they do not reduce total GER or symptoms attributed to GER. Reflux is reduced in the left lateral position (LLP). We hypothesize that the effect of LLP in combination with acid suppression is most effective in reducing GER symptoms in infants. METHODS: In this prospective sham-controlled trial, infants (0-6 months) with symptoms suggestive of gastroesophageal reflux disease were studied using 8-hour pH-impedance, cardiorespiratory and video monitoring, direct nurse observation, and a validated questionnaire...
August 2014: Journal of Pediatric Gastroenterology and Nutrition
Tuomo Rantanen
Although fundoplication has been found effective in the treatment of reflux disease, its long-term results have raised doubts due to the large number of patients taking acid blocker medication after the operation. Based on the five-year follow-up of the REFLUX study, reflux symptoms and quality of life associated with reflux were improved after the operation. Laparoscopic fundoplication was found to be a cost-effective form of treatment among those having a chronic reflux disease. The operation can be recommended for treating reflux disease in patients exhibiting a non-optimal PPI drug response...
2014: Duodecim; Lääketieteellinen Aikakauskirja
José Wálter Huamán, Verónica Aliaga, Gemma Domenech, Sebastián Videla, Esteban Saperas
BACKGROUND AND AIMS: Noncardiac chest pain (NCCP) often represents a diagnostic and therapeutic challenge. Given that gastroesophageal reflux disease (GERD) is the most common cause of NCCP, initial treatment with proton-pump inhibitors (PPI) has been proposed for all patients (PPI testing), reserving esophageal function testing solely for non-responders. The aim of the present study was to provide evidence on the clinical utility of PPI testing with high-dose pantoprazole in patients with NCCP...
October 2014: Gastroenterología y Hepatología
2015-06-11 21:12:51
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