MedWorm: Acid Reflux

FDA Issues Warning on Acid Reflux Drugs

MedPage Today Gastroenterology — Wed, 08 Feb 2012 19:43:03 +0100

(MedPage Today) -- The FDA warned today that use of proton pump inhibitors -- including popular brands such as Nexium, Prilosec, and Prevacid -- may increase the risk of Clostridium difficile-associated diarrhea. (Source: MedPage Today Gastroenterology)

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Comparison of central and intraesophageal factors between gastroesophageal reflux disease (GERD) patients and those with GERD‐related noncardiac chest pain

Diseases of the Esophagus — Mon, 06 Feb 2012 05:00:00 +0100

SUMMARYGastroesophageal reflux disease (GERD) causes a wide range of symptoms. Some patients present with typical symptoms such as heartburn and regurgitation and others with atypical symptoms such as chest pain. The mechanism responsible for the varying clinical presentation of GERD is still not fully elucidated. The aim of this study was to prospectively evaluate differences in central and local intraesophageal factors between patients with typical GERD symptoms and those with noncardiac chest pain (NCCP). Patients presenting with typical and atypical symptoms suspicious of GERD underwent upper endoscopy and 24‐hour pH monitoring with four sensors, each positioned at a different esophageal level. All patients completed GERD symptom, Hospital Anxiety and Depression Scale, and Symptom St...

Mechanism of association between BMI and dysfunction of the gastro-oesophageal barrier in patients with normal endoscopy

Gut — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion The association between reflux and BMI may be largely explained by effects of increased intra-abdominal pressure. However, the reduced LOS pressure associated with BMI may be mediated by another mechanism or effects of chronic rather than acute elevation of intra-abdominal pressure. (Source: Gut)

Outcome Following Management of Dysphagia after Laparoscopic Anti-reflux Surgery

World Journal of Surgery — Thu, 02 Feb 2012 18:12:34 +0100

Conclusions Approximately two thirds of patients with troublesome post-fundoplication dysphagia have a satisfactory outcome following either endoscopic dilatation or revisional surgery. However, approximately one third continue to be troubled by symptoms, despite further intervention. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-011-1416-9Authors Huiqi Yang, Flinders University Department of Surgery, Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, AustraliaCindy Meun, Flinders University Department of Surgery, Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, AustraliaXiangyu Sun, Flinders University Department of Surgery, Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, AustraliaDavid I. Watson, Flinders University Depart...

Lipid-Laden Alveolar Macrophages and pH Monitoring in Gastroesophageal Reflux-Related Respiratory Symptoms

Clinical and Developmental Immunology — Thu, 02 Feb 2012 11:21:45 +0100

This study was conducted to prove a correlation between the detection of alimentary pulmonary fat phagocytosis and an increasing amount of proximal gastroesophageal reflux. It was assumed that proximal gastroesophageal reflux better correlates with aspiration than distal GER. Patients from 6 months to 16 years with unexplained recurrent wheezy bronchitis and bronchial hyperreactivity, or recurrent pneumonia with chronic cough underwent 24-hour double-channel pH monitoring and bronchoscopy with bronchoalveolar lavage (BAL). Aspiration of gastric content was determined by counting lipid laden alveolar macrophages from BAL specimens. There were no correlations between any pH-monitoring parameters and counts of lipid-laden macrophages in the whole study population, even when restricting analys...

The CCK2 receptor antagonist, JNJ‐26070109, inhibits gastric acid secretion and prevents omeprazole‐induced acid rebound in the rat

British Journal of Pharmacology — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions and Implications. These studies demonstrated that chronic administration of JNJ‐26070109 effectively inhibited gastric acid secretion and suppressed proton pump inhibitor (PPI)‐induced acid rebound in the rat. This work advances the field by demonstrating that modest doses of a competitive CCK2 receptor antagonist have significant and functionally important anti‐trophic actions in the gastric mucosa. These properties make JNJ‐26070109 is a suitable candidate for clinical investigation for the treatment of GORD.© Janssen Research and Development LLC British Journal of Pharmacology © The British Pharmacological Society (Source: British Journal of Pharmacology)

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The decreased expression of Beclin-1 correlates with progression to esophageal adenocarcinoma: The role of deoxycholic acid.

American Journal of Physiology. Gastrointestinal and Liver Physiology — Thu, 02 Feb 2012 05:00:00 +0100

Authors: Roesly HB, Khan MR, Chen HD, Hill KA, Narendran N, Watts GS, Chen X, Dvorak K Abstract Beclin-1 has a central role in the regulation of autophagy. Barrett's esophagus (BE) is associated with a significantly increased risk for the development of esophageal adenocarcinoma (EAC). In the current study, we evaluated the role of Beclin-1 and autophagy in the esophageal carcinogenesis. Biopsies obtained from patients with BE and EAC, tissues from a rat model of BE and EAC, and esophageal cell lines were evaluated for the expression of Beclin-1 by immunohistochemistry, immunoblotting, or RT-PCR. Since reflux of bile acids is important in esophageal carcinogenesis, we also evaluated the effect of exposure to deoxycholic acid (DCA) on autophagy and Beclin-1 expression. Beclin-1 expr...

Duodenal lipid‐induced symptom generation in gastroesophageal reflux disease: role of apolipoprotein A‐IV and cholecystokinin

Neurogastroenterology and Motility — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions & Inferences Our results suggest excessive duodenal lipid‐induced release of apoA‐IV and CCK in GERD. We postulate that the resulting heightened activation of duodenal vagal afferents may underlie central sensitization, thereby increasing the perception of reflux events. (Source: Neurogastroenterology and Motility)

5-Aminolevulinic acid-induced protoporphyrin IX fluorescence as immediate intraoperative indicator to improve the safety of malignant or high-grade brain tumor diagnosis in frameless stereotactic biopsies

Acta Neurochirurgica — Wed, 01 Feb 2012 17:14:11 +0100

Conclusion 5-ALA fluorescence in stereotactic biopsies can increase the safety and accuracy of these procedures by reducing sampling errors and eliminating the need for multiple samples and/or frozen section verification, creating a more accurate, faster and safer procedure for cases of suspected malignant or high-grade brain tumors situated in deep or eloquent areas. Content Type Journal ArticleCategory Clinical ArticlePages 1-4DOI 10.1007/s00701-012-1290-8Authors Gord von Campe, Universitätsklinik für Neurochirurgie, Medizinische Universität Graz, Graz, AustriaMichael Moschopulos, Department of Neuropathology, Kantonsspital Aarau, Aarau, SwitzerlandMartin Hefti, Neurochirurgisches Zentrum, Klinik Am Rosenberg, Hasenbühlstrasse 11, 9410 Heiden, Switzerland ...

Gastroesophageal reflux disease and postlaryngectomy tracheoesophageal fistula

European Archives of Oto-Rhino-Laryngology — Wed, 01 Feb 2012 17:12:47 +0100

The objective of this study is to evaluate the incidence of pathologic gastroesophageal reflux in laryngectomized patient with phonatory prosthesis, analyzing potential related problems and appraising, at the same time, the effectiveness of a therapeutic protocol. A retrospective study was conducted on 43 phonatory prosthesis patients who had problems with regard to recurrent tracheoesophageal granulations, the need of frequent prosthesis replacement, within a 3-month period, and unsatisfactory vocal results. Such patients underwent physical examination of the fistula region and of the neopharynx and were submitted to esophagogastroduodenoscopy. Moreover the group of patients underwent a therapeutic protocol and were re-evaluated posttreatment, examining fistula region both on the tr...

Efficient, highly diastereoselective MS 4 Å-promoted one-pot, three-component synthesis of 2,6-disubstituted-4-tosyloxytetrahydropyrans via Prins cyclization

Beilstein Journal of Organic Chemistry — Wed, 01 Feb 2012 09:34:00 +0100

Abstract A simple, efficient and highly diastereoselective one-pot three-component synthesis of functionalized 2,6-disubstituted-4-tosyloxytetrahydropyrans was performed. The synthesis features an optimized Prins cyclization in which an aromatic homoallylic alcohol, an aromatic/aliphatic aldehyde, and p-toluenesulfonic acid (catalyst and reagent) are reacted in the presence of molecular sieves (MS) 4 Å at reflux in dichloromethane to afford excellent yields (72–96%) within short reaction times (20–90 min). The MS 4 Å-promoted synthesis proved to be versatile enough to provide an array of symmetrical and unsymmetrical tetrahydropyran derivatives in economical manner. Furthermore, cleavage of the 4-tosyl group under mild conditions afforded 4-hydroxytetrahydropyran in e...

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PPI heartburn drugs 'up hip fracture risk in smokers'

NHS News Feed — Wed, 01 Feb 2012 09:19:00 +0100

Conclusion This large study had several strengths. Unlike some previous studies, it collected information on and took into account other key risk factors for fracture, including body weight, smoking, alcohol use and physical activity. It also looked at the women’s use of PPIs every two years (rather than just asking them once) and took into account variations in use during this time in their analysis. However, as the authors note, it also had some limitations: It did not ask about the brands of PPI used, nor the doses of PPI the women took, both of which could affect risk of fracture. The information about hip fracture was self-reported and not confirmed by medical records (although a smaller study has found self-reporting of hip fracture to be reliable). Also, the study did ...

Acute phase 99mTc-dimercaptosuccinic acid scan in infants with first episode of febrile urinary tract infection.

World Journal of Pediatrics : WJP — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: Parenchymal damage found in a minority of infants with febrile UTI presented promptly to the hospital. Acute phase DMSA scan should be carried out only in selected patients. An abnormal acute DMSA scan is a moderate predictor for dilated VUR and its ability to exclude VUR is restricted. PMID: 22282382 [PubMed - in process] (Source: World Journal of Pediatrics : WJP)

What is cause and what is effect?

Sleep Medicine — Wed, 01 Feb 2012 05:00:00 +0100

We would like to thank Prof. Kountouras and co-workers for their interest in our article . Kountouras et al. raise the question whether Helicobacter pylori infection (Hp-I) could be a potential confounder involved in obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) pathophysiology associated with metabolic syndrome. The concept is interesting as OSA, GERD and metabolic syndrome are all common disorders. (Source: Sleep Medicine)

Pediatric and adult eosinophilic esophagitis: similarities and differences

Allergy — Wed, 01 Feb 2012 05:00:00 +0100

AbstractEarly in the 1990s, several case series described adults suffering from dysphagia and children with refractory reflux symptoms, both accompanied by an eosinophil‐predominant infiltration, thereby conclusively distinguishing it from gastroesophageal reflux disease. Eosinophilic esophagitis (EoE) was recognized as its own entity in the adult and in the pediatric literature. In the last decade, evidence has accumulated that EoE represents a T‐helper (Th)2‐type inflammatory disease. Remodeling of the esophagus is a hallmark of EoE, leading to esophageal dysfunction and bolus impaction. Familial occurrence and disease association with single‐nucleotide polymorphisms underscore the influence of genetics in this disease. Eosinophilic esophagitis may affect individuals at any age, ...

Severe gastro-oesophageal reflux necessitating fundoplication after percutaneous endoscopic and open gastrostomy in children

Langenbeck's Archives of Surgery — Tue, 31 Jan 2012 07:04:16 +0100

Conclusion The results of this study indicated a higher incidence for severe GER leading to fundoplication in children with OG, while no difference with complications and clinical outcome between the two techniques, OG and PEG, were observed. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00423-012-0909-9Authors Hannu Lintula, Department of Paediatric Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, FinlandHannu Kokki, Department of Anaesthesiology and Intensive Care, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, FinlandPetri Juvonen, Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, F...

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Short‐term electrical stimulation of the lower esophageal sphincter increases sphincter pressure in patients with gastroesophageal reflux disease

Neurogastroenterology and Motility — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions & Inferences Short‐term stimulation of the LES in patients with GERD significantly increases resting LESP without affecting esophageal peristalsis or LES relaxation. Electrical stimulation of the LES may offer a novel therapy for patients with GERD. (Source: Neurogastroenterology and Motility)

Twice‐daily proton pump inhibitor therapy does not decrease the frequency of reflux episodes during nocturnal recumbency in patients with refractory GERD: analysis of 200 patients using multichannel intraluminal impedance–pH testing

Diseases of the Esophagus — Tue, 31 Jan 2012 05:00:00 +0100

SummaryOver half of patients with gastroesophageal reflux disease (GERD) report nocturnal symptoms. Proton pump inhibitors (PPIs) are the main medications used to treat GERD. Multichannel intraluminal impedance with pH (MII‐pH) monitoring is the most sensitive method for detection and characterization of GERD. The aim of this study was to assess and compare reflux frequency in patients with refractory GERD symptoms on and off PPI therapy during the nocturnal recumbent period, as assessed by MII‐pH testing. We analyzed 24‐hour MII‐pH studies performed in 200 patients monitored either on twice‐daily (n = 100) or off (n = 100) PPI therapy. Demographic analysis of the on‐therapy group revealed a mean age of 52 years (24–78 years) with 37% males, and the off‐therapy grou...

Quality of life and surgical outcomes following laparoscopic surgery for refractory gastroesophageal reflux disease in a regional hospital.

Canadian Journal of Surgery — Fri, 27 Jan 2012 16:01:36 +0100

Conclusion: Excellent surgical outcomes in LAR surgery can be obtained with careful patient selection at a nonacademic regional hospital. Although GERD-HRQL improved in all patients, patients with CPS showed no improvement in general health QOL scores after LAR surgery. Careful patient counselling should be employed when offering LAR surgery to patients with CPS. PMID: 22269301 [PubMed - in process] (Source: Canadian Journal of Surgery)

Gastro‐oesophageal reflux disease is associated with up‐regulation of desmosomal components in oesophageal mucosa

Histopathology — Fri, 27 Jan 2012 05:24:08 +0100

Conclusions: Taken together, the uniform up‐regulation of desmosomal genes/proteins in the oesophageal mucosa of patients with GERD supports the concept of architectural and molecular changes in the desmosomal compartment in the pathogenesis of GERD. (Source: Histopathology)

Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa.

Atherosclerosis — Fri, 27 Jan 2012 05:00:00 +0100

This study seeks to evaluate the clinical findings in patients with SE. Thirty-one patients with necrotic superficial squamous epithelium, with endoscopic white plaques or membranes, but without fungi, were compared with 34 patients having esophageal biopsies done for any purpose other than Barrett's surveillance. Sloughing esophagits patients were older than controls (56 vs 43.5 years) and were more likely to be taking five or more medications (77 vs 32%), especially central nervous system depressants (65 vs 32%) and medications associated with esophageal injury (55 vs 18%). In 69% the plaques were in the distal and/or mid-esophagus; 23% involved the entire esophagus; 8% were limited to the proximal esophagus. There was no correlation between medication history and site. Sloughing esophag...

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Predictors of acid suppression success in patients with chronic laryngitis

Neurogastroenterology and Motility — Thu, 26 Jan 2012 21:07:07 +0100

Conclusions & Inferences The success of acid suppression on chronic laryngitis could be predicted using reflux parameters detected by MII‐pH, among which increased laryngopharyngeal BET is the best. (Source: Neurogastroenterology and Motility)

Dextranomer-hyaluronic Acid implants misdiagnosed as bladder tumor on transvaginal ultrasonography.

Obstetrics and Gynecology — Thu, 26 Jan 2012 20:31:14 +0100

CONCLUSION: : It is important for health care providers to be aware of the radiographic appearance of dextranomer-hyaluronic acid implants in adults and to elicit an appropriate past medical history to avoid misdiagnosis and invasive diagnostic procedures. PMID: 22270444 [PubMed - in process] (Source: Obstetrics and Gynecology)

Reflux Drugs No Help for Children With Asthma (CME/CE, with video)

MedPage Today Allergy — Thu, 26 Jan 2012 10:13:00 +0100

(MedPage Today) -- Proton pump inhibitor treatment doesn't ease asthma for children without gastroesophageal reflux symptoms, even for those with a positive pH test, a randomized trial determined. (Source: MedPage Today Allergy)

Early experience with single-incision laparoscopic Nissen fundoplication for gastroesophageal reflux disease in patients with mental retardation via a gastrostomy site incision: report of five cases

Surgery Today — Wed, 25 Jan 2012 18:04:11 +0100

Abstract Single-incision laparoscopic fundoplication for gastroesophageal reflux disease is not widespread because of its technical difficulty. On the other hand, patients with gastroesophageal reflux frequently also have mental retardation and eating disorders. We have been performing single-incision laparoscopic fundoplication via a gastrostomy site incision since October 2009 for these patients. The treated patients were 4 males and 1 female. A small skin incision was made on the gastrostomy site and a SILS port was placed. Under pneumoperitoneum, a single-incision laparoscopic Nissen fundoplication and gastrostomy were performed with a flexible scope, conventional instruments, and high-dexterity instruments. The pneumoperitoneal time was 115–180 min and blood lo...

Study Finds Treatment of Silent Acid Reflux Does Not Improve Asthma in Children

MedlinePlus Health News — Wed, 25 Jan 2012 15:21:07 +0100

Source: National Heart, Lung, and Blood Institute - Related MedlinePlus Page: Asthma in Children (Source: MedlinePlus Health News)

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Treatment of silent acid reflux does not improve asthma in children, NIH study finds

National Institutes of Health (NIH) News Releases — Wed, 25 Jan 2012 14:46:00 +0100

Adding the acid reflux drug lansoprazole to a standard inhaled steroid treatment for asthma does not improve asthma control in children who have no symptom of acid reflux, according to a new study funded in part by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. (Source: National Institutes of Health (NIH) News Releases)

Heartburn drugs don't help kids' hard-to-control asthma

CTV Health — Wed, 25 Jan 2012 12:14:05 +0100

An acid reflux drug often used for hard-to-treat asthma doesn't help children with the breathing disease and may cause side effects, a study in 300 children found. (Source: CTV Health)

Video: Fundoplication

MayoClinic.com Full Feed — Wed, 25 Jan 2012 06:00:00 +0100

Fundoplication video shows this surgical treatment for stomach acid reflux and heartburn. (Source: MayoClinic.com Full Feed)

High prevalence of gastroesophageal reflux symptoms in type 2 diabetics with hypoadiponectinemia and metabolic syndrome

Nutrition and Metabolism — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions: Our study showed that the coexistence of MetS and low levels of serum adiponectin was associated with the higher prevalence of FSSG score >8 and the higher scores of GERD symptom in subjects with T2DM.Trial Registration: UMIN 000002271. (Source: Nutrition and Metabolism)

Air column in esophagus and symptoms of gastroesophageal reflux disease

BMC Medical Imaging - Latest articles — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions: Air bubbles in the esophagus may be seen frequently in CT scans, but their size and location can vary. The GERD symptoms can arise when a small diameter air column is present within the esophagus, especially in the middle and lower parts. (Source: BMC Medical Imaging - Latest articles)

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High-Throughput Screening of Potassium-Competitive Acid Blockers

Journal of Biomolecular Screening — Wed, 25 Jan 2012 05:00:00 +0100

H+,K+-ATPase is a key enzyme in the process of gastric acid secretion, and proton pump inhibitors (PPIs) have been accepted as one of the most effective treatments for peptic ulcer and gastroesophageal reflux disease. To discover a novel class of PPIs, the authors screened a low-molecular-weight compound library and identified two prospective acid blockers that were pyrrole derivatives. Both compounds inhibited H+,K+-ATPase in a reversible and potassium-competitive manner. These compounds led to the development of TAK-438 (1-[5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl]-N-methylmethanamine monofumarate), which is currently undergoing clinical trials as a novel potassium-competitive acid blocker for the treatment of acid-related diseases. (Source: Journal of Biomolecular Scre...

Study: Heartburn Drugs Don’t Help Children’s Asthma

Health — Tue, 24 Jan 2012 23:28:20 +0100

An acid reflux drug often used for hard-to-treat asthma doesn't help children with the breathing disease and may cause side effects, a study in 300 children found. Use of these drugs has more than doubled in U.S. children in recent years, but the study results suggest doctors should put the brakes on that practice, said UA asthma expert Dr. Fernando Martinez. (Source: Health)

Heartburn Meds Won’t Help, May Harm Kids With Asthma

Pharmacy News - Doctors Lounge — Tue, 24 Jan 2012 22:00:00 +0100

Acid-reducing drugs might boost respiratory infections in children without reflux, study finds (Source: Pharmacy News - Doctors Lounge)

Acid Reflux Drug Does Not Improve Asthma in Children

Public Health News Headlines from Johns Hopkins — Tue, 24 Jan 2012 21:28:53 +0100

(Source: Public Health News Headlines from Johns Hopkins)

Study: Heartburn drugs don't aid children's asthma

USATODAY.com Health — Tue, 24 Jan 2012 21:27:10 +0100

An acid reflux drug often used for hard-to-treat asthma doesn't help children with the breathing disease and may cause side effects. (Source: USATODAY.com Health)

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Heartburn Meds Won't Help, May Harm Kids with Asthma

MedlinePlus Health News — Tue, 24 Jan 2012 21:00:00 +0100

Acid-reducing drugs might boost respiratory infections in children without reflux, study finds Source: HealthDay Related MedlinePlus Pages: Asthma in Children, GERD, Heartburn (Source: MedlinePlus Health News)

Treatment of silent acid reflux does not improve asthma in children, NIH study finds

EurekAlert! - Medicine and Health — Tue, 24 Jan 2012 05:00:00 +0100

(NIH/National Heart, Lung and Blood Institute) Adding the acid reflux drug lansoprazole to a standard inhaled steroid treatment for asthma does not improve asthma control in children who have no symptom of acid reflux, according to a new study funded in part by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health. Lansoprazole therapy slightly increased the risk of sore throats and other respiratory problems in children, however (Source: EurekAlert! - Medicine and Health)

Wireless pH capsule – yield in clinical practice

Endoscopy — Tue, 24 Jan 2012 05:00:00 +0100

EndoscopyDOI: 10.1055/s-0031-1291541Wireless pH monitoring is one of the recent technologies that focus on improving the diagnosis of gastroesophageal reflux disease (GERD). The capsule, which is fixed within the esophagus, transmits data via telemetry to an external receiver. The capsule is usually inserted 6 cm above the squamocolumnar junction during an upper endoscopy. The standard recording duration is 48 hours but this can be extended to 96 hours. The wireless capsule has been shown to be at least as accurate as the conventional catheter for the monitoring of esophageal pH. Normal pH values have been established in three different series. The use of a wireless capsule provides an increased diagnostic yield for GERD compared with the conventional catheter. The increased yield is the...

Lansoprazole for Children With Poorly Controlled Asthma: A Randomized Controlled Trial [Original Contribution]

JAMA — Tue, 24 Jan 2012 05:00:00 +0100

Conclusion In this trial of children with poorly controlled asthma without symptoms of GER who were using inhaled corticosteroids, the addition of lansoprazole, compared with placebo, improved neither symptoms nor lung function but was associated with increased adverse events. Trial Registration clinicaltrials.gov Identifier: NCT00442013 (Source: JAMA)

Prevalence and causes of dysphonia in a large treatment‐seeking population

The Laryngoscope — Mon, 23 Jan 2012 20:20:24 +0100

Conclusions:This analysis of insurance claims data from a nationally representative database represents the largest study of its kind. Important differences in dysphonia prevalence related to age, sex, diagnosis, and physician type were identified. Laryngoscope, 122:343–348, 2012 (Source: The Laryngoscope)

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How to evaluate a patient with chronic cough?

Clinical Cases and Images — Mon, 23 Jan 2012 13:34:00 +0100

Initial evaluation of chronic cough (defined as more than 8 weeks' duration in adults and 4 weeks in children) should include a chest radiography (CXR) in most adult patients. Patients who are taking an angiotensin-converting enzyme inhibitor (ACEi) should switch to a medication from another drug class. Differential diagnosis of cough, a simple mnemonic is BAD CAT TOM (Bronchitis or pneumonia, Asthma, Drugs, CF or Cardiogenic, Aspiration, TB, Thyroid enlargement, Other, e.g. GERD, Malignancy, e.g. lung cancer). Click here to enlarge the image. The most common causes of chronic cough in adults are: - upper airway cough syndrome (post-nasal drip) - asthma - gastroesophageal reflux disease (GERD) - any combination of the above If upper airway cough syndrome is suspected, a trial of ...

Laparoscopic antireflux surgery and esomeprazole similarly efficacious for symptoms in people with gastro-oesophageal reflux disease who respond well to proton pump inhibitors

Evidence-Based Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Context Gastro-oesophageal reflux disease (GERD) is a chronic, relapsing condition – manifesting mostly with heartburn and acid regurgitation – that negatively affects daily quality of life. The two main treatments for GERD are medical – proton pump inhibitors (PPIs) and laparoscopic antireflux surgery (LARS). Both treatments have advantages and side effects that continue to be debated. On one hand, medical therapy may be associated with residual regurgitation and the potential long-term side effects of PPI (eg, osteoporotic fractures, drug–drug interaction). On the other hand, LARS may be associated with technical failures, dysphagia and bloating. Methods Under the acronym LOTUS, this 5-year randomised study compared efficacy and safety of LARS with ‘optimise...

The Basics of GERD

About Heartburn / Acid Reflux — Mon, 23 Jan 2012 05:00:00 +0100

GERD occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents reflux back up into the esophagus. Heartburn and acid regurgitation are the main symptoms of GERD, though some people with GERD don't experience any heartburn episodes. This is why it's important to know all the possible symptoms of GERD. While the majority of doctors will prescribe a trial of acid-suppressive therapy, and make a diagnosis based on the patient's response to this, there are tests to diagnose GERD a doctor may want to have performed. Treatment for GERD will usually start with certain lifestyle modifications and dietary changes. If you continue to have symptoms after these modifications, your physician will discuss with you the use of antacids, H2 blockers, and Proton Pump In...

Hiatal Hernia Basics

About Heartburn / Acid Reflux — Mon, 23 Jan 2012 05:00:00 +0100

A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm, and up into the chest. This opening is called a esophageal hiatus or diaphragmatic hiatus. Approximately 50 percent of hiatal hernia patients don't experience any symptoms. For the other 50 percent of patients, the these hiatal hernia symptoms may occur. There are a number of contributing factors that can cause hiatal hernias. While some patients with a hernia hernia may also have GERD, GERD doesn't cause a hiatal hernia. Various tests can be used to diagnose a hiatal hernia, though the tests most often used are the barium x-ray and the upper endoscopy. After the presence of a hernia is diagnosed, the treatment will vary by patient. As mentioned above, approximately 50% of patients with...

Peptic Ulcer Basics

About Heartburn / Acid Reflux — Mon, 23 Jan 2012 05:00:00 +0100

Peptic ulcers can cause a variety of symptoms, and these vary from patient to patient. Some patients with ulcers have minimal, unusual, or even no symptoms at all. Others may have every symptom. This is why it is very important to consult your doctor if you have any concerns. It is important to understand the causes of peptic ulcers. In the past, it was believed stress and diet caused peptic ulcers. Later, researchers stated stomach acids (hydrochloric acid and pepsin) contributed to the majority of ulcer formation. Today, however, research shows that most ulcers develop as a result of infection with a bacterium called Helicobacter pylori (H. pylori). Since most peptic ulcers are caused by H. pylori, your doctor will most likely confirm the presence of this bacteria before doing other ...

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Use of acid suppressive therapy more than 10 years after the endoscopic diagnosis of reflux esophagitis with specific emphasis to trademark and generic proton pump inhibitors

Journal of Gastroenterology and Hepatology — Fri, 20 Jan 2012 20:47:31 +0100

Conclusion: More than 10 years after the diagnosis, 22% of patients stopped using acid‐suppressive therapy. Only a minority (28%) were in clinical remission, associated with significantly higher satisfaction and compliance to therapy, as compared to their symptomatic counterparts. There was no difference in effect and usage of trademark versus generic medication preparations. (Source: Journal of Gastroenterology and Hepatology)

Localization of mGluR5, GABAB, GABAA, and cannabinoid receptors on the vago‐vagal reflex pathway responsible for transient lower esophageal sphincter relaxation in humans: an immunohistochemical study

Neurogastroenterology and Motility — Fri, 20 Jan 2012 20:42:28 +0100

Conclusions & Inferences Human mGluR5, GABAA,B, and CB1,2 receptors are abundantly expressed along the vago‐vagal neural pathway and involved in the triggering of TLESRs. These findings are not only in line with the central side effects observed during treatment with reflux inhibitors such as GABAB receptor agonists and mGluR5 antagonists, but also suggest that peripherally acting compounds may be effective. (Source: Neurogastroenterology and Motility)

Association of Gastroesophageal Reflux Disease Symptoms with Stable Chronic Obstructive Pulmonary Disease

Lung — Thu, 19 Jan 2012 08:03:30 +0100

Conclusion The severity of hyperinflation and dyspnea may be important associated risk factors for the incidence of GERD symptoms in patients with clinically stable COPD. Content Type Journal ArticlePages 1-6DOI 10.1007/s00408-011-9365-5Authors Bin-Miao Liang, Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041 Sichuan Province, ChinaYu-Lin Feng, Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041 Sichuan Province, China Journal LungOnline ISSN 1432-1750Print ISSN 0341-2040 (Source: Lung)

Gastroesophageal Reflux Disease – Another Risk Factor for Atrial Fibrillation

Cardiology — Wed, 18 Jan 2012 23:00:00 +0100

Cardiology 2011;120:185–186 (DOI:10.1159/000334799) (Source: Cardiology)

Esophageal Cancer May Be Caused By Migration Of Cancer-Causing Stomach Cells

Health News from Medical News Today — Wed, 18 Jan 2012 10:00:00 +0100

A new study is providing clues that may answer a decades-old question about the cells that give rise to a particularly lethal form of esophageal cancer. The research, published by Cell Press in the January 17th issue of the journal Cancer Cell, links inflammation and bile acid reflux with migration of cancer-causing stomach cells into the esophagus and may help guide future strategies for early therapeutic intervention. Esophageal adenocarcinoma is a cancer of the esophagus that is associated with acid reflux disease and Barrett esophagus (BE)... (Source: Health News from Medical News Today)

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Factors associated with asthma control in a pediatric reference center

Revista Paulista de Pediatria — Wed, 18 Jan 2012 06:37:28 +0100

OBJETIVO:Descrever os dados epidemiológicos, clínicos e os fatores associados ao controle da asma em pacientes asmáticos seguidos em um ambulatório pediátrico especializado. MÉTODOS: Estudo transversal de pacientes asmáticos ambulatoriais, para os quais eram fornecidas medicações profiláticas. A classificação da asma, as etapa de tratamento e a avaliação do controle seguiram a IV Diretrizes Brasileiras para o Manejo da Asma, de 2006. Os fatores avaliados foram: outras alergias, obesidade, imunodeficiências, refluxo gastresofágico e sensibilização alérgica, sendo comparados pacientes com asma controlada ou não com relação à etapa do tratamento, à obesidade e à sensibilização alérgica. RESULTADOS: Foram analisados 300 pacientes com asma (1,38M:1F), com mediana de ...

Duodenal bulb nodularity: an endoscopic sign of cow's milk protein allergy in infants?

Gastrointestinal Endoscopy — Tue, 17 Jan 2012 22:04:55 +0100

We report an association between LNH of the duodenal bulb and CMPA in infants with previous diagnoses of gastroesophageal reflux (GER) who subsequently experienced hematemesis and required upper endoscopy. (Source: Gastrointestinal Endoscopy)

Weak and absent peristalsis

Neurogastroenterology and Motility — Tue, 17 Jan 2012 21:39:57 +0100

This article aims to review the current insights in the terminology, pathology, pathophysiology, clinical manifestations, diagnostic work‐up,and management of weak and absent peristalsis. (Source: Neurogastroenterology and Motility)

Fluorescent spray 'detects oesophageal cancer'

NHS News Feed — Tue, 17 Jan 2012 08:30:00 +0100

Conclusion This small study has developed a fluorescently tagged molecule that can help identify areas of Barrett’s oesophagus that have progressed towards becoming cancerous. This is an early study with limitations, including the following: This was a small study, which only tested the technique in sections of oesophagus from four patients. The study only looked at oesophageal samples that had been removed from the body, although the researchers did try to replicate how the oesophagus would be examined in real life. The fluorescent molecule binds more strongly to normal tissue and less strongly to abnormal tissue. The researchers note that an ideal marker for cancerous tissue would usually work in the opposite way: binding to abnormal tissue but not normal tissue. This study...

Put a ring on it: New implant device for chronic heartburn

Health Facts and Fears — Tue, 17 Jan 2012 05:00:00 +0100

Those who suffer from chronic, severe gastroesophageal reflux disease (GERD) may soon be able to seek relief via a new implantable device. (Source: Health Facts and Fears)

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Bile Acid and Inflammation Activate Gastric Cardia Stem Cells in a Mouse Model of Barrett-Like Metaplasia

Cancer Cell — Tue, 17 Jan 2012 00:00:00 +0100

Michael Quante, Govind Bhagat, Julian A. Abrams, Frederic Marache, Pamela Good, Michele D. Lee, Yoomi Lee, Richard Friedman, Samuel Asfaha, Zinaida Dubeykovskaya, Umar Mahmood, Jose-Luiz Figueiredo, Jan Kitajewski, Carrie Shawber, Charles J. Lightdale, Anil K. Rustgi, Timothy C. Wang. Esophageal adenocarcinoma (EAC) arises from Barrett esophagus (BE), intestinal-like columnar metaplasia linked to reflux esophagitis. In a transgenic mouse model of BE, esophageal overexpression o.... (Source: Cancer Cell)

Palladium nanoparticles supported on layered hydroxide salts and their use in carbon-carbon coupling organic reactions

Journal of the Brazilian Chemical Society — Sun, 15 Jan 2012 07:04:39 +0100

Palladium nanoparticles supported on zinc hydroxide salts were prepared by intercalation of [PdCl6]2- and its further reduction with ethanol under reflux. All the materials were completely characterized by atomic absorption spectroscopy (AAS), X-ray diffraction (XRD), thermogravimetric/derivative thermogravimetric (TG/DTG) analyses, scanning electron microscopy (SEM), UV-Visible spectrometry and transmission electron microscopy (TEM). TEM analysis confirmed that the palladium nanoparticles were properly supported. The material containing supported palladium nanoparticles was used to promote Heck and Suzuki coupling reactions starting from aryl halides, with isolated yields of 98, 75 and 62% of biphenyl, cinnamic acid and 3-nitrobiphenyl, respectively.Nanopartículas de paládio suportadas ...

Agreement with Guidelines from a Large Database for Management of Systemic Sclerosis: Results from the Canadian Scleroderma Research Group.

J Rheumatol — Sun, 15 Jan 2012 05:00:00 +0100

CONCLUSION: There did not seem to be an increase in adherence to recommendations once the guidelines were published. For many guidelines, 25% to 40% of patients who would qualify received the recommended treatment. PMID: 22247347 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Pulmonary Immune Changes Early After Laparoscopic Antireflux Surgery in Lung Transplant Patients with Gastroesophageal Reflux Disease

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

Neutralization of Gastric Fluid Ph Does not Affect Pulmonary Transplant Pathology Associated with Chronic Gastroesophageal Reflux Aspiration

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

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Partial Fundoplication Relieves More GERD SymptomsPartial Fundoplication Relieves More GERD Symptoms

Medscape General Surgery Headlines — Fri, 13 Jan 2012 22:49:39 +0100

Short-term findings from an observational study favor 270-degree partial fundoplication as the surgical therapy for gastroesophageal reflux disease (GERD). Reuters Health Information (Source: Medscape General Surgery Headlines)

Systematic review: the treatment of noncardiac chest pain with antidepressants

Alimentary Pharmacology and Therapeutics — Fri, 13 Jan 2012 05:00:00 +0100

ConclusionsThere is modest evidence for the benefit of antidepressants in reducing NCCP and improving patients’ general health. However, there is significant heterogeneity amongst the studies with several study limitations to warrant more rigorous trials and to assess the usefulness of low‐dose antidepressants in non‐GERD NCCP. (Source: Alimentary Pharmacology and Therapeutics)

Extraesophageal gastroesophageal reflux disease (GERD) symptoms are not more frequently associated with proximal esophageal reflux than typical GERD symptoms

Diseases of the Esophagus — Fri, 13 Jan 2012 05:00:00 +0100

SUMMARYExtraesophageal (EE) symptoms such as cough and throat clearing are common in patients referred for reflux testing, but are less commonly associated with gastroesophageal reflux disease (GERD). Patients with reflux associated EE symptoms often lack typical GERD symptoms of heartburn and regurgitation. Our aim was to compare the frequency of proximal esophageal reflux between esophageal (typical) symptoms and EE (atypical) symptoms. Combined multichannel intraluminal impedance‐pH (MII‐pH) tracings were blinded by an investigator so that symptom markers were relabeled with a number without disclosure of symptom type. We selected 40 patients with at least five reflux‐related symptom events for one of four symptoms (heartburn, regurgitation, cough, or throat clearing). A blinded i...

Impedance nadir values correlate with barium bolus amount

Diseases of the Esophagus — Fri, 13 Jan 2012 05:00:00 +0100

We examined the value of impedance monitoring in measuring bolus volume compared with videoesophagram. Eighty consecutive subjects were studied with simultaneous impedance‐manometry‐videoesophagram. A catheter with both an impedance electrode pair and a pressure transducer at four sites (5, 10, 15, 20 cm above lower esophageal sphincter) was passed per nares. Six 10‐cc boluses of 45% barium mixed with 0.9% NaCl were swallowed at 20‐ to 30‐second intervals. When impedance fell to below 1000 ohms, other than that occurring during administered swallows, the videofluoroscopic image corresponding to the time of impedance nadir was reviewed. If barium was present at the impedance site, barium area was calculated. The video was reviewed for the cause of abnormal barium transit causi...

FDA Panel Backs New Device for Chronic Heartburn

WebMD Health — Thu, 12 Jan 2012 20:19:06 +0100

An implantable device to treat chronic, severe acid reflux disease has moved one step closer to approval. (Source: WebMD Health)

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Fluoroscopic findings in pediatric eosinophilic esophagitis

Pediatric Radiology — Thu, 12 Jan 2012 16:48:02 +0100

Conclusion Fluoroscopic studies are not a sensitive method to diagnose EE because nearly half of the studies are normal. Findings that have been described in the setting of EE such as food impaction, a ringed esophagus, a small-caliber esophagus and esophageal stricture do not occur with a high enough frequency to reliably make a diagnosis. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00247-011-2329-3Authors Lincoln O. Diniz, Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., ML 5031, Cincinnati, OH 45229, USAPhilip E. Putnum, Department of Gastroenterology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USAAlexander J. Towbin, Department of Radiology, Cincinnati Children’s Ho...

Partial fundoplication relieves more GERD symptoms

Modern Medicine — Thu, 12 Jan 2012 05:00:00 +0100

NEW YORK (Reuters Health) - Short-term findings from an observational study favor 270-degree partial fundoplication as the surgical therapy for gastroesophageal reflux disease (GERD). (Source: Modern Medicine)

Evolution of GERD Over 5 Years Under Routine Medical CareEvolution of GERD Over 5 Years Under Routine Medical Care

Medscape Today Headlines — Thu, 12 Jan 2012 04:00:00 +0100

How does gastroesophageal reflux disease generally progress in most patients? This new study examines a 5-year period. Alimentary Pharmacology & Therapeutics (Source: Medscape Today Headlines)

LINX Reflux Management System Scores a Hat Trick at the FDALINX Reflux Management System Scores a Hat Trick at the FDA

Medscape Today Headlines — Thu, 12 Jan 2012 01:17:55 +0100

An expert FDA advisory panel liked LINX, unanimously voting yes to all 3 questions and affirming efficacy, safety, and favorable risk-benefit ratio for the novel treatment for drug-refractory GERD. Medscape Medical News (Source: Medscape Today Headlines)

Impact of antisecretory treatment on respiratory symptoms of gastroesophageal reflux disease in children

Diseases of the Esophagus — Wed, 11 Jan 2012 05:00:00 +0100

SUMMARYThe effect of antisecretory treatment on extraesophageal symptoms of gastroesophageal reflux disease was evaluated. Seventy‐eight children presenting with typical and extraesophageal symptoms of gastroesophageal reflux disease underwent a multichannel intraluminal impedance and pH monitoring (MII/pH). Children with a positive MII/pH were randomly treated with proton pump inhibitors (PPIs) or histamine H2‐receptor antagonists (H2RAs) during 3 months. At the end of the treatment period, all patients were recalled. A second treatment period of 3 months was given to those patients who were not symptom‐free after 3 months. Thirty‐five of the forty‐one (85.4%) children with a pathologic MII/pH presented with extraesophageal symptoms and were treated with PPIs (omeprazole; n:19) ...

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Managing children under 36 months of age with febrile urinary tract infection: a new approach

Pediatric Nephrology — Tue, 10 Jan 2012 17:00:11 +0100

Conclusions The application of our guidelines leads to a decrease in invasive examinations without missing any useful diagnoses or compromising the child’s health. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00467-011-2087-3Authors Marco Pennesi, Department of Pediatrics, Institute for Child and Maternal Health, IRCCS Burlo Garofolo, Via dell’Istria 65/1, 34137 Trieste, ItalyInes L’Erario, Department of Pediatrics, Institute for Child and Maternal Health, IRCCS Burlo Garofolo, Via dell’Istria 65/1, 34137 Trieste, ItalyLaura Travan, Department of Neonatal Intensive Care Unit, Institute for Child and Maternal Health, IRCCS Burlo Garofolo, Via dell’Istria 65/1, 34137 Trieste, ItalyAlessandro Ventura, Department of Pediatrics, Ins...

Detection of gastro-oesophageal reflux disease (GORD) in patients with obstructive lung disease using exhaled breath profiling

Journal of Breath Research — Tue, 10 Jan 2012 05:00:00 +0100

Gastro-oesophageal reflux disease (GORD) has been implicated in the worsening of several respiratory disorders. Current methods of diagnosis lack accuracy, are invasive and can be costly. Recently, novel methods of analysing lung pathophysiology have been developed including the use of an electronic nose and analysis of components of exhaled breath condensate (EBC). We hypothesised that these methods would distinguish patients with GORD from those without GORD in the common obstructive lung diseases and healthy controls. In a cross-sectional study, exhaled breath was analysed using the Cyranose 320 electronic nose, using principal components and canonical discriminant analyses. EBC pH and pepsin were quantified using a pH meter and an enzyme-linked immunosorbent assay, respectively...

Impact of participation in randomized trials on outcome following surgery for gastro-oesophageal reflux.

The British Journal of Surgery — Mon, 09 Jan 2012 05:00:00 +0100

CONCLUSION: Participation in a randomized trial assessing surgery for reflux did not influence outcomes. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 22231692 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)

Reflux symptoms prevalence on the rise

MedWire News - Gastroenterology — Sun, 08 Jan 2012 20:50:44 +0100

Findings from the HUNT study shed light on the epidemiology of gastroesophageal reflux symptoms, showing an increase in prevalence and a low likelihood of spontaneous improvement. (Source: MedWire News - Gastroenterology)

Oesophageal sensation in response to high PCO2 and acidic solutions in nonerosive reflux disease

European Journal of Clinical Investigation — Sat, 07 Jan 2012 11:48:30 +0100

Conclusions In NERD subjects, acid perfusion reliably evoked heartburn symptoms of greater intensity than in healthy controls. Nevertheless, a high PCO2 perfusion failed to produce symptoms in either group. (Source: European Journal of Clinical Investigation)

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Role of GERD in Children with Otitis Media with Effusion

Indian Journal of Pediatrics — Fri, 06 Jan 2012 16:49:37 +0100

Conclusions OME appears to be multifactorial disease.GERD may be one of the contributing factors in the etiopathogenisis of OME. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s12098-011-0671-yAuthors Surendran Nair, Department of ENT, Amrita Institute of Medical Sciences and Research Centre, (AIMS), Ponekkara P.O., Kochi, Kerala 682041, IndiaMadhumita Kumar, Department of ENT, Amrita Institute of Medical Sciences and Research Centre, (AIMS), Ponekkara P.O., Kochi, Kerala 682041, IndiaPrathapan Nair, Department of ENT, Amrita Institute of Medical Sciences and Research Centre, (AIMS), Ponekkara P.O., Kochi, Kerala 682041, India Journal Indian Journal of PediatricsOnline ISSN 0973-7693Print ISSN 0019-5456 (Source: Indian Journal of Pediat...

Long-term results of ablation with antireflux surgery for Barrett’s esophagus: a clinical and molecular biologic study

Surgical Endoscopy — Thu, 05 Jan 2012 06:49:56 +0100

Conclusions The neosquamous mucosa, generated by the ablation of BE and the treatment of GERD with fundoplication, was stable during long-term follow-up evaluation in two-thirds of the patients with initial eradication. It had normal p53 expression and no Cdx2 protein expression. The oxidative stress of the neosquamous esophagus remained high, although the clinical significance of this is unclear. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2121-3Authors Tuuli Kauttu, Division of General Thoracic and Esophageal Surgery, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, 00029 HUS Helsinki, FinlandJari Räsänen, Division of General Thoracic and Esophageal Surgery, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, 0...

Distal Esophageal Spasm

Dysphagia — Wed, 04 Jan 2012 06:58:33 +0100

Abstract Distal esophageal spasm (DES) is an uncommon esophageal motility disorder associated with dysphagia and/or chest pain. Its pathophysiology implies an impairment of esophageal inhibitory neural function. Using conventional manometry, DES was defined by the presence of simultaneous esophageal contractions. With the introduction of high-resolution manometry and esophageal pressure topography (EPT) in clinical practice, rapidly propagated contractions are nonspecific of esophageal spasm. Hence, a more physiological and clinically relevant definition was proposed. Distal latency (DL) measures the period of inhibition that precedes contraction in the distal esophagus immediately proximal to the esophagogastric junction (EGJ). Premature contractions, defined as reduced D...

Evaluations of Hospitalizations Associated With Thiazide‐Associated Hyponatremia

The Journal of Clinical Hypertension — Sun, 01 Jan 2012 05:00:00 +0100

J Clin Hypertens (Greenwich).****;**:**–**. ©2011 Wiley Periodicals, Inc.The prevalence of hypertension in the United States has grown dramatically in recent years. Thiazide diuretics have played a major role in the rising rate of blood pressure (BP) control. Accompanying this has been the appearance of adverse drug events, including hospitalizations associated with thiazide‐associated hyponatremia (HTAH). Hyponatremia is a common yet often overlooked side effect of this drug class. Identification of HTAH risk factors may aid in creating strategies to prevent hospitalizations. This is a retrospective, case‐controlled study of 10,805 patients (1802 cases, 9003 controls) examining HTAH risk factors within a group‐model integrated‐care organization. Multivariate analysis revealed t...

Early effects of oral administration of omeprazole and roxatidine on intragastric pH.

J Zhejiang Univ Sci ... — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: In Helicobacter pylori-negative healthy male subjects, oral administration of roxatidine 75 mg increased the intragastric pH more rapidly than that of omeprazole 20 mg. PMID: 22205617 [PubMed - in process] (Source: J Zhejiang Univ Sci ...)

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A novel antireflux procedure: gastroplasty with restricted antrum to control emesis (GRACE)

Journal of Pediatric Surgery — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: In this canine model, GRACE appears to be significantly more effective than Nissen fundoplication at reducing emetic reflux. This novel procedure preserves gastric function and is well tolerated. The GRACE procedure may provide an alternative to Nissen fundoplication as a primary or repeat antireflux procedure for children with neurologic impairment. (Source: Journal of Pediatric Surgery)

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Journal of Pediatric Surgery — Sun, 01 Jan 2012 05:00:00 +0100

The authors report on their experience with a modified Spitz procedure using a Collis gastroplasty for the repair of long-gap esophageal atresia (EA). The authors reviewed 5 cases of children with long-gap (5-6 vertebral bodies) EA. The repair was carried out 3 months after permanent monitoring, enteral nutrition via gastrostomy tube, and permanent aspiration of the proximal esophagus. The Collis gastroplasty was performed to create a gastric tube along the lesser gastric curvature using an Endo-GIA linear stapler. The gastric tube can be easily mobilized into the thorax after ligation of the gastric vessels and anastomosed to the proximal esophageal segment. There were no introperative complications. The median postoperative hospital stay was 39 days (range, 30-60 days) with a median fol...

Whey- vs Casein-Based Enteral Formula and Gastrointestinal Function in Children With Cerebral Palsy.

JPEN Journal Of Parenteral And Enteral Nutrition — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: This pilot study shows that in children who have severe CP with a gastrostomy and fundoplication, GE of the whey-based enteral formula is significantly faster than casein. The acceleration in GE does not alter GOR frequency, and there appears to be no effect of whey vs casein in reducing acid, nonacid, and total reflux episodes. The results indicate that enteral formula selection may be particularly important for children with severe CP and delayed GE. PMID: 22237871 [PubMed - in process] (Source: JPEN Journal Of Parenteral And Enteral Nutrition)

Factors associated with the initiation of proton pump inhibitors in corticosteroid users

Pharmacoepidemiology and Drug Safety — Sun, 01 Jan 2012 05:00:00 +0100

ConclusionsOverall, PPI therapy among corticosteroid users was uncommon, even among those with risk factors for gastrointestinal toxicity. PPI use was significantly more common among patients who had recently been hospitalized, had a greater burden of comorbid illness, or were receiving high daily doses of corticosteroids. Copyright © 2012 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)

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Variation of health‐care resource utilization according to GERD‐associated complications

Diseases of the Esophagus — Sun, 01 Jan 2012 05:00:00 +0100

SUMMARYComplications associated with gastroesophageal reflux disease (GERD) can include esophageal stricture, Barrett's esophagus, gastrointestinal hemorrhage, and extraesophageal symptoms. The impact of GERD‐associated complications on health‐care utilization deserves further evaluation. We identified commercial enrollees 18–75 years old with claims for GERD (International Classification of Diseases, Ninth Revision, Clinical Modification Codes: 530.81 or 530.11) and subsequent usage of proton pump inhibitors from 01/01/05 to 06/30/09. The initial GERD diagnosis date was designated as the index date, and patients were studied for 6 months preindex and postindex. Eligible patients were subsequently stratified based on medical claims for GERD‐associated complications as follows: stag...

Step‐by‐step management of refractory gastresophageal reflux disease

Diseases of the Esophagus — Sun, 01 Jan 2012 05:00:00 +0100

SUMMARYUp to a third of the patients who receive proton pump inhibitor (PPI) once daily will demonstrate lack or partial response to treatment. There are various mechanisms that contribute to PPI failure and they include residual acid reflux, weakly acidic and weakly alkaline reflux, esophageal hypersensitivity, and psychological comorbidity, among others. Some of these underlying mechanisms may coincide in the same patient. Evaluation for proper compliance and adequate dosing time of PPIs should be the first management step before ordering invasive diagnostic tests. Doubling the PPI dose or switching to another PPI is the second step of management. Upper endoscopy and pH testing appear to have limited diagnostic value in patients who failed PPI treatment. In contrast, esophageal impedance...

Risk factors for laryngopharyngeal reflux

European Archives of Oto-Rhino-Laryngology — Fri, 30 Dec 2011 07:10:04 +0100

Abstract The aim of this study was to evaluate the demographic and clinicopathologic characteristics of gastroesophageal reflux disease (GERD) with and without laryngopharyngeal reflux (LPR) to determine the risk factors for the occurrence of LPR in patients with GERD. This is a retrospective study of GERD patients with and without LPR. From the outpatient computer program of our hospital we randomly enrolled 45 GERD patients with LPR into the first group and another 45 GERD patients without LPR to the second group. Medical records of the patients in both groups were examined. All patients underwent upper gastrointestinal system endoscopy. LPR was confirmed by laryngoscopy, and LPR-related laryngoscopy scoring. Non-erosive GERD (NERD), erosive GERD (ERD) and Barrett’s es...

Efficacy of leukotriene receptor antagonist for erosive esophagitis: a preliminary retrospective comparative study

Diseases of the Esophagus — Fri, 30 Dec 2011 05:00:00 +0100

In conclusion, this preliminary retrospective analysis demonstrated that patients who underwent long‐term treatment with a LTRA had low incidence of endoscopic minimal change esophagitis. (Source: Diseases of the Esophagus)

Technical feasibility and safety of a new, implantable reflux control system to prevent gastroesophageal reflux in patients with stents placed through the lower esophageal sphincter (with video)

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

This study involved 10 patients who had an “open” stent placed through the LES and 1 patient with severe bile reflux after esophagojejunostomy. Intervention: Placement of an RCS with fluoroscopic and (in selected cases) endoscopic guidance, from April to October 2010. Main Outcome Measurements: Technical success of RCS placement and complications. Results: Placement of an RCS was successful on the first attempt in all patients; complete expansion to the wall of the host stent was confirmed by fluoroscopy in all cases. In 3 patients, the host stent migrated in (Source: Gastrointestinal Endoscopy)

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Induced Sputum Substance P in Children with Difficult-to-Treat Bronchial Asthma and Gastroesophageal Reflux: Effect of Esomeprazole Therapy

Clinical and Developmental Immunology — Tue, 27 Dec 2011 23:55:03 +0100

Conclusions. GER was found in 49% of our patients with childhood DA. Very high ISSP levels in children with DA may be used as a marker for presence of GERD. Esomeprazole therapy improved asthma symptoms but did not improve lung function. (Source: Clinical and Developmental Immunology)

'Tis The Season For Turkey, Gravy, Pie And Acid Reflux

Health News from Medical News Today — Tue, 27 Dec 2011 08:00:00 +0100

Jack Selby, of Lansing, Mich., had suffered from heartburn all of his life, especially around the holidays when he overindulged in some of his favorite food and drink. "Special days anytime of the year, but particularly holidays, the turkeys and the gravies and all of the dishes with onions, great salads, punches and alcohol bothered me a great deal because of the stomach acid and of course you overeat and fall asleep," says Selby, a 68-year-old retiree. "So that's not a particularly good thing to have happen." He thought over-the-counter antacids had solved his problem... (Source: Health News from Medical News Today)

Oral symptoms including dental erosion in gastroesophageal reflux disease are associated with decreased salivary flow volume and swallowing function

Journal of Gastroenterology — Mon, 26 Dec 2011 16:45:36 +0100

Conclusions Oral symptoms in GERD are likely to be associated with impaired salivary flow volume or swallowing function. Treatment for the oral dryness induced by reduced salivary flow volume and rehabilitation for swallowing function could be indicated in patients with GERD. Content Type Journal ArticleCategory Original Article—Alimentary TractPages 1-9DOI 10.1007/s00535-011-0515-6Authors Hiroo Yoshikawa, Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, JapanKenji Furuta, Department of Internal Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, JapanMayumi Ueno, Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89...

Heartburn Resolutions -- 2012

About Heartburn / Acid Reflux — Mon, 26 Dec 2011 05:00:00 +0100

The beginning of a new year has always been a time we reflect on the changes we want or need to make. It is a time we make resolutions for change, and resolve to follow through on those changes. If you are thinking about making some changes in the coming new year on how you approach the care and treatment of your heartburn, these heartburn resolutions will make a good start. Related Information: Quick Tips for Preventing Heartburn Keeping a Heartburn Record Meal Planning Tips for Preventing Heartburn Why Some Foods Cause Heartburn Eating Out Without Heartburn Preventing Nighttime Heartburn Heartburn Resolutions -- 2012 originally appeared on About.com Heartburn / GERD on Monday, December 26th, 2011 at 00:57:20.Permalink | Comment | Email this (Source: About Heartburn / Acid...

Preventing Stress-Related Heartburn

About Heartburn / Acid Reflux — Mon, 26 Dec 2011 05:00:00 +0100

While stress hasn't been linked directly to heartburn, it is known that it can lead to behaviors that can trigger heartburn. During stressful times, routines are disrupted and people may not follow their normal routines in regards to meals, exercise, and medication. More than half of people who suffer frequent heartburn say a hectic lifestyle and work-related stress increases their heartburn. It is important to find ways to alleviate the stress, and thus make stress-related heartburn less likely. Following the relaxation tips at Managing Stress to Ease the Heartburn can help. Related Information on Preventing Heartburn: 8 Quick Ways to Prevent Heartburn Meal Planning Tips for Preventing Heartburn Preventing Nighttime Heartburn Preventing Heartburn During Pregnancy 6 Steps to...

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Nocturnal gastroesophageal reflux, lung function and symptoms of obstructive sleep apnea: Results from an epidemiological survey

Respiratory Medicine — Mon, 26 Dec 2011 05:00:00 +0100

Conclusions: In our cross-sectional epidemiological study, untreated nGER is strongly associated with both respiratory and OSA symptoms as well as airflow obstruction. (Source: Respiratory Medicine)

Acid Reflux 50% More Common Than Ten Years Ago

Health News from Medical News Today — Sat, 24 Dec 2011 08:00:00 +0100

A long-term Norwegian study reveals the number of people who experience acid reflux at least once a week has gone up by nearly 50% in the last 10 years, with women appearing to be more susceptible to the condition than men. The findings raise concerns that this will lead to an increase in cancer of the oesophagus, a once rare but now more common malignancy that is very difficult to treat. The researchers write about their findings in the online first issue of the journal Gut, published on 21 December... (Source: Health News from Medical News Today)

The relevance of symptom association analysis in GORD patients undergoing anti-reflux surgery

Gut — Sat, 24 Dec 2011 05:00:00 +0100

We read with great interest the article by Broeders et al1 on the effects of anti-reflux surgery on weakly acidic reflux and belching. The authors evaluated 31 gastro-oesophageal reflux disease (GORD) patients, refractory to proton pump inhibitors, by means of upper gastrointestinal endoscopy, validated symptoms questionnaires, stationary oesophageal manometry and 24-hour impedance–pH monitoring off antisecretory therapy before and 6 months after laparoscopic Nissen fundoplication (LNF). They observed that LNF reduced oesophageal acid exposure time (AET) and proximal migration of reflux events and similarly controlled both acidic and weakly acidic reflux, while gas reflux was diminished to a lesser extent. Moreover, they found that out of 15 patients with persisting symptoms aft...

As obesity rises, more suffer from acid reflux

USATODAY.com Health — Fri, 23 Dec 2011 15:23:07 +0100

As the obesity epidemic spreads more people are suffering from acid reflux, likely increasing the number of those who will develop esophageal ... (Source: USATODAY.com Health)

Acid Reflux 50% More Common

Health News from Medical News Today — Fri, 23 Dec 2011 14:00:00 +0100

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Gastroesophageal Reflux Disease (GERD)

MedicineNet Allergies General — Fri, 23 Dec 2011 07:00:00 +0100

Title: Gastroesophageal Reflux Disease (GERD)Category: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 12/23/2011 (Source: MedicineNet Allergies General)

Study: Acid Reflux Prevalence Increasing

eMedicineHealth.com — Fri, 23 Dec 2011 07:00:00 +0100

(Source: eMedicineHealth.com)

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Acid Reflux Disease (GERD)

eMedicineHealth.com — Fri, 23 Dec 2011 07:00:00 +0100

Acid Reflux (GERD) (Source: eMedicineHealth.com)

Gastroesophageal Reflux Disease (GERD)

MedicineNet Asthma General — Fri, 23 Dec 2011 07:00:00 +0100

Title: Gastroesophageal Reflux Disease (GERD)Category: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 12/23/2011 (Source: MedicineNet Asthma General)

NHS Choices assessment of press reports about heartburn reflux rise triggered by fatty diet

NeLM - News — Fri, 23 Dec 2011 05:00:00 +0100

Source: NHS Choices Area: News NHS Choices has conducted an assessment of a report in the Daily Mail that "obesity could be driving a 50% rise in people suffering acid reflux over the last decade." The report is based on a study published in Gut which found that the number of people experiencing at least one acid reflux attack a week has risen from 11.6% to 17.1% in just over a decade, while for those suffering severe symptoms, it is up from 5.4% to 6.7%. The assessment notes that this was a well-conducted, study although it had some important limitations, including its reliance on people self-reporting their symptoms of acid reflux; also, much of it relied on people themselves deciding if their symptoms were minor or severe. The assessment notes that the ...

Med Sci Monit 2012; 18(1):BR9-15 "Orally administered L-arginine and glycine are highly effective against acid reflux esophagitis in rats"

Medical Science Monitor — Thu, 22 Dec 2011 19:17:00 +0100

Conclusions: The results confirmed an essential role for acid and pepsin in the pathogenesis of acid reflux esophagitis in the rat model and further suggested that various amino acids affect the severity of esophagitis in different ways, due to yet unidentified mechanisms; L-alanine and L-glutamine exert a deleterious effect on the esophagitis, while L-arginine and glycine are highly protective, independent of endogenous prostaglandins and nitric oxide. (Source: Medical Science Monitor)

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Study: Acid Reflux Prevalence Increasing

WebMD Health — Thu, 22 Dec 2011 19:11:25 +0100

The prevalence of weekly heartburn and other symptoms associated with acid reflux rose by almost 50% over the last decade, according to one of the largest studies ever to examine the issue. (Source: WebMD Health)

Heartburn reflux rise 'triggered by fatty diet'

NHS News Feed — Thu, 22 Dec 2011 18:00:00 +0100

Conclusion This was a well-conducted study and its size reduces the risk of findings being due to chance. While it does suggest that the incidence of GORD may be rising, it does have some important limitations: It relied on people self-reporting their symptoms of acid reflux and also recalling how often symptoms had occurred over the last 12 months, rather than, for example, using medical records. Relying on self-reporting, particularly when people have to remember symptoms over a period of months, can make the results less accurate. The first two surveys used did not ask people specifically how many attacks of reflux they had, although the researchers say they conducted a smaller study to validate the results. There was a sharp drop in participants between the two surveys, which ...

Study: Acid Reflux Prevalence Increasing

WebMD Health — Thu, 22 Dec 2011 14:02:09 +0100

Acid reflux cases soar by 50% in ten years

Nursing Times Breaking News — Thu, 22 Dec 2011 10:08:00 +0100

The proportion of people suffering acid reflux has jumped almost 50% in a decade, research suggests. (Source: Nursing Times Breaking News)

CYP2C19 genotypes determine the efficacy of on‐demand therapy of pantoprazole for reflux esophagitis as Los‐Angeles grades C and D

Journal of Gastroenterology and Hepatology — Thu, 22 Dec 2011 09:16:18 +0100

Conclusion: For RE‐CD with complete healing after continuous pantoprazole, the successful shift to ODT is determined by the CYP2C19 genotypes of the patients. (Source: Journal of Gastroenterology and Hepatology)

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As Obesity Rises, More Suffer From Acid Reflux

MedicineNet Cancer General — Thu, 22 Dec 2011 07:00:00 +0100

Title: As Obesity Rises, More Suffer From Acid RefluxCategory: Health NewsCreated: 12/21/2011 8:06:00 PMLast Editorial Review: 12/22/2011 (Source: MedicineNet Cancer General)

Enjoy holiday meals again - Ten tips to cure acid reflux naturally

NaturalNews.com — Thu, 22 Dec 2011 06:00:00 +0100

Sharing a big meal is a time-honored tradition for most holiday celebrations, and over-indulging is often accompanied by food coma and acid indigestion. Swallowing gallons of antacids or sucking on chalky lozenges won't stop the pain for long, or keep it from returning... (Source: NaturalNews.com)

Big rise in acid reflux

OnMedica Latest News — Thu, 22 Dec 2011 05:00:00 +0100

Experts warn of link with rising rates of throat cancer Related items from OnMedicaColleges urge GPs to take on maternity carePlacebo may not rely on deceptionParents unsure of HPV vaccine for daughters Higher breast cancer risk with HRTFour in five girls have had HPV jab (Source: OnMedica Latest News)

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Connection Between Rising Obesity and 50% Increase in Acid Reflux Sufferers

About Heartburn / Acid Reflux — Thu, 22 Dec 2011 05:00:00 +0100

A new study is showing evidence that as obesity increases around the world, the number of people suffering from acid reflux is also increasing. Dr. Eivind Ness-Jensen, from the HUNT Research Center's Department of Public Health and General Practice at the Norwegian University of Science and Technology in Levanger, is leading a group of researchers who are finding that the prevalence of acid reflux (gastroesphageal reflux disease, or GERD) has increased by nearly 50% in the past 10 years. The research is showing that the increasing number of people who are obese is the "main attributable factor," Ness-Jensen said. "It's purely mechanical in one way. Added weight increases the pressure between the stomach and esophagus," forcing stomach acid back up, Ness-Jensen said. "There's an increasin...

Share Your Favorite Heartburn Friendly Recipes

About Heartburn / Acid Reflux — Thu, 22 Dec 2011 05:00:00 +0100

We all like creating recipes and sharing them with others. Now is your opportunity to share with others any recipes you have either adapted to be heartburn free or newly created by yourself. In this Share Your Favorite Heartburn Friendly Recipes article, you can select one of more categories to submit your recipes to. Share with others your favorite recipes that you have created or adapted that are heartburn free for you. Related Resources: Safe Foods for Heartburn Sufferers Foods Okay in Moderation Foods Heartburn Sufferers Should Avoid Why Certain Foods Can Cause Heartburn Meal Planning Tips to Prevent Heartburn Heartburn-free School Lunches Share Your Favorite Heartburn Friendly Recipes originally appeared on About.com Heartburn / GERD on Thursday, December 22nd, 2011 a...

Holiday Tips for Children with GERD

About Heartburn / Acid Reflux — Thu, 22 Dec 2011 05:00:00 +0100

Despite the delights holiday feasts can bring, for many children with gastroesophageal reflux disease (GERD), this may not be a happy dining experience for them. Avoiding foods that can trigger heartburn symptoms is important for the management of pediatric GERD, but it can be difficult because of the many rich traditional holiday foods served. Parents can still make holiday dining enjoyable for their children with these heartburn-prevention tips.Holiday Tips for Children with GERD originally appeared on About.com Heartburn / GERD on Thursday, December 22nd, 2011 at 08:05:05.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Preventing Heartburn at Holiday Parties

About Heartburn / Acid Reflux — Thu, 22 Dec 2011 05:00:00 +0100

The holidays are filled with feasts and festivities -- and sometimes heartburn, too. Here's how to avoid holiday heartburn. During the holidays, and anytime during the year, it's important to avoid the foods that can cause heartburn, learn how to prevent nighttime heartburn, and follow other methods of preventing heartburn each day. And while this season is joyful, it can also be stressful. While stress doesn't directly cause heartburn, it can have an affect, so learn about heartburn and stress and how to relax.Preventing Heartburn at Holiday Parties originally appeared on About.com Heartburn / GERD on Thursday, December 22nd, 2011 at 08:01:39.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

As Obesity Rises, More Suffer From Acid Reflux

RWJF News Digest - Childhood Obesity — Thu, 22 Dec 2011 05:00:00 +0100

As the obesity epidemic spreads around the world more people are suffering from acid reflux, likely increasing the number of those who will develop esophageal cancer, a new study suggests. (Source: RWJF News Digest - Childhood Obesity)

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Cancer fears as fatty diets trigger 50% surge in acid reflux in just a decade

the Mail online | Health — Thu, 22 Dec 2011 02:45:50 +0100

Reflux – where acid from the stomach leaks into the gullet, or oesophagus, causing heartburn – has been linked to obesity, diets high in fatty foods, alcohol and smoking. (Source: the Mail online | Health)

As Obesity Rises, More Suffer From Acid Reflux

The Doctors Lounge - Oncology — Thu, 22 Dec 2011 01:19:57 +0100

GERD symptoms have been linked to cancer of esophagus, researchers say (Source: The Doctors Lounge - Oncology)

Prevalence of Gastroesophageal Reflux Up Nearly a ThirdPrevalence of Gastroesophageal Reflux Up Nearly a Third

Medscape Today Headlines — Thu, 22 Dec 2011 00:11:54 +0100

A new longitudinal population study of nearly 30,000 Norwegians found a substantial increase in the prevalence of gastroesophageal reflux symptoms during the past decade. Medscape Medical News (Source: Medscape Today Headlines)

Obesity causes number of heartburn sufferers to soar (and women are more likely to be affected)

the Mail online | Health — Thu, 22 Dec 2011 00:01:18 +0100

Experts are concerned by the rapid spread of acid reflux, one of the main causes of heartburn, as it can trigger oesophageal cancer, which is also on the increase. (Source: the Mail online | Health)

As Obesity Rises, More Suffer from Acid Reflux

MedlinePlus Health News — Thu, 22 Dec 2011 00:00:00 +0100

GERD symptoms have been linked to cancer of esophagus, researchers say Source: HealthDay Related MedlinePlus Pages: Esophageal Cancer, GERD, Obesity (Source: MedlinePlus Health News)

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Cough Hypersensitivity Syndrome Is an Important Clinical Concept: A Pro/Con Debate

Lung — Wed, 21 Dec 2011 19:46:41 +0100

Abstract The major etiologies of chronic cough are generally accepted to consist of upper airway cough syndrome (formerly postnasal drip syndrome), eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), and gastroesophageal reflux disease (GERD). However, only a small percentage of patients with these very common conditions suffers from chronic cough. Furthermore, acute cough due to viral upper respiratory tract infection (URI) is almost always a transient, self-limited condition, yet in a small subgroup of patients, URI heralds the onset of chronic, refractory cough. The cough hypersensitivity syndrome has been proposed to explain the occurrence of chronic cough in a subgroup of patients exposed to the same putative triggers as the vast majority ...

Risk Factors for Erosive Esophagitis and Barrett's Esophagus in a high Helicobacter pylori Prevalence Area.

Medicina (Kaunas) — Wed, 21 Dec 2011 10:12:03 +0100

CONCLUSIONS. The prevalence of EE was found to be low, and the prevalence of BE was found to be very low among routinely endoscoped patients in primary and secondary care settings in a Lithuanian rural area with high H. pylori prevalence. Increasing severity of gastroesophageal reflux disease was associated with the decreasing prevalence of Helicobacter pylori. PMID: 22123558 [PubMed - as supplied by publisher] (Source: Medicina (Kaunas))

Creating Your Acid Reflux Diet

About Heartburn / Acid Reflux — Wed, 21 Dec 2011 05:00:00 +0100

There is a significant amount of debate going on between researchers and other professionals as to whether certain foods can cause heartburn. Granted, if you don't have an underlining condition that leaves you open to chronic heartburn, what you eat may not be a big deal. But if you are like me, there are certain foods that will trigger heartburn. Over the last couple of decades I've learned what my food triggers are, and what foods are safe for me to eat. If you are still struggling with the whole food / heartburn link, or if you want to know how you can help your friend or loved one suffering from chronic heartburn, you can use this acid reflux diet guide to help you get started with creating your heartburn free diet. Related Resources: Heartburn Diary Why Some Foods Cause Heart...

Fifteen-Year Outcome of Laparoscopic and Open Nissen Fundoplication: A Randomized Clinical Trial [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions The 15-year results obtained in the present study define laparoscopic Nissen fundoplication as the procedure of choice in the surgical management of GERD. The long-term symptomatic outcomes of open and laparoscopic Nissen fundoplication appear to remain unaltered after the first 10 postoperative years. (Source: The Annals of Thoracic Surgery)

Gastrointestinal symptoms and obesity: a meta‐analysis

Obesity Reviews — Wed, 21 Dec 2011 05:00:00 +0100

SummaryWeight loss is a recognized alarm symptom for organic gastrointestinal (GI) disease, yet the association between obesity and specific GI symptoms remains poorly described. A meta‐analysis was conducted to determine which GI symptoms predominate among obese individuals.A search of the literature using the databases MEDLINE, EMBASE PubMed and Current Contents (1950 – November 2011) was conducted. All studies assessing GI symptoms and increasing body mass index (BMI)/obesity were included. English and non‐English articles were searched. A random effect model of the studies was undertaken.Overall, significant associations between GI symptoms and increasing BMI were found for upper abdominal pain (odds ratio [OR] = 2.65, 95% confidence interval [CI]: 1.23–5.72), gastroesophag...

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The Microbiota and Bariatric Surgery: It's a Bug's Life

Gastroenterology — Wed, 21 Dec 2011 05:00:00 +0100

Li J, Ashrafian H, Bueter M, et al. Metabolic surgery profoundly influences gut microbial-host metabolic cross-talk. Gut 2011;60:1214–1223. Obesity, one of the great pandemics of our time, is a major threat to public health and a challenge to health care resources. This complex syndrome is influenced by host susceptibility and by environmental or lifestyle factors, such as diet and physical activity. Obesity is associated with a number of serious health consequences, including type 2 diabetes, cardiovascular disease, pulmonary hypertension, obstructive sleep apnea, gastroesophageal reflux disease, musculoskeletal disorders, and a variety of cancers (Mayo Clin Proc 2006;81[suppl]:S5–S10) and has been repeatedly shown to be associated with an increased risk of mortality (Gastroenterolog...

As Obesity Rises, More Suffer From Acid Reflux

Cancercompass News: Other Cancer — Wed, 21 Dec 2011 00:00:00 +0100

GERD symptoms have been linked to cancer of esophagus, researchers say (Source: Cancercompass News: Other Cancer)

Esophageal sensation in premature human neonates: temporal relationships and implications of aerodigestive reflexes and electrocortical arousals

AJP: Gastrointestinal and Liver Physiology — Mon, 19 Dec 2011 05:00:00 +0100

Electrocortical arousal (ECA) as an effect of visceral provocation or of its temporal relationships with aerodigestive reflexes in premature neonates is not known. We tested the hypothesis that esophageal provocation results in both esophageal reflex responses and ECAs during sleep and that ECAs are dependent on the frequency characteristics of esophageal neuromotor responses. We defined the spatiotemporal relationship of ECAs in relation to 1) spontaneous pharyngoesophageal swallow sequences and gastroesophageal reflux (GER) events and 2) sensory-motor characteristics of esophageal reflexes. Sixteen healthy premature neonates born at 27.9 ± 3.4 wk were tested at 36.8 ± 1.9 wk postmenstrual age. Ninety-five midesophageal and 31 sham stimuli were given in sleep during concurre...

Does Hydronephrosis After Extravesical Ureteral Reimplantation Deteriorate Renal Function?

The Journal of Urology — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions: Although newly developed or aggravated hydronephrosis after extravesical ureteral reimplantation is common, especially in younger patients, it is transient and does not affect differential renal function. A postoperative decrease in differential renal function without further urinary tract infection could develop when there is a parenchymal reduction on preoperative dimercapto-succinic acid scan. (Source: The Journal of Urology)

Long‐term maintenance treatment with omeprazole in children with healed erosive oesophagitis: a prospective study

Alimentary Pharmacology and Therapeutics — Sun, 18 Dec 2011 05:00:00 +0100

Conclusions Remission of erosive oesophagitis is maintained with omeprazole treatment for at least 21 months in most children aged 1–16 years, and the drug is well tolerated. To maintain remission, some 60% of patients require more than half the dose required for healing. In children with GERD‐predisposing conditions, GERD is often chronic and relapsing, and requires long‐term management. (Source: Alimentary Pharmacology and Therapeutics)

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Conventional versus robot-assisted laparoscopic Nissen fundoplication: a comparison of postoperative acid reflux parameters

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:47 +0100

Conclusions Robot-assisted LNF provided a significant gain in postoperative acid reflux parameters compared with the conventional technique. In a challenging clinical setting, such as PPI-refractoriness, in which the efficacy of endoscopic or pharmacological treatment modalities is only moderate, even a small therapeutic gain can be clinically relevant. In centers where robot-assisted LNF is available, it should be preferred to conventional LNF in PPI-refractory GERD. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-2091-5Authors Marzio Frazzoni, Fisiopatologia Digestiva, Nuovo Ospedale S. Agostino, Viale Giardini 1355, 41100 Modena, ItalyRita Conigliaro, Endoscopia Digestiva, Nuovo Ospedale S. Agostino, Viale Giardini 1355, 41100 Modena, ItalyGiovanni C...

Laparoscopic sleeve gastrectomy for obesity: can it be considered a definitive procedure?

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:28 +0100

Conclusion LSG results in stable and adequate weight loss with resolution/improvement in comorbidities in a high percentage of patients. It can be considered a definitive operation for morbid obesity. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-1960-2Authors Ajay Chopra, Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY 10461, USAEdward Chao, Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY 10461, USAYana Etkin, Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY 10461, USALynn Merklinger, Department of Surgery, Jacobi Medical Center, Albert Eins...

Experimental model of smoking and simulation of reflux with acid and pepsin in rats.

Acta Cirurgica Brasileira — Thu, 15 Dec 2011 09:32:01 +0100

CONCLUSION: The experimental models were highly efficient, practical, easy to use and economical and can be employed in other similar studies to determine the harmful effects by smoking and reflux. PMID: 22159434 [PubMed - in process] (Source: Acta Cirurgica Brasileira)

Transoral incisionless fundoplication (TIF 2.0) with EsophyX for gastroesophageal reflux disease: long-term results and findings affecting outcome

Surgical Endoscopy — Thu, 15 Dec 2011 06:44:15 +0100

Conclusions TIF using the EsophyX device allowed withdrawal or reduction of PPI in about 77% of patients at 6-month follow-up and about 69% at 24 months. Larger number of fasteners deployed during TIF was predictive of positive outcome; pre-TIF ineffective esophageal motility and hiatal hernia raised the risk of recurrence of GERD symptoms, but were not significant from a prospective point of view. Content Type Journal ArticlePages 1-11DOI 10.1007/s00464-011-2050-1Authors Pier Alberto Testoni, Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, via Olgettina 58, 20132 Milan, ItalyCristian Vailati, Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific...

Idiopathic pulmonary fibrosis: increased survival with "gastroesophageal reflux therapy": fact or fallacy?

American Journal of Respiratory and Critical Care Medicine — Thu, 15 Dec 2011 05:00:00 +0100

Idiopathic pulmonary fibrosis: increased survival with "gastroesophageal reflux therapy": fact or fallacy? Am J Respir Crit Care Med. 2011 Dec 15;184(12):1330-2 Authors: Raghu G PMID: 22174112 [PubMed - in process] (Source: American Journal of Respiratory and Critical Care Medicine)

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Best GERD Results From Fixed Nondeformable FundoplicationBest GERD Results From Fixed Nondeformable Fundoplication

Medscape Today Headlines — Thu, 15 Dec 2011 01:17:32 +0100

Complete fixed "nondeformable" fundoplication resulted in lower long-term recurrence of gastroesophageal reflux disease than the Nissen and partial fundoplication techniques. Medscape Medical News (Source: Medscape Today Headlines)

Is Laparoscopic Heller Myotomy Superior to Pneumatic Dilation to Treat Achalasia?

Seminars in Thoracic and Cardiovascular Surgery — Wed, 14 Dec 2011 22:48:01 +0100

Achalasia is a primary esophageal motility disorder that is characterized by the inability of the lower esophageal sphincter to relax and by absence of esophageal body peristalsis, causing dysphagia, chest pain, and regurgitation of undigested food. The goal of treatment is to eliminate dysphagia by opening the lower esophageal sphincter, while preventing gastroesophageal reflux. The currently available treatment options include injection of botulinum toxin at the esophagogastric junction, endoscopic pneumatic dilation, and laparoscopic Heller myotomy (LHM); all therapeutic approaches are palliative and centered on relief of esophageal outlet obstruction. With the widespread acceptance of minimally invasive surgical approaches to diseases of the upper abdomen, LHM combined with a partial a...

Chronic Cough and OSA: A New Association?

Journal of Clinical Sleep Medicine : JCSM — Wed, 14 Dec 2011 21:29:02 +0100

Chronic cough is defined as cough lasting more than 2 months. Common causes for chronic cough in nonsmokers with normal chest radiographs and pulmonary functions include gastroesophageal reflux disease (GERD), cough-variant asthma (CVA), and upper airway cough syndrome (UACS). Current guidelines recommend diagnosing the etiology of chronic cough based upon the results of therapy for suspected GERD, CVA, and UACS. Despite following current recommendations for diagnosis and treatment, the cause for a significant proportion of chronic cough remains unexplained.Recent reports indicate the resolution of chronic cough following treatment of concomitantly diagnosed obstructive sleep apnea (OSA). Whether this represents a co-occurrence of two commonly prevalent disorders or a pathophysiologic rela...

An all-endo Approach to Complete Ureteral Duplications Complicated by Ureterocele and/or Vesicoureteral Reflux: Feasibility, Limitations, and Results

Journal of Biomedicine and Biotechnology — Wed, 14 Dec 2011 12:51:38 +0100

Conclusion. The all-endo approach for VUR in DS is an effective therapeutic option. UC collapse was achieved by puncture in most of the patients; secondary VUR was the main complication in a small group of extravesical UC. (Source: Journal of Biomedicine and Biotechnology)