Effect Of Gastroesophageal Reflux Disease Research Articles

Prevalence of Gastroesophageal Reflux Disease and Its Impact on the Quality of Life Among Obese Individuals in Al-Baha Region, Saudi Arabia.

Background Gastroesophageal reflux disease (GERD) is a global gastrointestinal disorder, and obesity is a particular risk factor. Symptoms of GERD, such as heartburn and acid reflux, are caused by abnormal relaxation in the lower esophagus, causing gastric acid reflux. Persistent symptoms can affect the patient's quality of life (QOL) and can cause complications, such as esophageal adenocarcinoma. Management of GERD includes lifestyle changes, antacids, and anti-reflux surgery. Even though GERD is a common disease, few research has been carried out on it in Saudi Arabia. Aim This study aimed to estimate the prevalence of GERD and its associated risk factors among obese individuals in the Al-Baha region population and the effect of GERD on their QOL. Methods A cross-sectional study included 314 obese participants from the Al-Baha region. A questionnaire was filled out to measure the prevalence of GERD, risk factors, and effects on the QOL of the participants. Data were analyzed by the IBM SPSS Statistics for Windows, version 26.0 (released 2019, IBM Corp., Armonk, NY). Descriptive statistics and the chi-squared test were applied. Logistic regression analysis was used to determine the factors associated with the incidence of GERD. A p-value of <0.05 was considered statistically significant. Results A total of 314 patients who met our inclusion criteria completed the survey; 42% of them were women, the mean age of all patients was 35.3 ± 12.9 years, and 38.2% of the patients were diagnosed with GERD. Epigastric pain and burning sensation were the most common symptoms (44.9%). Five out of six domains in the QOL questionnaire showed more effects among GERD participants than non-GERD participants, and the results were statistically significant (p = 0.001). Logistic regression analysis showed that men are 1.8 times more likely than women to be diagnosed with GERD, and smokers have 2.6 times the risk of being diagnosed with GERD than non-smokers. Conclusion The present study showed a high prevalence of GERD among obese patients in the Al-Baha region, negatively affecting their QOL. Major risk factors included gender, smoking, dyslipidemia, and hypertension. Public health programs to raise awareness of these risk factors and lifestyle habits are necessary to improve QOL and prevent complications.

Modifiable risk factors mediate the effect of gastroesophageal reflux disease on stroke and subtypes: A Mendelian randomization study

ObjectivesPrevious observational studies have suggested that gastroesophageal reflux disease (GERD) increases the risk of stroke, but the specific underlying mechanisms are unclear. We investigated the causal associations of GERD with stroke and its subtypes using Mendelian randomization (MR), and evaluated the potential mediating effects of modifiable stroke risk factors in the causal pathway. MethodsGenetic instrumental variables for GERD were extracted from the latest genome-wide association study (GWAS) summary level data. We initially performed two-sample MR to examine the association of GERD with stroke and its subtypes, including ischemic stroke, intracranial hemorrhage, and the major subtypes of ischemic stroke. Two-step MR was further employed to investigate the mediating effect of 15 risk factors in the causal pathway. ResultsWe found significant causal associations of genetically predicted GERD with increased risk of stroke (OR: 1.22 95% CI: 1.126–1.322), ischemic stroke (OR: 1.19 95% CI: 1.098–1.299), and large-artery stroke (OR: 1.49 95% CI: 1.214–1.836). Replication and sensitivity analyses yielded consistent effect directions and similar estimates. Further mediation analyses indicated that hypertension (HTN), systolic blood pressure (SBP), and type 2 diabetes (T2D) mediated 36.0%, 9.0%, and 15.8% of the effect of GERD on stroke; 42.9%, 10.8%, and 21.4% for ischemic stroke, and 23.3%; 7.9%, and 18.7% for large-artery stroke, respectively. ConclusionsThis study supports that GERD increases susceptibility to stroke, ischemic stroke, and large-artery stroke, and is partially mediated by HTN, SBP, and T2D.

The causal role of gastroesophageal reflux disease in anxiety disorders and depression: A bidirectional Mendelian randomization study.

Observational studies have shown an association between gastroesophageal reflux disease (GERD) and anxiety disorders/depression. However, these evidences may be influenced by confounding factors. Therefore, our study aimed to determine the causal relationship between GERD and anxiety disorders/depression by conducting a bidirectional Mendelian randomization (MR) study. We performed a bidirectional MR analysis using summary statistics from genome-wide association studies (GWAS) in European individuals. The inverse-variance weighted (IVW) method was used as the primary analytical method to assess causality. In addition, five additional MR methods [maximum likelihood, MR-Egger, weighted median, robust adjusted profile score (MR-RAPS), and mode-based estimate (MR-MBE)] were performed to supplement the IVW results. Furthermore, several sensitivity analyses were performed to assess heterogeneity, horizontal pleiotropy, and stability. Finally, a multivariable MR (MVMR) analysis was performed to determine the causal relationship by adjusting for potential confounders. MR results of the IVW method indicated that GERD significantly increases the risk of anxiety disorders [odds ratio (OR) = 1.35, 95% confidence interval (CI) 1.15-1.59, P = 2.25 × 10-4] and depression (OR = 1.32, 95% CI: 1.15-1.52, P = 1.26 × 10-4). In addition, the MR results of maximum likelihood, MR-Egger, weighted median, MR-RAPS, and MR-MBE remained parallel to the IVW results. Furthermore, sensitivity analysis suggested that the results were robust, with no pleiotropy or heterogeneity detected. Nevertheless, reverse MR analysis showed that anxiety or depression did not increase GERD risk. Finally, MVMR analysis showed that the effect of GERD on increasing the risk of anxiety disorders/depression was independent of confounders. This MR study supports a causal association between GERD and an increased risk of anxiety disorders and depression. Therefore, complementing symptomatic treatment of GERD with psychological assessment and necessary psychological support therapy may help reduce the risk of future anxiety disorders and depression.

The role of smoking and alcohol in mediating the effect of gastroesophageal reflux disease on lung cancer: A Mendelian randomization study.

Observational studies have suggested a positive association between gastroesophageal reflux disease and lung cancer, but due to the existence of confounders, it remains undetermined whether gastroesophageal reflux disease (GERD) has a causal association with lung cancer. Therefore, Mendelian randomization (MR) analyses were applied to investigate the relationship between the two conditions. Two-sample Mendelian randomization analysis was utilized with summary genetic data from the European Bioinformatics Institute (602,604 individuals) and International Lung Cancer Consortium, which provides information on lung cancer and its histological subgroups. Furthermore, we used two-step Mendelian randomization and multivariable Mendelian randomization to estimate whether smoking initiation (311,629 cases and 321,173 controls) and alcohol intake frequency (n = 462,346) mediate any effect of gastroesophageal reflux disease on lung cancer risk. The Mendelian randomization analyses indicated that gastroesophageal reflux disease was associated with and significantly increased the risk of lung cancer (ORIVW = 1.35, 95% CI = 1.18-1.54; p = 1.36 × 10-5). Smoking initiation and alcohol intake frequency mediated 35% and 3% of the total effect of gastroesophageal reflux disease on lung cancer, respectively. The combined effect of these two factors accounted for 60% of the total effect. In conclusion, gastroesophageal reflux disease is associated with an increased risk of lung cancer, and interventions to reduce smoking and alcohol intake may reduce the incidence of lung cancer.

Evaluating the Effect of Gastroesophageal Reflux Disease on Postoperative Dysphagia Following Anterior Cervical Spine Surgery-A Prospective, Multicenter Study.

Prospective cohort study. The purpose of this study was to prospectively evaluate the impact of a preoperative diagnosis of gastroesophageal reflux disease on the incidence and severity of postoperative dysphagia in a multicenter population. After Institutional Review Board approval, written informed consent was obtained from all participating patients. Patients over 18 years of age who underwent an elective anterior cervical discectomy and fusion for a degenerative condition were prospectively enrolled at two academic centers from the years 2018 to 2020. Patients were separated into two groups: those with and without a preoperative diagnosis of GERD. Continuous variables were assessed using either an independent t-test or Mann Whitney U-test for parametric and non-parametric data. All categorical variables were compared using a chi-square test. A total of 116 patients met study criteria and were subsequently enrolled. Overall rates of postoperative dysphagia increased to 47.3% (n = 53) at 2-weeks but eventually decreased towards the preoperative prevalence of 25.0% at the 24-week mark. Patients with preoperative diagnosis of GERD had lower dysphagia severity scores on a continuous variable analysis in both the DSQ and EAT-10 surveys at 2-week follow-up in addition to the Bazaz survey at 24-week follow-up. Our follow up at 24-weeks was 85.7%. Our study shows that having a preoperative diagnosis of GERD has no significant effect on the incidence of dysphagia following ACDF. Nevertheless, having a preoperative diagnosis of GERD does seem to provide some protective effect on the severity of dysphagia that this patient population develops at multiple intervals over a 24-week postoperative period.

Effect of gastroesophageal reflux disease on clinical signs of vasomotor rhinitis

Effect of gastroesophageal reflux disease on clinical signs of vasomotor rhinitis

Effect of gastroesophageal reflux disease on the clinical characteristics of patients with laryngopharyngeal reflux disease

Objective: To investigate the effect of gastroesophageal reflux disease (GERD) on the clinical characteristics of patients with laryngopharyngeal reflux disease(LPRD). Methods: The data of 141 patients with symptoms of LPRD, who were admitted to the Department of Pharyngology, Laryngology& Phonosurgery at the Sixth Medical Center of the PLA General Hospital from November 2020 to October 2021, were retrospectively analyzed.There were 118 males and 23 females, aged 28-75 (56.72±10.04) years old. The included patients underwent simultaneous 24-hour hypopharyngeal and esophageal multichannel intraluminal impedance pH monitoring (24h-HEMII-pH), salivary pepsin test at multiple times, Reflux Symptom Index (RSI), and Reflux Finding Score (RFS). One laryngopharyngeal reflux event on 24 h-HEMII-pH monitoring results was used as a diagnostic criterion for LPRD. And the duration of lower esophageal pH<4.0>4.0% at 24 h or DeMeester score>14.7 were used as diagnostic criteria for GERD. Among them, patients with both positive LPRD and GERD were classified as L&G group, patients with positive LPRD and negative GERD were classified as IL group, patients with negative LPRD and positive GERD were classified as IG group, and patients with both negative LPRD and GERD were classified as N group. The differences in the clinical characteristics of reflux and salivary pepsin assay in each group were statistically analyzed. SPSS 23.0 software was applied for statistical analysis. Results: According to the 24 h-HEMII-pH results, 116 (82.3%) patients were diagnosed with LPRD and 45 (31.9%) with GERD, including 82 (58.2%) in the IL group, 34 (24.1%) in the L&G group, 11 (7.8%) in the IG group, and 14 (9.9%) in the N group. Based on the salivary pepsin test, a total of 106 patients had positive results, and the L&G group had a significantly higher rate of positive total salivary pepsin test (94.1%) and positive morning test (70.6%) than the IL group (75.6%, 26.8%), IG group (63.6%, 27.3%) and N group (35.7%, 28.6%), with chi-square values of 19.01 and 20.81, both with P<0.001. The patients in the L&G group had a significantly higher RSI score (14.0) than the IL group (7.0), IG group (1.0) and N group (0), H=52.26,P<0.001. The difference in RFS between the L&G and IL groups was not statistically significant (Z=-0.92,P>0.05). Conclusion: Combined with GERD, LPRD patients have more obvious clinical symptoms and higher positive rate of pepsin test in saliva.

Investigation of the effect of gastroesophageal reflux disease on dental erosion and oral tissue alterations

Aim: This study aimed to investigate the relationship between gastroesophageal reflux disease (GERD) and dental erosion and the alterations in oral tissues. Materials and Methods: In this study, the GERD group consisted of 50 individuals with gastroesophageal reflux symptoms, and the control group consisted of 50 healthy individuals. The prevalence of teeth wears and caries was evaluated using the Smith and Knight tooth wear index (TWI) and the decayed, missing, and filled teeth index (DMFT), respectively. Oral complaints were also evaluated. Stimulated saliva samples were collected, and the salivary buffering capacity, pH and flow rate values were measured. Results: In the GERD group, wear was observed in the palatal surface of the maxillary teeth, whereas no wear was observed in the control group (p&amp;lt;0.05). Although the incisal surfaces of the maxillary anterior teeth and the occlusal surfaces of the maxillary/mandibular posterior teeth were observed as eroded in both groups, the values in the patient group were significantly higher compared with those of controls (p&amp;lt;0.05). In the GERD group, complaints of inflammatory mouth sensitivity, tongue sensitivity, nonspecific itching and burning, halitosis, dry mouth, tooth sensitivity, erythema in the soft/hard palatinal mucosa/uvula were significantly more frequent than the control group (p&amp;lt;0.05, for each). The groups were similar with respect to DMFT (p=0.480). The salivary flow rate, pH and buffering capacity values were found to be significantly lower in the GERD group (p&amp;lt;0.05, for each). Conclusion: The results showed that patients with GERD had wear in palatal surfaces of maxillary teeth. Moreover, these patients also complained more commonly from oral tissue alterations and had lower salivary flow rate, pH, and buffering capacity. Hence dentists should consider GERD as a potential risk factor for oral health.

Stimulatory effect of gastroesophageal reflux disease (GERD) on pulmonary fibroblast differentiation

Epidemiological studies indicate that prolonged micro-aspiration of gastric fluid is associated in gastroesophageal reflux disease with the development of chronic respiratory diseases, possibly caused by inflammation-related immunomodulation. Therefore, we sought to ascertain the effect of gastric fluid exposure on pulmonary residential cells. The expression of α-smooth muscle actin as a fibrotic marker was increased in both normal human pulmonary fibroblast cells and mouse macrophages. Gastric fluid enhanced the proliferation and migration of HFL-1 cells and stimulated the expression of inflammatory cytokines in an antibody assay. Elevated expression of the Rho signaling pathway was noted in fibroblast cells stimulated with gastric fluid or conditioned media. These results indicate that gastric fluid alone, or the mixture of proinflammatory mediators induced by gastric fluid in the pulmonary context, can stimulate pulmonary fibroblast cell inflammation, migration, and differentiation, suggesting that a wound healing process is initiated. Subsequent aberrant repair in pulmonary residential cells may lead to pulmonary fibroblast differentiation and fibrotic progression. The results point to a stimulatory effect of chronic GERD on pulmonary fibroblast differentiation, and this may promote the development of chronic pulmonary diseases in the long term.

Gastroesophageal Reflux Disease: A Cause for Eustachian Tube Dysfunction in Obstructive Sleep Apnea.

To explore the effect of gastroesophageal reflux disease (GERD) on Eustachian tube function in patients with obstructive sleep apnea (OSA). This was a cross-sectional study. The patients were divided into 4 groups according to OSA and GERD: OSA+GERD group; OSA-only group; GERD-only group; and normal control group. There were no differences among the 4 groups regarding age, sex, smoking history, and alcohol history (all P > .05). The patients in the OSA and OSA+GERD groups had a significantly larger body mass index than those in the control and GERD-only groups (all P < .05). The proportions of patients with abnormal ETS-7 and ETD-Q results were higher in the GERD and OSA+GERD groups compared to the control group (P < .008). There were no significant differences in ETS-7 and ETD-Q between the control and the OSA-only groups (P > .008). The multivariable analysis showed that only GERD was independently associated with abnormal ETS-7 results (odds ratio = 3.090, 95% CI: 1.332-7.169, P = .009). Given the high concomitance rate in patients with OSA, GERD might be an important association factor of Eustachian tube dysfunction in patients with OSA.

Effect of Gastroesophageal Reflux Disease on Pulmonary Function Tests

Background&#x0D; Gastroesophageal reflux disease (GERD) is a condition in which the esophagus becomes irritated or inflamed because of acid backing up from the stomach. Heartburn and regurgitation are the typical symptoms of GERD. GERD can cause esophageal and extra-esophageal syndromes. Respiratory manifestations of GERD represent one of the most prevalent and challenging of these extra-esophageal syndromes. It is known to be associated with many forms of respiratory diseases, including asthma, pulmonary fibrosis, cystic fibrosis, and obstructive sleep apnea syndrome. The following study is taken up to know the extent to which the GERD affects the lung functions so that it can be diagnosed and treated at the earliest in order to prevent irreversible damage to the lungs.&#x0D; Objectives&#x0D; To assess the lung function tests in individuals suffering from Gastroesophageal Reflux disease.&#x0D; Materials and Method&#x0D; The study included 30 patients suffering from GERD as cases and 30 subjects not suffering from GERD as controls. Pulmonary function tests of each subject were recorded using Helios 401 spirometer. The results were compiled and statistically analyzed for significant differences.&#x0D; Results&#x0D; It was found that the following PFT Parameters FVC, FEV1, PEFR, FEV1/FVC, FEF25–75% were significantly reduced in GERD patients in comparison with controls.&#x0D; Conclusion&#x0D; The results of the study conclude that GERD patients have a significantly lower Pulmonary function in comparison with controls.

Lung function parameters in patients with gastroesophageal reflux without respiratory symptoms: a case-control study.

This research aimed to evaluate the effect of gastroesophageal reflux disease (GERD) on pulmonary volumes, airflows, and airway resistance in the patients without respiratory symptoms and compare them with the healthy subjects. GERD is the return of gastric content into the esophagus and beyond. GERD may play an essential role in the extraesophageal diseases, including chest pain, asthma, laryngitis, chronic cough, and sinusitis. The relation between GERD and airway involvement in asthma and also bronchoconstrictor effects of GERD are well recognized, but its impact on lung parameters in the patients with GERD without respiratory symptoms is unclear. In a case-control study, 78 GERD patients without pulmonary symptoms and 93 healthy subjects as control group were enrolled. The impulse oscillometry examined airway resistance. The body plethysmograph measured the pulmonary volumes and airflows. The mean age of GERD patients and the healthy subjects were 37.30±9.76 and 34.74±11.10, respectively. A total of 53.8% of patients and 67.7% of healthy subjects were male. The lung volumes measured by the body plethysmography were normal in both patients and healthy subjects. However, there was a significant difference between the groups in forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (P=0.01) and maximal mid expiratory flow (MMEF) (P=0.008). Airway resistance at R5Hz was significantly higher in the case group than the control group (P=0.001). The results of the current study demonstrated that GERD patients have small airway disease even in the absence of respiratory symptoms.

Effect of Gastroesophageal Reflux Disease on Pulmonary Function Tests

Background Gastroesophageal reflux disease (GERD) is a condition in which the esophagus becomes irritated or inflamed because of acid backing up from the stomach. Heartburn and regurgitation are the typical symptoms of GERD. GERD can cause esophageal and extra-esophageal syndromes. Respiratory manifestations of GERD represent one of the most prevalent and challenging of these extra-esophageal syndromes. It is known to be associated with many forms of respiratory diseases, including asthma, pulmonary fibrosis, cystic fibrosis, and obstructive sleep apnea syndrome. The following study is taken up to know the extent to which the GERD affects the lung functions so that it can be diagnosed and treated at the earliest in order to prevent irreversible damage to the lungs. Objectives To assess the lung function tests in individuals suffering from Gastroesophageal Reflux disease. Materials and Method The study included 30 patients suffering from GERD as cases and 30 subjects not suffering from GERD as controls. Pulmonary function tests of each subject were recorded using Helios 401 spirometer. The results were compiled and statistically analyzed for significant differences. Results It was found that the following PFT Parameters FVC, FEV1, PEFR, FEV1/FVC, FEF25–75% were significantly reduced in GERD patients in comparison with controls. Conclusion The results of the study conclude that GERD patients have a significantly lower Pulmonary function in comparison with controls.

Effect of gastroesophageal reflux disease on spirometry, lung diffusion, and impulse oscillometry

Gastroesophageal reflux disease (GERD) is known to be associated with many forms of respiratory diseases, including asthma, pulmonary fibrosis, cystic fibrosis, and obstructive sleep apnea syndrome. It is frequently coexistent, and may be causative or may exacerbate pre-existing lung disease. The main purpose of this study was to assess the effects of GERD on spirometry, lung diffusion, and impulse oscillometry. This study included 48 consecutive newly endoscopically diagnosed GERD patients with no pulmonary symptoms or previous smoking history who attended the Gastrointestinal Clinic at Ain Shams Hospital and Misr University for Science and Technology with complaints of reflux symptoms. Spirometry, lung diffusion, and oscillometry were performed in all included patients. There were statistically significant differences between cases with different grades of reflux as regards age. Most of the patients were included within grade B GERD with the highest mean age being 46.33±11.51. However, there was no significant difference as regards sex. There were statistically significant differences between cases with different grades of reflux as regards forced expiratory volume at the first second/forced vital capacity, maximum expiratory flow 25–75, and diffusing capacity of the lung for carbon monoxide (DLCO), but there was a highly statistically significant difference regarding residual volume/total lung capacity and residual volume. The grade of reflux was the only independent factor affecting DLCO, and grade B patients showed lower DLCO compared with grade A patients. There was a statistically significant positive correlation between grades of reflux and forced expiratory volume at the first second/forced vital capacity, maximum expiratory flow 25–75, and maximum mid-expiratory flow/peak expiratory flow, and a statistically significant negative correlation between grades of reflux and R20. There was a negative correlation between grades of reflux and DLCO, but it was not significant. GERD severity is associated with impairment of gas exchange (DLCO) and central airway affection (R20) on impulse oscillometry. This may be due to microaspiration of gastric acid or fluid into the airways.

The Impact of Gastroesophageal Reflux on Hospitalization Outcomes for COPD Exacerbations: A Report of the Nationwide Inpatient Sample

Introduction: Gastroesophageal reflux disease (GERD) has been associated with pulmonary disorders such as asthma and chronic obstructive pulmonary disease (COPD). However, the underlying pathophysiology of these associations is not clear. Microaspiration of refluxate may contribute to lung diseases, while worsening pulmonary function may also lead to increased reflux. Recent studies suggest that GERD may be associated with increased COPD exacerbations, hospitalizations, and medication use. However, the effect of reflux diagnosis on hospitalization outcomes for acute exacerbations of COPD (AECOPD) remains unclear. We aimed to evaluate the impact of GERD or reflux esophagitis on intubation rate and mortality during AECOPD hospitalization using a large, national inpatient database. Methods: This was a population-based cohort study of adult patients admitted to U.S. hospitals for AECOPD in 1998-2010 using the Nationwide Inpatient Sample database. Hospitalization outcomes assessed included rate of intubation and death. The effects of GERD or reflux esophagitis on hospitalization outcomes were evaluated by logistic regression models, adjusting for potential confounders such as age, gender, medical conditions, Charlson Comorbidity Index (CCI), disease severity, and hospital characteristics. Subgroup analysis was performed to examine the impact of reflux severity (reflux esophagitis vs GERD alone) on AECOPD outcomes. Results: 2,723,541 patients (mean age 70.2 yrs, 53% F, mean CCI 1.067) were included in the analysis, with 9,064 (70.4 yrs, 57% F, CCI 1.074) with reflux esophagitis, 335,760 (69.7 yrs, 60% F, CCI 1.014) with GERD alone, and 2,378,717 (70.3 yrs, 52% F, CCI 1.075 ) without any reflux disease. The overall intubation rate was 6.1% and mortality was 4.5%. After adjusting for potential confounders, there were independent positive associations between GERD and both intubation (OR 1.725, p < 0.0001) and death (OR 1.716, p < 0.0001). Reflux esophagitis was also independently associated with increased intubation (OR 1.739, p < 0.0001) and mortality (OR 1.724, p < 0.0001). Subgroup analyses showed no significant differences in outcomes between patients with a diagnosis of reflux esophagitis and those with GERD alone. Conclusion: A diagnosis of GERD or reflux esophagitis is independently associated with increased rate of intubation and mortality in patients hospitalized for AECOPD. Further prospective studies are needed to assess the benefit of aggressive anti-reflux therapy on AECOPD outcomes.

Value of proton pump inhibitors therapy in patients having GERD concurrent with uncontrolled asthma

ObjectiveTo study the effect of gastroesophageal reflux disease (GERD) management by using high dose of proton pump inhibitors (PPIs) on the outcome of uncontrolled asthma. Study designThe study included 100 patients with their ages ranging from 21 to 69years. They presented with uncontrolled asthma (FEV1 less than 80%, with daily rescue medications and more than one urgent care visit/year). And all patients were on high dose of inhaled oral corticosteroid (more than 880μg fluticasone).F-scale questionnaire was done for the diagnosis of GERD.Patients with GERD and bronchial asthma received PPIs (40mg omeprazole) and inhaled oral corticosteroid (500μg fluticasone with long acting beta-2 agonist 100μg salmeterol) for 3months. ResultsThirty-one (31%) patients showed combined GERD and bronchial asthma. Twenty-three patients showed significant improvement in asthma control after combined therapy (p value 0.01).Twenty-three patients showed significant improvement in lung function (FEV1 more than 80%), maintained moderate dose of inhaled corticosteroid without rescue medication (p value 0.01). ConclusionGERD is an important cause of uncontrolled asthma and its management significantly improves the uncontrolled asthma and significantly reduces the inhaled oral corticosteroid.

Real-world effect of gastroesophageal reflux disease on cough-related quality of life and disease status in asthma and COPD

BackgroundGastroesophageal reflux disease (GERD) is one of the most common causes of chronic cough and often coexists with asthma or chronic obstructive pulmonary disease (COPD); however, it is unknown whether there are differences in the effect of GERD on these diseases. The purpose of this study was to assess the difference in the effect of GERD on cough-related quality of life and disease status in asthma and COPD in a real-world setting. MethodsSubjects were 132 patients with overall controlled asthma and 102 patients with stable COPD. They completed the frequency scale for symptoms of GERD (FSSG), a validated Japanese questionnaire for GERD, the Leicester Cough Questionnaire (LCQ), and the Asthma Control Test (ACT) or COPD assessment test (CAT) questionnaires. ResultsWe found that 29 (22.0%) patients with asthma and 22 (21.6%) patients with COPD had GERD. There was no difference in the FSSG scale between the diseases. The patients with GERD, regardless of having asthma or COPD, had lower LCQ scores affecting all health domains and lower ACT or higher CAT scores than those without GERD. Overall, the patients with COPD had lower LCQ scores regardless of the presence or absence of GERD. The FSSG scale was negatively correlated with the LCQ total score in asthma and in COPD. In contrast, the FSSG scale was positively correlated with the CAT score but not with the ACT score. ConclusionsPatients with GERD had impaired cough-related quality of life, poor asthma control or more symptoms and impacts of COPD.

Effect of gastroesophageal reflux disease on disease severity and characteristics of lung functional changes in patients with asthma.

Introduction: Almost one third of patients with asthma have symptomatic evidence for coexisting gastroesophageal reflux disease (GERD), which is thought to be aggravating factor in asthma at least in some cases. We investigated the impact of coexisting GERD on asthma severity and parameters of lung function. Methods: Ninety two asthma patients diagnosed according to ATS criteria were studied. After full history and physical examination, asthma severity was measured in each patient using asthma control test (ACT). GERD symptoms was verified in each patient. Impulse oscillometry (IOS) and lung volume studies (using body-plethysmography and IOS) were performed. The difference between total airway resistance (TAWR) indicated by resistance at 5 Hz and central airway resistance (CAWR) as indicated by resistance at 20 Hz in oscillometry was calculated and considered as representative of resistance at peripheral airways (PAWR). The relationship between the presences of GERD symptoms, ACT score and parameters of lung function were analyzed. Results: PAWR and TAWR were both significantly higher in asthmatic patients with GERD symptoms than patients without GERD symptoms (256.64±161.21 versus 191.68±98.64; P=0.02, and 102.73±122.39 versus 56.76±71.43; P=0.01, respectively). However, no significant difference was noted in mean values of ACT, FEV1 (forced expiratory volume in 1 sec), FVC (forced vital capacity), PEF (peak expiratory flow), and CAWR in these two groups. Conclusion: These findings suggest that the severity of asthma as measured by ACT score is not different in patients with and without GERD symptoms. However, total and peripheral airway resistance measured by IOS is significantly higher in asthmatic patients with GERD symptoms.

Reflux nach bariatrischen Operationen

Obesity and gastro-esophageal reflux disease (GERD) are two of the major health problems of the industrialized world. Both condition have increased prevalence, pathophysiological and endoscopic studies identified obesity a major risk factor in the development of GERD. Conversely, successful weight reduction improves GERD symptoms and diminishes the use of acid suppressive medication. Bariatric interventions are not all equal when it comes to controlling GERD symptoms, lesions and use of medication. Gastric banding has a variable influence on GERD, while most patients report improved reflux symptoms, up to 20% of patient can develop "de novo" reflux symptoms following gastric banding. Gastric sleeve resection increases reflux symptoms, in particular in patients with an ideal, tubular gastroplasty and those with proximal (fundic) pouch. Roux-en-Y gastric bypass has a positive effect of GERD, reducing symptoms and use of acid suppressive medications. From an esophageal perspective, gastric bypass is the preferred bariatric procedure to treat and prevent GERD in morbidly obese patients.

Maternal Psychopathology and Psychomotor Development of Children With GERD

The relation between gastroesophageal reflux disease (GERD) and maternal psychopathology as well as the role of impairments in mother-child interactions in the perpetuation of feeding problems in children with GERD was previously implicated but not confirmed. The present study aimed to study the relation between maternal psychopathology and feeding problems in children with GERD and the effects of GERD on the psychomotor development of children. The case group included 39 children with GERD and their mothers and the comparison group included 39 healthy children and their mothers. The groups were matched for age, gestational age, socioeconomic status, and sex. Scales used for the psychiatric assessment of mothers were the Beck Anxiety Inventory, Hamilton Rating Scale for Depression, Eating Attitudes Test, and Experiences in Close Relationships-Revised. The children's developmental levels were assessed by the Brunet-Lezine Revised test. Maternal Beck Anxiety Inventory, Hamilton Rating Scale for Depression, Eating Attitudes Test, and Experiences in Close Relationships-Revised scores were significantly higher in the case group. Forced feeding and maternal thoughts of the child's feeding as insufficient were associated with a high level of maternal attachment-related anxiety and avoidance. Children with GERD had significantly lower Brunet-Lezine-Revised scores. Maternal psychopathology, especially insecure attachment, may play a role in the feeding problems in children with GERD. Children with GERD should be examined for maternal psychopathology and feeding problems so that maladaptive feeding behaviors can receive appropriate intervention before the development of negative reinforcement to feeding. The psychomotor development of children should be kept in mind.