Esophageal Reflux In Patients Research Articles

Impact of obesity on severity of esophageal reflux in gastroesophageal reflux disease measured by pH-Meter impedance

The prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide, and it is correlated with obesity. To ascertain if there is an association between obesity and severity of esophageal reflux, GERD must be diagnosed with greater precision and accuracy. Further, no studies have specifically examined the relationship between obesity and severity of esophageal reflux in patients with GERD. This study aimed to assess the impact of obesity on severity of esophageal reflux in GERD patients. This cross-sectional study was conducted from August to October 2017, and we enrolled GERD patients from Jakarta. Using consecutive sampling, 98 GERD patients were recruited and divided into two groups: (1) patients with body mass index (BMI) ≥ 25 kg/m2 (obese, n = 49) and (2) patients with BMI 18.5–23.5 kg/m2 (normal, n = 49). Upper gastrointestinal endoscopy was performed to assess hiatal hernia and erosive esophagitis. All patients underwent multichannel intraluminal impedance pH-meter (MII-pH) monitoring for quantification of the DeMeester score and acid exposure time. The results were analyzed using bivariate analysis. The DeMeester scores were significantly different between the obese and normal groups (166.65; p < 0.05). Bivariate analysis showed a significant difference between the two groups in terms of acid exposure time (p < 0.05; Relative Risk (RR) = 6.12 (3.25–11.54); CI 95%) and incidences of hiatal hernia (p < 0.05; RR = 7; 95% CI, 3.28–14.94) and erosive esophagitis (p < 0.05; RR = 4.5; 95% CI, 2.57–7.87). Obese patients had a higher DeMeester score than the normal BMI patients, along with greater risk of prolonged acid exposure time, hiatal hernia, and erosive esophagitis.

Heartburn severity can predict the presence of pathologic esophageal reflux in patients with GERD

Heartburn severity can predict the presence of pathologic esophageal reflux in patients with GERD

Effect of One Week of CPAP on Esophageal Reflux in Patients With Obstructive Sleep Apne

PURPOSE: Patients with obstructive sleep apnea (OSA) syndrome have a very high incidence of gastro-esophageal reflux disease (GERD). Previous studies have shown that one night of CPAP is efficacious in reducing the frequency of reflux events. The aim of this study was to assess the effect of one week of CPAP treatment on gastro-esophageal reflux in patients with objectively documented OSA and GERD.

Gastrointestinal Complications of Diabetes Mellitus

Gastrointestinal problems in diabetes mellitus include esophageal reflux, gastroparesis, diarrhea, constipation and possibly biliary tract abnormalities. In addition, abnormal gastrointestinal motility has been associated with poor glycemic control. This article reviews these complications including pathophysiology, epidemiology, clinical presentation and treatment. Factors in treating esophageal reflux in patients with diabetes are considered. Treatment options for gastroparesis are compared, including use of prokinetic agents (cisapride, metoclopramide, erythromycin and domperidone), antiemetic agents and combination therapy. Clinical trials, adverse effects, drug-drug interactions, and costs of the prokinetic agents are compared. Pharmacological management of diabetic diarrhea, including use of antimicrobial therapy, clonidine and octreotide, is discussed. Some considerations in treating constipation in patients with diabetes are reviewed.

Gastric tube reconstruction prevented esophageal reflux after proximal gastrectomy.

Although the standard operation for early cancer of gastric cardia is proximal gastrectomy followed by jejunal interposition, we recently reported a simple and useful technique for proximal gastrectomy with gastric tube reconstruction. The operative procedures included resection of the proximal two-thirds of the stomach, followed by anastomosis between the esophagus and gastric tube, using a circular stapler (Proximate ILS 25; Ethicon, Cincinnati, OH, USA). The gastric tube was about 20 cm long and 4 cm wide. The patient a 76-year-old man had no reflux symptoms such as heartburn, retrosternal pain, and regurgitation. Endoscopy showed no evidence of reflux esophagitis, including mucosal redness, erosion, and ulceration. Ambulatory 24-h pH monitoring indicated that the pH of the lower esophagus was between 6 and 8 when the patient was upright and between 5 and 7 when he was in the supine position. There were nine reflux episodes during the day, and no reflux episode while he was asleep. The duration of each reflux episode was less than 1 min, and the total reflux time was 1 min in the 12-h day (0.1%). These data indicate that reconstruction by gastric tube may prevent esophageal reflux in patients who have undergone proximal gastrectomy for early cancer of the gastric cardia.

Production of anti-CagA IgG correlates with IL-8 induction in human gastric mucosal organ culture

The frequency of gastric acid breakthrough and accompanying esophageal reflux in patients with GERD is not known. Aim: To determine the prevalence of noctumal gastric acid breakthrough and associated distal esophageal reflux in patients with GERD who are treated with PPI. Methods: Records from the esophageal lab from 1989-1997 were reviewed to determine the number of patients having pH metry while on PPI BID. Fifteen patients with Barrett's (13 males; mean age 53 yr, range 29-73 yr) and 60 patients with GERD but no Barrett's (25 males; mean age 47 yr, range 20-81 yr) were studied by ambulatory dual electrode (esophageal and gastric) pH testing on PPI BID. Supine gastric acid breakthrough defined as pH 1 hour in supine position, and esophageal reflux defined as > 0% time supine distal esophageal pH < 4 during breakthrough period. Results: The prevalence of nocturnal supine gastric acid breakthrough and accompanying esophageal acid reflux is shown below.

Gastric tube reconstruction prevented esophageal reflux after proximal gastrectomy

Although the standard operation for early cancer of gastric cardia is proximal gastrectomy followed by jejunal interposition, we recently reported a simple and useful technique for proximal gastrectomy with gastric tube reconstruction. The operative procedures included resection of the proximal two-thirds of the stomach, followed by anastomosis between the esophagus and gastric tube, using a circular stapler (Proximate ILS 25; Ethicon, Cincinnati, OH, USA). The gastric tube was about 20 cm long and 4 cm wide. The patient a 76-year-old man had no reflux symptoms such as heartburn, retrosternal pain, and regurgitation. Endoscopy showed no evidence of reflux esophagitis, including mucosal redness, erosion, and ulceration. Ambulatory 24-h pH monitoring indicated that the pH of the lower esophagus was between 6 and 8 when the patient was upright and between 5 and 7 when he was in the supine position. There were nine reflux episodes during the day, and no reflux episode while he was asleep. The duration of each reflux episode was less than 1 min, and the total reflux time was 1 min in the 12-h day (0.1%). These data indicate that reconstruction by gastric tube may prevent esophageal reflux in patients who have undergone proximal gastrectomy for early cancer of the gastric cardia.

Long-term survival after perforation of advanced gastric cancer: Case report and review of the literature.

Although the standard operation for early cancer of gastric cardia is proximal gastrectomy followed by jejunal interposition, we recently reported a simple and useful technique for proximal gastrectomy with gastric tube reconstruction. The operative procedures included resection of the proximal two-thirds of the stomach, followed by anastomosis between the esophagus and gastric tube, using a circular stapler (Proximate ILS 25; Ethicon, Cincinnati, OH, USA). The gastric tube was about 20 cm long and 4 cm wide. The patient a 76-year-old man had no reflux symptoms such as heartburn, retrosternal pain, and regurgitation. Endoscopy showed no evidence of reflux esophagitis, including mucosal redness, erosion, and ulceration. Ambulatory 24-h pH monitoring indicated that the pH of the lower esophagus was between 6 and 8 when the patient was upright and between 5 and 7 when he was in the supine position. There were nine reflux episodes during the day, and no reflux episode while he was asleep. The duration of each reflux episode was less than 1 min, and the total reflux time was 1 min in the 12-h day (0.1%). These data indicate that reconstruction by gastric tube may prevent esophageal reflux in patients who have undergone proximal gastrectomy for early cancer of the gastric cardia.