Frequency Of Gastroesophageal Reflux Disease Research Articles

Two-Year Results of Sleeve Gastrectomy Combined with Posterior Fundoplication for Obesity Patients with Gastroesophageal Reflux Disease.

Currently, gastroesophageal reflux disease (GERD) is the main side effect after sleeve gastrectomy (SG), causing discomfort and potential long-term risks. Surgical techniques combining fundoplication with SG are being evaluated to limit postoperative GERD. This single-center retrospective study evaluated patients who underwent SG with posterior fundoplication in the context of GERD between 2018 and 2021, with postoperative follow-up up to 24 months. The results were compared to a control group (ratio 1 to 4) who had SG without fundoplication. Observed total weight loss (TWL) was compared to predicted TWL using the Sophia multinational study's machine learning-based calculator. The series included 22 patients (mean body mass index 44.4 kg/m2) with GERD conditions: GERD symptoms (n = 15), hiatal hernia (n = 6), esophagitis (n = 7), and Barrett's esophagus (n = 5). Two patients required reoperation, including one for valve perforation. At 2 years, GERD was present in three patients (13.6%), including two who regularly took proton pump inhibitors. Compared to the control group (n=88), the frequency of GERD persisting at 2 years was significantly reduced in the SG with fundoplication group (p=0.05). The TWL at 12 and 24 months was 27.7% and 26.1%, respectively, with no significant difference compared to the weight predicted by the model, nor compared to the control group. The combination of posterior fundoplication with SG can be proposed in patients with GERD who have a contraindication to Roux-en-Y gastric bypass. Specific morbidity may exist at the beginning of the experience.

Transoral incisionless fundoplication with or without hiatal hernia repair for gastroesophageal reflux disease after peroral endoscopic myotomy.

Background and study aims Gastroesophageal reflux disease (GERD) following peroral endoscopic myotomy (POEM) occurs in 40% to 60% of patients. There are limited data evaluating antireflux surgery or transoral incisionless fundoplication (TIF) for refractory post-POEM GERD. Patients and methods In a single-center prospective cohort study, consecutive patients with medically refractory post-POEM regurgitation and/or GERD treated with TIF or combined laparoscopic hernia repair and TIF (cTIF) were evaluated. Baseline evaluation: GERD-Health Related Quality of Life (GERD-HQRL) and Reflux Symptom Questionnaire 7-day recall (RESQ-7) questionnaires, EGD, high-resolution manometry (HRM), 48-hour pH test off proton pump inhibitors (PPIs) and impedance planimetry of the esophagogastric junction (EGJ) to calculate the diameter distensibility index (EGJ-DI). A PPI was taken twice daily for 2 weeks after TIF and restarted later if required. Patients returned 9 to 12 months after treatment when all preoperative studies were repeated. Quality of life, pH studies and EGJ metrics before and after antireflux surgery were compared. Results Seventeen patients underwent TIF (n=2, 12%) or cTIF (n=15, 88%) a mean 25±15 months after POEM. At follow-up a mean of 9±1 months after TIF/cTIF, patients required less frequent daily PPIs (n=0.001), were more satisfied (P=0.008), had improved GERD-HQRL (P=0.001), less intensity and frequency of GERD (P=0.001) and fewer reflux episodes (P=0.04) by pH testing. There was no change in EGJ-DI, EGJ diameter, integrated relaxation pressure, % total time pH <4, or DeMeester score. Conclusions TIF and cTIF for difficult-to-control post-POEM GERD appear safe, decrease PPI use and reflux episodes, and improve QOL without significant change in IRP, EGJ compliance, diameter or esophageal acid exposure time.

Non-cardiac Chest Pain in Japan: Prevalence, Impact, and Consultation Behavior - A Population-based Study.

Non-cardiac chest pain (NCCP) is defined as recurring angina-like retrosternal chest pain of non-cardiac origin. Information about the epidemiology of NCCP in Japan is lacking. We aim to determine the prevalence and characteristics of NCCP in the Japanese general population. Two internet-based surveys were conducted among the general population in March 2017. Questions investigated the characteristics of symptoms associated with chest pain and consultation behavior. Quality of life, anxiety, depression, and gastroesophageal reflux disease were analyzed. Five percent of the survey respondents reported chest pain. Subjects with chest pain showed higher frequencies of anxiety and depression and lower quality of life. Among subjects with chest pain, approximately 30% had sought medical attention for their symptoms. Among all consulters, 70% were diagnosed with NCCP. Females were less likely to seek consultations for chest pain than males. Further, severity and frequency of chest pain, lower physical health component summary score, and more frequent gastroesophageal reflux disease were associated with consultation behavior. Subjects with NCCP and cardiac chest pain experienced similar impacts on quality of life, anxiety, and depression. Among subjects with NCCP, 82% visited a primary-care physician and 15% were diagnosed with reflux esophagitis. The prevalence of chest pain in this sample of a Japanese general population was 5%. Among all subjects with chest pain, less than one-third consulted physicians, approximately 70% of whom were diagnosed with NCCP. Sex and both the severity and frequency of chest pain were associated with consultation behavior.

Modern trends in the formation of comorbid pathology of the esophagus and gastroduodenal zone in children

The article presents modern views on trends and controversial issues in the formation of combined pathology of the gastroduodenal zone and esophagus in children. The purpose of the authors of this study: to identify the features of the formation, course and outcomes of gastroesophageal reflux disease (GERD) in children with pathology of the gastroduodenal zone (GDZ) based on endoscopic and morphological comparisons. Own long-term observations were analyzed depending on the type of pathology, the severity of motor disorders, endoscopic and morphological picture, infection Helicobacter pylori. Possible options for the formation of gastroesophageal reflux disease in children and adolescents with various diseases of the gastroduodenal zone were determined. It has been established that the combined nature of the pathology of the esophagus and gastroduodenal zone in children occurs in more than 75% of patients. The nature and severity of esophageal disorders depend on the nature of the nosology of the gastroduodenal zone and, as a rule, are secondary. The increase in the frequency of GERD in modern children, the increase in the proportion of its complicated variants (including ulcers and Barrett's esophagus), make it a priority in the study of diseases of the upper digestive tract in children at the present time. For this contingent of young patients, it is urgent and urgent to develop clear diagnostic criteria (including endoscopic and morphological criteria), therapy tactics, and a strategy for cancer prevention.

Assessing cancer in people with profound and multiple disabilities

BackgroundCancers are as common in individuals with intellectual disabilities as in the general population (GP). For the subgroup of people with profound and multiple disabilities (PMD) who present with both severe intellectual disability and major motor disorders, the frequency and distribution of cancers are currently not known, preventing proper cancer surveillance.MethodsWe carried out a systematic and synthetic review of the medical literature, including a focused search of Japanese data.ResultsThe total risk of cancer in individuals with PMD is thought to be lower than in the GP, possibly due to a shorter life expectancy. They have reduced exposure to cancer risk factors, such as alcohol, tobacco, sunlight, human papillomavirus infection, occupational toxins, and being overweight. On the other hand, individuals with PMD present a greater frequency of gastroesophageal reflux disease, Helicobacter pylori gastritis, chronic cystitis, and cryptorchidism, which increase the risk for cancer of the esophagus, stomach, urinary bladder, and testes. In addition, certain genetic disorders underlying compromised motor and cognitive functions are associated with higher risk of childhood cancers. An analysis of 135 cancers in persons with PMD in Japan suggested that they present a particular tumor profile, with certain cancers rarer than in the GP, whereas cancers of the digestive tract are frequent. Cancers of the digestive tract occurred significantly earlier than in the GP (colon: average age 48.3 years vs. 71.3 years in the GP, esophagus: 39 years vs. 72 years in the GP). An increasing number of therapeutic successes in children and adults with PMD have been reported in different countries when cancers are discovered early.ConclusionIndividuals with PMD must be appropriately monitored for cancer. Screenings for breast and colon cancer, as well as regular monitoring of the esophagus, stomach, urinary bladder, and testicles, are necessary. Population-based epidemiological studies are needed to better understand risk factors, frequency, and distribution of cancers in the PMD population.

Concurrent paraesophageal hernia repair in revisional/conversional laparoscopic Roux-en-Y gastric bypass: propensity score-matched analysis of the MBSAQIP database.

Patients requiring concurrent paraesophageal hernia repair (CPHR) have been shown to have favorable outcomes in primary bariatric surgery. However, patients requiring revisional or conversional surgery represent a group of patients with higher perioperative risk. Currently, few reports on concurrent paraesophageal hernia repair utilizing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database are available. The primary aim of this study was to determine perioperative complications associated with CPHR and the Roux-en-Y gastric bypass (RYGB) as a revisional/conversional operation. In this study, patients undergoing revisional/conversional RYGB between 2015 and 2020 were accessed via the MBSAQIP database. Patients were categorized based on the presence of a paraesophageal hernia as a concurrent procedure. Patients who underwent revisional/conversional surgery without additional procedures were utilized for controls. A propensity score-matched cohort was generated and E-analysis utilized to assess unmeasured confounding. After exclusions, 35,698 patients were available. Patients receiving CPHR were more likely to be female (90.79% vs 87.37%; p < 0.001) and have increased frequency of gastroesophageal reflux disease (69.20% vs 51.69%; p < 0.001). However, these patients had lower frequencies of sleep apnea (24.12% vs 30.13%; p < 0.001), hypertension requiring medication (38.51% vs 42.59%; p < 0.001), and decreased frequency of hyperlipidemia (19.44% vs 21.60%;p < 0.001). After matching, 6,231 patient pairs were developed and showed that patients undergoing CPHR were at increased risk of readmission (9.44% vs 7.58%; p < 0.001), intervention (3.56% vs 2.79%; p = 0.018), increased requirement for outpatient dehydration treatment (5.87% vs 4.67%;p = 0.004), and overall increased operation time (169.3min ± 76.0 vs 153.5 ± 73.3; p < 0.001). However, there were no significant increases in the rates of reoperation, death, postoperative leak complications, or bleeding complications after CPHR. Patients undergoing revisional/conversional RYGB with CPHR may be at higher risk for a small number of rare postoperative complications. CPHR is a safe procedure in patients undergoing revisional/conversional RYGB in the short-term postoperative period.

Frequency of GERD in women of childbearing age in Malatya region

Gastroesophageal reflux disease (GERD) is frequently seen not only in our country but also all over the world. GERD not only impairs health and quality of life, but also causes serious financial losses in the working population. In this study, our aim is to determine the frequency of gastroesophageal reflux disease among female healthcare professionals of childbearing age in our region. Questions were asked about demographic data such as weight, age, height, BMI, medical history, and gastroesophageal reflux of female healthcare workers, whose data were generated by us. The answers to the questionnaires were collected and evaluated retrospective. All participants in the study were women. This study was carried out on 1224 female healthcare workers of reproductive age working in Malatya Turgut Özal University training and research hospital. Approximately 1150 of the employees who were distributed questionnaires filled out the questionnaires. The mean age of the female healthcare workers of childbearing age was 30.01±5.38 years, between 19-50. The mean height of the healthcare workers was 1.64±7.8 meters, the average weight was 68.05±13.2 kg, and their body mass index (BMI) was 27.4±3.6 kg/m². The frequency of GERD in the study group was found to be positive in 24%. 38.5% of the healthcare workers had previously gone to the doctor with complaints of pyrosis and/or regurgitation. A significant relationship was found between GERD and stress, fizzy drinks, lying down after meals, and family history of GERD. There was no significant relationship between the smoking and coffee use and age of the participants in the study in terms of the presence of GERD.We think that gastroesophageal reflux symptoms are common due to stress, unbalanced diet, irregular sleep and lifestyle habits due to the COVID pandemic in the last two years due to the fact that the participants in the study were healthcare professionals. Among our healthcare professionals, both pyrosis and other GERD symptoms were found to be higher than some of the previous studies, similar to those in our country. We think that the reason for this is that the extremely stressful work of health workers in the last 2 years has contributed to this. As it is known, health workers have worked very hard in the last 2 years, they did not even use their annual leaves, even those who wanted to retire could not retire. We think that this stress environment may also contribute to GERD symptoms.

Frequency of Gastroesophageal Reflux Disease in Chronic Obstructive Pulmonary Disease Patients

Background: About 20% to 30% of the general population, especially in individuals with old age, suffers from gastroesophageal reflux disease. Association between gastroesophageal reflux disease and chronic obstructive pulmonary disease has been reported in numerous studies. Objective: To find out the frequency of gastroesophageal reflux disease in chronic obstructive pulmonary disease patients Methodology: This cross-sectional study was carried out at the department of Pulmonology, Fatima Jinnah Institute of Chest Diseases and Sheikh Khalifa Bin Zayyed Al Nahyan Medical Complex Quetta from December 2021 to May 2022. The inclusion criteria for our study were all the patients of either gender in age range 18 to 60 years diagnosed with COPD of any severity level. A proforma developed solely for this research was used to record all the data. All the collected data was analyzed by using SPSS version 23. Results: In our study, totally 180 patients were enrolled. There were 120 (66.67%) male participants and 60 (33.33%) female participants in our study. The overall frequency of gastro-esophageal reflux disease in COPD patients was 93 (51.67%). The frequency of gastro-esophageal reflux disease in mild, moderate severe and very severe COPD patients COPD patients was 4 (44.44%), 39 (48.15%), 38 (52.78%) and 12 (66.66%) respectively. Conclusion: Our study concludes that the frequency of gastroesophageal reflux disease is high in chronic obstructive pulmonary disease patients. Based on our results, every patient who presents with COPD should be screened for GERD. Keywords: Frequency, gastroesophageal reflux disease, chronic obstructive pulmonary disease

Chronic Obstructive Pulmonary Disease Patients have A Higher Risk of Developing Gastroesophageal Reflux Disease than the General Population A-Multi-Center-Study

Background: Partially reversible airflow restriction is a symptom typical of COPD, a kind of obstructive lung disease. Chronic obstructive pulmonary disease distinct pathological and clinical phenotypes: emphysema and chronic bronchitis (COPD). Both elements are quite individualistic. Whether or not to regularly examine COPD patients for the possibility of GERD and treat it effectively might be aided by the discovery of an increased prevalence of Gastroesophageal reflux disease (GERD) in this patient population. Objective: As GERD is associated with a worse prognosis in COPD patients, it is important to understand the prevalence of this condition among those who suffer from the disease. Methodology: From January 2021 to January 2022, researchers at a major hospital in Peshawar analyzed data from many similar hospitals. A total of 108 participants participated in this trial. Comprehensive histories and physical examinations were performed on patients (aged 20 to 75). Then, spirometry and the Q-questionnaire were administered to individuals who had satisfied the inclusion and exclusion criteria. All patients had their spirometry readings taken by the same CPSP-certified technicianpatients' FEV1 measurements following a bronchodilator treatment were assessed by the same CPSP-fellow consultant of pulmonology using the GOLD criteria, giving each patient a grade (from "01" to "04"). The prevalence of GERD was calculated as a percentage of all COPD cases in patients who completed the Q-questionnaire. Results: There was a 12.580 standard variation in the individuals' ages, with a mean of 58.76. Most patients were women (60%), while men made up just 40% of the Total. The prevalence of GERD among those with COPD was 52 percent. Conclusion: This study's findings led us to conclude that patients with COPD had a frequency of gastroesophageal reflux disease (GERD), which was 52%. Keywords: Acid Reflux In The Stomach; COPD, Multicenter

A Comparison Between the Postoperative Complications of Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-en-Y Gastric Bypass (RNYGB) in Patients With Morbid Obesity: A Meta-Analysis.

The most successful method for treating obesity is bariatric surgery. The two most common surgeries for treating morbid obesity are the laparoscopic Roux-en-Y gastric bypass (RNYGB) and the laparoscopic sleeve gastrectomy (LSG). However, there has not been a thorough analysis of the differences in their adverse effects. The aim of this study was to analyze if RNYGB and LSG had comparable postoperative complications and mortality. To that end, results from trials comparing those who underwent RNYGB and those who underwent LSG were combined. We explored the Cochrane Library, PubMed, EMBASE, and Web of Science databases for collecting pertinent data, and 10 RCTs were included in the study. Standard deviations were used to determine the risk ratio (RR) and the 95% confidence interval (CI).No substantial difference in mortality was observed between the two procedures. However, our pooled analysis showed that patients who underwentRNYGB needed some reoperation at a higher rate compared to those who had LSG, with a pooled RR of 0.64 (95% CI: 0.42-0.98; p=0.04). Patients who had LSG suffered from fewer postoperative sequelae. While the risk of other complications was higher in RNYGB, our analysis showed that the frequency of gastroesophageal reflux disease (GERD) after LSG was greater than after RNYGB, with a pooled RR of 4.00 (95% CI: 2.55-6.28; p<0.001). Based on the above-mentioned findings, RNYGB and LSG had comparable mortality rates; however, patients who underwent LSG had a reduced risk of complicationsand reoperations after surgery compared to those who had RNYGB.

Characteristics of gastroesophageal reflux disease in children with interstitial lung disease.

Childhood interstitial lung disease (chILD) is a rare group of respiratory tract disorders. One of the factors suggested to be associated with its etiopathogenesis is microaspiration related to gastroesophageal reflux disease (GERD). The aim of the present study was to determine the frequency and characteristics of GERD in children with chILD, with a particular focus on proximal GER episodes. This was a prospective cross-sectional study. Consecutive patients with chILD underwent 24-h multichannel intraluminal pH-impedance monitoring. Different types of gastroesophageal reflux episodes (GER) were recorded and compared with regard to the GERD diagnosis. Sixty-two children (median age of 1.22 years) were included. GERD was diagnosed in 20 (32.3%) of them. The GERD (+) and GERD (-) subgroups differed mainly in their esophageal exposure to acid content (2.9 vs. 1.0%, p = 0.02) and bolus exposure (3.0 vs. 1.4%, p < 0.0001), as well as total number of GER (72.5 vs. 42.0 p = 0.0004), acid GER (35.5 vs. 15.0 p = 0.004), and acid proximal GER (21.0 vs. 12.0 p = 0.02). There were no differences in the number of proximal GER comparing GERD (+) and GERD (-) subgroups. The frequency of GERD seems to be relatively high in the population of children with chILD used in this study. However, it has not demonstrated an association between proximal GER and GERD diagnosis in chILD, which casts uncertainty over the microaspiration theory proposed to link the two diseases. The latter conclusion, however, needs to be confirmed using more accurate aspiration assessment methods.

Role of esophageal symptoms in the diagnosis of gastroesophageal reflux disease in children with recurrent and chronic respiratory diseases

Gastroesophageal reflux disease (GERD) is one of comorbid diseases, that worsen the course and outcomes of respiratory pathology. The study aimed to determine role of esophageal symptoms in the diagnosis of GERD in children with recurrent and chronic respiratory diseases (RCRD). The study included 125 children (70 boys, 55 girls), median 3,75 years (interquartile range, IQR – 1,21-9,38 years), with RCRD, refractory to standard therapy. GERD was diagnosed on the basis of clinical and complex instrumental examination, including fluoroscopy esophagus with contrast, esophagogastroduodenoscopy (EGDS), 24-hour esophageal pH-monitoring, dual pH-multichannel intraluminal impedance (pH-MII). In children with RCRD, the frequency of GERD was 86,4%. Among children without esophageal manifestations of GERD, pathological reflux was confirmed by instrumental methods in 81% of patients; in children with esophageal manifestations - 92%, with no statistically significant differences (p = 0,0637). Nonacid reflux is more common in patients without esophageal manifestations of GERD. The frequency of GERD in children with RCRD is very high. It is possible to screen GERD in children with RCRD, independent on the presence of clinical esophageal symptoms.

Atrophic gastritis is inversely associated with gastroesophageal reflux disease in a twin register based study.

BackgroundThe association between atrophic gastritis (AG) and symptomatic gastroesophageal reflux disease (GERD) needs to be better assessed.ObjectiveWe aimed to study this association in a twin setting, controlling for genetic and familial factors, in addition to a range of known covariates.MethodsWe performed a co‐twin control study based on the Swedish Twin Registry, including confirmed monozygotic (MZ) and dizygotic (DZ) twins. AG was determined by the measurement of serum pepsinogen I (PGI) and pepsinogen II (PGII), with different cut‐off values. GERD was defined using a structured questionnaire, by questions on symptoms of heartburn, acid regurgitation, pain behind the breastbone, and drug history. Patients were grouped into total GERD, less frequent (<1/week), and frequent GERD (≥1/week).ResultsA total of 12,533 twins were included in the study, among whom 37.7% showed less frequent GERD, and 18.7% had frequent GERD. There was an inverse association between AG and GERD, especially for frequent GERD. When PGI<30 was used as cut‐off value for AG, the odds ratio (OR) and corresponding 95% confidence interval (CI) was 0.52 (0.44, 0.62). When PGI<70 and PGI/PGII<3 was used as cut‐off value for AG, the OR (95% CI) was 0.53 (0.46, 0.63). A risk reduction for GERD was also observed in AG patients when the analysis was restricted in MZ or DZ twins.ConclusionIn this co‐twin control study from the Swedish Twin Register, AG is persistently associated with a reduced risk for GERD, after controlling for genetic and shared familial factors.

Częstość choroby refluksowej u pacjentek z jadłowstrętem psychicznym

Cel pracyCelem pracy była ocena częstości występowania choroby refluksowej przełyku (ChR) u dziewcząt z jadłowstrętem psychicznym (JP)MetodaUdział w badaniu zaproponowano dziewczętom z JP w wieku 12-18 lat hospitalizowanym w Klinice Psychiatrii Wieku Rozwojowego Warszawskiego Uniwersytetu Medycznego. Kryteriami wyłączenia były: obecność innych niż JP zaburzeń psychicznych oraz leczenie lekami prokinetycznymi i(lub) lekami zobojętniającymi np. inhibitorami pompy protonowej lub antagonistami receptora histaminowego w trakcie ostatnich 2 tygodni. Od pacjentek zebrano wywiad dotyczący objawów ze strony przewodu pokarmowego mogącym odpowiadać ChR. Wykonano pomiary antropometryczne w celu oceny stanu odżywienia. U wszystkich pacjentek wykonano 24-godzinną pH-impedancję. Zapis pH-impedancyjny uznawano za nieprawidłowy, gdy ogólna liczba epizodów przekraczała 70 i/lub wyrażony w procentach ogólny czas ekspozycji błony śluzowej przełyku na kwaśną treść przekraczał 6%.WynikiDo badania włączono 23 pacjentki. Dziewczęta zgłaszały liczne dolegliwości tj. ból w nadbrzuszu, nudności, wymioty, zgagę, ból w klatce piersiowej, nadmierne odbijanie. Jedynie u 2 (8,7%) dziewcząt z JP zdiagnozowano ChR na podstawie 24-godzinnej pH-impedancji. Pacjentki z ChR prezentowały restrykcyjny typ anoreksji.WnioskiCzęstość ChR u dziewcząt z JP jest relatywnie niska mimo bardzo powszechnego zgłaszania przez nie objawów sugerujących to rozpoznanie. W związku z tym rozpoznanie ChR u pacjentów z JP nie może opierać się tylko na objawach, ale powinno być potwierdzone badaniem obiektywnym, najlepiej pH-impedancją.

GASTROESOPHAGEAL REFLUX DISEASE IN INFANTS WHO PRESENTED BRIEF RESOLVED UNEXPLAINED EVENT (BRUE).

The term brief resolved unexplained events (BRUE) is a description of the acute event occurring in infants less than 1-year-old that includes at least one of the following characteristics: cyanosis or pallor; absent, decreased, or irregular breathing; marked change in tone or altered level of responsiveness. An investigative proceeding is required to identify the triggering phenomenon in those who are at high risk of complications. Prolonged esophageal pHmetry has been used as a tool in searching for gastroesophageal reflux disease (GERD) as one of the underlying etiologies. The study aims to verify the frequency of GERD in infants up to 1-year-old, when pHmetry has been performed for investigating high-risk BRUE (HR-BRUE) and to analyze if clinical characteristics or any particular symptom related by caregivers during BRUE could be correlated to GERD. It was performed a cross-sectional study. The data was collected retrospectively of patients less than 1-year-old, who had performed pHmetry in a tertiary hospital for investigating HR-BRUE between October 2008 and January 2018. For the analysis of medical records, a data collection protocol included: gender, age at the first HR-BRUE episode, age at the time of the pHmetry, gestational age, type of delivery (normal or caesarean) and birth weight and symptoms associated to HR-BRUE related by caregivers. Relation between variables were assessed using Fisher's exact test and Mann-Whitney test. The significance level was set at 0.05. A total of 54 infants were included (preterm 25, term 29), 62.9% males, median age at the HR-BRUE was 36 days, 53.7% HR-BRUE episodes had occurred during or right after feeding. According to pHmetry results: nine pHmetry results were considered inconclusive, physiological reflux (n=30) and GERD (n=15). The frequency of GERD diagnosed by pHmetry was 33%. GERD was not statistically related to gender (P-value=0.757), age at first HR-BRUE episode (P-value=0.960), age at the time of the pHmetry (P-value=0.720), prematurity (P-value=0.120) or type of delivery (P-value=0.738). GERD was statistically related to low birth weight (P-value=0.023). There was no association between symptoms reported by caregivers during HR-BRUE and GERD. GERD diagnosed by the pHmetry was found in one third of infants that experiencing a HR-BRUE, showing the importance of properly investigation. In half of infants BRUE occurred during or right after feeding. Besides low birth weight, it was not possible to select other data from the clinical history that suggest that these patients would be more likely to have GERD.

Frequency of Obesity among Gastroesophageal Reflux Disease Patients

Objective: Gastroesophageal reflux disease (GERD) prevalence ranges from 24% to 35% in Pakistani population. Studies have demonstrated GERD frequency is directly proportional to increasing weight. Thus, the frequency of obesity among gastro esophageal reflux disease patients was determined. Methodology: This cross-sectional study was conducted on outpatients with GERD visiting Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi; from December 2017 to June 2018. Clinical and demographic parameters of study population were recorded. Body mass index (BMI) more than 27 was labeled as obese. Patients with history of ischemic heart disease, pregnancy, ascites and/or Patients on NSAIDS, bisphosphonates or steroids were excluded. Results: One hundred and fifty patients with mean age of 43.3±11.5 years were included in study. Eighty-seven patients (63.3%) had age more than 40 years. Majority of study population were males 95 (63.3%). Mean height and weight of study population were 163.09±9.56 cm and 72.92±15.13 kg, respectively. Mean BMI were 27.55±6.02 in which 71 (47.3%) were obese i.e., BMI &gt;27. Majority were Urdu speaking i.e., 57 (38%) followed by Sindhi 31 (20%) Diabetes mellitus was documented in 22 (14.7%) and hypertension in 16 (10.7%) patients. Statistically significant association of GERD was seen in obese females (p-value: 0.018) Conclusion: Increase frequency of obesity is significantly associated with GERD. More proportion of obese females has GERD. Keywords: Gastro esophageal reflux disease; Body mass index; Weight; height

Внепищеводные маски гастроэзофагеальной рефлюксной болезни: частота, особенности диагностики и подготовки пациентов к офтальмохирургическим операциям

Purpose. Evaluation of the frequency of gastroesophageal reflux disease (GERD) in the structure of somatic diseases of patients admitted to ophthalmic surgery, features of the manifestation and difficulties in diagnosing. Material and methods. The analysis of the preoperative state of 1213 patients with pathology of the gastrointestinal tract (GIT) was carried out. The frequency of GERD with typical and extraesophageal manifestations was studied. The assessment of the adequacy and effectiveness of drug therapy is given. Results. Pathology of the gastrointestinal tract in the structure of nosological forms of somatic diseases of patients entering ophthalmic surgery is 5–6%. GERD accounts for 30% of their number. Typical clinical manifestations of GERD occurred in 287 patients (79.1%). Of these, 203 people. (70.7%) were able to compensate for the disease, received adequate therapy with proton pump inhibitors. In 84 patients (29.3%), heartburn and epigastric discomfort persisted. In 76 patients (20.9%) with GERD, its extraesophageal manifestations were revealed. Have 29 people. (38%) they manifested themselves in the form of retrosternal pain. A paroxysmal dry cough, asthma attacks arising after eating, the appearance and aggravation of nocturnal symptoms of bronchial asthma disturbed 35 people (46%). Complaints of burning tongue, hoarseness, soreness when swallowing, sore throat, periodic laryngospasm were observed in 12 patients (16%). Conclusion. GERD takes the leading place among diseases of the upper gastrointestinal tract (more than 30%). About 21% are atypical manifestations of GERD. The most clinically significant among them, limiting the possibility of conducting planned surgical treatment, are cardiological and pulmonary masks. Modern etiopathogenetic treatment of GERD makes it possible to effectively stop the symptoms of the disease, avoid polypharmacy and unreasonable refusal in planned surgical treatment for patients with ophthalmic diseases. Key words: gastroesophageal reflux disease, extraesophageal manifestations, ophthalmic surgery.

Gastroesophageal Reflux Disease in Patients with Chronic Obstructive Pulmonary Disease

Objective: To determine the frequency of gastroesophageal reflux disease (GERD) in patients with chronic obstructive pulmonary disease in our population Methodology: This cross-sectional study was conducted at medical out-patient Department, Services Hospital, Lahore; from September 2014 to March 2015. All the patients having chronic obstructive pulmonary disorder (COPD) were included. COPD was defined as the patients having a ratio of “forced expiratory volume in one second” (FEVI) to “forced vital capacity” (FVC) below 70% and having no improvement in FEVI after bronchodilator. Severity GERD was categorized as per episodes of symptoms. Information regarding the frequency of GERD was collected via study proforma. Data was analyzed using SPSS version 16. Results: Overall 100 cases were studied; their mean age was 47.54+3.62 years. Out of all 90% were males and 10% were females. Frequency of GERD in patients with COPD reveals 33%, followed by 03% study subjects had mild GERD, 7% had moderate, 11% had severe and 12% had very severe symptoms of GERD, while 67% had no nay symptoms of GERD. Conclusion: In the conclusion the frequency of gastroesophageal reflux disease (GERD) was found to be 33.0% among COPD subjects. Â

Особливості перебігу патології шлунково-кишкового тракту у хворих на гастроезофагеальну рефлюксну хворобу на тлі гіпотиреозу

The article identifies the features of the pathology of the gastrointestinal tract in patients with gastroesophageal reflux disease on the background of hypothyroidism. The frequency of gastroesophageal reflux disease and the severity of this disease increase with age and the presence of comorbid pathology. In the elderly, the frequency of the typical esophageal manifestations decreases, and the erosive esophagitis with atypical symptoms is more common. The growing number of cases of combined thyroid dysfunction with gastropathology requires in-depth study of the reasons for the relationship between these processes. Pathological changes in the gastrointestinal tract in these patients make their condition severer, contributing to the development and progression of metabolic disorders. An important aggravating effect on the regulatory mechanisms of esophageal kinetics has a pathological functioning of the thyroid gland on the background of iodine deficiency. Results and discussion. In patients with gastroesophageal reflux disease with hypothyroidism, all changes in gastric and duodenal function are associated with a decrease in the acid-forming function of the gastric mucosa, due to its atrophy, decreased tone and contractility of the stomach. This in turn leads to a slowing of gastric and duodenal evacuation, dysfunction of the closing capacity of the cardia and, as a consequence, the development of duodenogastroesophageal reflux. The esophageal contents are not so pronounced, so patients with non-erosive forms of esophagitis predominate (46.2%) against 16% of patients in the second group (patients with gastroesophageal reflux disease). At the same time, erosive forms predominate among patients in the control group with predominant acid reflux. It should be noted that there is a clear relationship between the frequency of erosive changes in the esophageal mucosa and the duration of the disease. Thus, among patients of the main group with a 5-year history of the disease, the number of erosive forms of gastroesophageal reflux disease was minimal. The number of erosive changes in the esophageal mucosa increased sharply in patients with a 10-year history and reached its maximum after 15 years from the onset of the disease. Conclusion. The delay in gastric evacuation is more pronounced in patients with gastroesophageal reflux disease on the background of hypothyroidism. It can be explained by a decrease in gastric motility and the presence of duodenostasis. The slowing of gastric evacuation was more pronounced in patients with gastroesophageal reflux disease on the background of reduced thyroid function. In patients with gastroesophageal reflux disease on the background of hypothyroidism there is an alkaline duodenogastroesophageal reflux as a consequence of reduced acid-forming function of the gastric mucosa and reduced contractility of the stomach and duodenum

Intraoperative high-resolution esophageal manometry during peroral endoscopic myotomy

Peroral endoscopic myotomy is an accepted treatment of achalasia. Some of the treatment failures can be attributable to an insufficient length of the myotomy on the gastric side, because of a more technically challenging submucosal dissection. We assessed the feasibility and the impact of an intraoperative esophageal manometry during the peroral endoscopic myotomy procedure. A high-resolution manometry catheter was introduced through the nostril before the endoscope, and left in place during the peroral endoscopic myotomy procedure. The lower esophageal sphincter pressure was recorded throughout the peroral endoscopic myotomy. The myotomy was extended on the gastric side until the lower esophageal sphincter pressure dropped below 10 mmHg. We included 10 patients (mean age = 55 years old, 3 men) treated by peroral endoscopic myotomy for type I (3/10), type II (3/10), type III achalasia (3/10) or esophagogastric junction outflow obstruction (1/10). Manometric recording was possible in all patients. The median (IQR) lower esophageal sphincter resting pressure was 23 (17–37) mmHg before myotomy, 15 (13–19) mmHg at the end of the tunnel, and 7 (6–11) mmHg at the end of the myotomy. In 4 patients out of 10, the myotomy was extended on the base of the intraoperative manometry findings. High-resolution esophageal manometry is feasible during the peroral endoscopic myotomy procedure, and leads to increase the length of the gastric myotomy in 4 out of 10 patients. However, the cumbersome nature of intraoperative high-resolution manometry during peroral endoscopic myotomy and the high frequency of gastro-esophageal reflux disease after extended gastric myotomy suggest to limit this technique to selected patients refractory to a first myotomy.