Prevalence Of Gastroesophageal Reflux Disease Research Articles

Helicobacter pylori infection is associated with reduced risk of Barrett\u2019s esophagus: a meta-analysis and systematic review

BackgroundHelicobacter pylori (Hp) is a class I carcinogen in gastric carcinogenesis, but its role in Barrett’s esophagus (BE) is unknown. Therefore, we aimed to explore the possible relationship.MethodsWe reviewed observational studies published in English until October 2019. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for included studies.Results46 studies from 1505 potential citations were eligible for inclusion. A significant inverse relationship with considerable heterogeneity was found between Hp (OR = 0.70; 95% CI, 0.51–0.96; P = 0.03) and BE, especially the CagA-positive Hp strain (OR = 0.28; 95% CI, 0.15–0.54; P = 0.0002). However, Hp infection prevalence was not significantly different between patients with BE and the gastroesophageal reflux disease (GERD) control (OR = 0.99; 95% CI, 0.82–1.19; P = 0.92). Hp was negatively correlated with long-segment BE (OR = 0.47; 95% CI, 0.25–0.90; P = 0.02) and associated with a reduced risk of dysplasia. However, Hp had no correlated with short-segment BE (OR = 1.11; 95% CI, 0.78–1.56; P = 0.57). In the present infected subgroup, Hp infection prevalence in BE was significantly lower than that in controls (OR = 0.69; 95% CI, 0.54–0.89; P = 0.005); however, this disappeared in the infection history subgroup (OR = 0.88; 95% CI, 0.43–1.78; P = 0.73).ConclusionsHp, especially the CagA-positive Hp strain, and BE are inversely related with considerable heterogeneity, which is likely mediated by a decrease in GERD prevalence, although this is not observed in the absence of current Hp infection.

May cardia mucosa histopathology aid in the diagnosis of gastroesophageal reflux disease in children?

Introduction: Gastroesophageal reflux disease (GERD) is a common diagnosis in children referred to pediatricians. This disease is diagnosed clinically based on the patient’s signs and symptoms; however, there are endoscopic and pathological evaluations to diagnose this disease too. This study evaluated the relationship between GERD and cardia mucosa histopathology in children under six years old. Objectives: Studies on adults with GERD had shown different cardia histopathology related to GERD, and this relationship in children was less evaluated. According to this and the high prevalence of GERD in children. Patients and Methods: Children who were a candidate for endoscopy were selected. Endoscopy was conducted for each participant and biopsies from the cardia area were obtained. In the recovery room, Infant Gastroesophageal Reflux Disease Questionnaire-Revised (IGERQ-R) was completed by children’s parents for identifying GERD in children. Then the relation between the presence of GERD and histopathology of the cardia area was assessed. Results: In this study, 80 children with a mean age of 33.8±20.7 months were evaluated, while 53.8% of them were male. The histopathology finding in participants with GERD was 48.1% oxyntic mucosa and 51.9% oxyntocardiac mucosa with lymphoid aggregation. This histopathology in patients without GERD was 67.9% oxyntic mucosa and 32.1% oxyntocardiac mucosa with lymphoid accumulation. There was a significant relationship between GERD and cardia mucosa type (P=0.043). Conclusion: Children with GERD had different cardia histopathology compared with those without reflux disease.

Prevalence of Gastroesophageal Reflux Disease and Associated Risk Factors in the Eastern Region, Saudi Arabia.

BackgroundGastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder characterized by heartburn and acid regurgitation. A higher incidence is found in Arab countries. Untreated GERD has a negative impact on individuals that interfere with daily activities and impaired quality of life. This study aims to estimate the prevalence of GERD and associated risk factors in the Eastern region, Saudi Arabia.Material & MethodologyA descriptive cross-sectional study was carried out among 1517 healthy participants from the Eastern province of Saudi Arabia from May to August 2021. The sample was randomly collected through a structured self-administered questionnaire. The questionnaire was composed of questions related to sociodemographic and lifestyle characteristics as risk factors for GERD. The existence of GERD was assessed by using GERD Questionnaire (GerdQ) for diagnosing GERD, when the score is 8 or more.ResultsA total of 1517 participants were included in the study: 58.8% male, 41.2% female; 9% of whom were pregnant. The age of participants ranged from 18 to 58 with a mean age of 27.5 ± 11.4 years old. The existence of GERD was 20.6% among the total participants, in which their GerdQ scores were 3-7 (68.9%), 8-10 (22.1%), and 8-11 (8.5%). The higher risk groups of having GERD were pregnant women, smoker, being male, regular usage of analgesia, soft drinks, and having a family history of GERD.ConclusionThis study showed the prevalence of GERD among the general population of the Eastern region, Saudi Arabia was 20.6%. Several sociodemographic and lifestyle characteristics were associated with the disease. Further studies are needed to explore the role of psychological factors in developing GERD.

Assessing the Degree of Gastroesophageal Reflux Disease (GERD) Knowledge Among the Riyadh Population.

BackgroundGastroesophageal reflux disease (GERD) is a chronic disease mainly characterized by heartburn and acid regurgitation. To our knowledge, there have been a limited number of studies in Saudi Arabia looking at the knowledge level among the general population regarding this disease and its associated factors. Therefore, this study aims to identify the knowledge level of the disease and its associated factors, assess the prevalence of GERD among the Riyadh general population, and assess the need for educational programs for GERD.MethodologyA cross-sectional study was conducted among the general public in Riyadh, Saudi Arabia. The degree of GERD knowledge was assessed by translating and editing Jorgen Urnes’ 24-item questionnaire into Arabic. In addition, six questions related to the symptoms and complications of GERD were added. Convenience sampling was done by using a Google form to distribute the questionnaire. The questionnaire assesses GERD knowledge by asking about the signs, symptoms, risk factors, predisposing factors, and management of GERD. Statistical analysis was performed using R v. 3.6.3 (https://cran.r-project.org/bin/windows/base/old/3.6.3/). Counts and percentages were used to summarize the distribution of categorical variables.ResultsThe questionnaire was completed by 664 respondents (48.2% males and 51.8% females). The average age of the included respondents was 34.1 ± 12.8 years and Saudis represented 97% of the included respondents. The majority of the respondents had heard of GERD (83%). The average number of correct answers was 12.7 ± 6.1. In total, 40 respondents did not answer any questions correctly. Approximately one-third of respondents answered >50% of the questions correctly (n = 250, 37.6%). Approximately half of the respondents identified all risk factors for GERD. Other common risk factors identified included caffeine (23.6%), fast food (26.8%), and smoking (17.6%). Slightly more than a quarter of the respondents reported being diagnosed with GERD (28.8%). Knowledge was significantly higher among respondents who had received a diagnosis of GERD. A statistically significant positive association was observed between age and knowledge (r = 0.19, p < 0.001).ConclusionThe study shows a relatively good knowledge level compared to previously reported figures in Saudi Arabia and worldwide. Educational programs for GERD should be increased in Saudi Arabia and more health conferences and teaching school students of the disease should be highlighted to increase the general knowledge of this disease in the Kingdom of Saudi Arabia (KSA).

Gastroesophageal reflux disease and salivary pepsin in patients with heterotopic gastric mucosa in the upper esophagus.

Heterotopic gastric mucosa in the upper esophagus (HGMUE) is reported to be related to gastroesophageal reflux disease (GERD). This study investigated the prevalence of GERD and the use of salivary pepsin to diagnose gastroesophageal reflux, especially proximal reflux, in HGMUE patients. One hundred and fifty-three HGMUE patients and 50 healthy volunteers were studied. All subjects took a reflux symptom index questionnaire (RSI); underwent endoscopy, barium esophagogram, high-resolution manometry (HRM), and 24-hour multichannel intraluminal impedance-pH-metry (MII-pH); and salivary pepsin test. Ninety-five (62.1%) HGMUE patients but no control subjects were diagnosed with GERD. The salivary pepsin concentration, RSI score, DeMeester score, acid exposure time (AET), total reflux episodes, proximal acidic reflux episodes, and proximal weakly acidic reflux episodes were significantly higher in the HGMUE group than in the control group (P < 0.05). The salivary pepsin test showed a sensitivity of 85.9% and specificity of 56.9% for diagnosing GERD using the optimal cut-off value of 75ng/mL. One hundred and seven (69.9%) and 46 (30.1%) HGMUE patients were categorized as pepsin (+) and pepsin (-), respectively when 75ng/mL was used as a cut-off value. Male sex, RSI, AET, and proximal acid reflux episodes were positive predictive factors for the occurrence of pepsin (+) in HGMUE patients. GERD, especially GERD with proximal acid reflux and related symptoms, was common in HGMUE patients. The salivary pepsin test could be an additional useful test for testing reflux in HGMUE patients, but it will not replace the MII-pH.

Prevalence of Gastro-esophageal Reflux Disease in Suspected Laryngo- pharingeal Reflux Unresponsive to Proton-pump Inhibitors.

Laryngopharyngeal Reflux (LPR) may be part of Gastroesophageal Reflux Disease (GERD). However, sometimes suspected LPR seems refractory to Proton Pump Inhibitors (PPI), questioning therefore the GERD diagnosis. Our aim was to evaluate the real-life prevalence of GERD in patients with a recent laryngoscopic diagnosis of LPR, and unresponsive to PPI. We also assessed whether other causes than GERD could explain the laryngoscopic findings in those patients. We retrospectively analyzed patients with the diagnosis of LPR, and unresponsive to PPI. Those patients must have been investigated by: upper gastrointestinal endoscopy with biopsies; multichannel intraluminal impedance and pH monitoring (MII-pH); X-ray of the chest and/or of the paranasal sinuses; hormonal thyroid assessment; prick tests to assess food and/or inhalants and pollen allergy. We enrolled 28 patients (18, 64.3%, males and 10, 35.7%, females; median, IQR age 39.4, 21-75 yrs). Endoscopic hiatal hernia was found in 9/28 (32.1%) patients; the MII-pH analysis showed abnormality in 2/28 (7.14%) patients (both having also GERD symptoms); Chest X-ray found chest diseases in 2/28 (7.14%) patients and X-rays of the paranasal sinuses found sinusitis in 1/28 (3.6%); 2/28 (7.14%) patients had hyperthyroidism; food and/or inhalants and pollen allergy was found in 9 (32.1%) patients. In 12/28 (42.9%) patients, any of the investigated diseases was found. This study found that the real prevalence of GERD in patients with a recent laryngoscopic diagnosis of LPR, and unresponsive to PPI, is low. Moreover, more than 40% of them did not show any of the investigated diseases in real life.

2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease.

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

High Prevalence of Gastroesophageal Reflux Symptoms in Patients with both Acute and Nonacute Cough

Background and Aim: Gastro esophageal reflux disease (GERD) affects more than 30% of the Asian population, and its symptoms are common. The high prevalence of atrophic gastritis in the Pakistani population is exacerbated by gastro esophageal reflux disease. The present study aims was to assess the high prevalence of gastro esophageal reflux symptoms in patients with both acute and no acute cough. Materials and Methods: This cross-sectional study was conducted on 426 consecutive patients who attended the General Medicine and Emergency department of Sheikh Khalifa bin Zayed Hospital Rawalakot and Avicenna Hospital, Lahore from February 2021 to July 2021. Informed consent in written form was taken from all the patients. Patients with partial gastrectomy previous history and user of antagonist H2-receptor, steroids, proton pump inhibitor (PPI), and other inflammatory drugs two months prior to the investigation were excluded. Helsinki Declaration was utilized for this study with ethical approval taken from the hospital ethics committee. SPSS version 24 was used for data analysis. Results: Of the total 426 patients, GERD diagnosed patients were 248 (58.2%) and 178 (41.8%) had respiratory symptoms. The prevalence of GERD symptoms was higher in respiratory symptoms patients compared to without respiratory symptoms patients (p-value=0.05). Out of 178respiratory symptoms patients, GERD symptoms were present in 71 (39.9%) of acute cough while 107 (60.1%) of non-acute cough while 86 (34.7%) of 248 had no respiratory symptoms. The GERD development has no significant association with respiratory symptoms duration, however, patients having respiratory symptoms are at substantially elevated risk for GERD development. Conclusion: Our study found that respiratory symptoms patients are considerably more likely to develop GERD. GERD prevalence was similar in both acute and non-acute cough patients, implying that the presence of respiratory diseases is associated with the development of GERD regardless of the duration of respiratory symptoms. Keywords: Gastro esophageal reflux; Acute cough; Respiratory symptoms

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Laparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery. Both laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) represent viable options, but the long-term results are still lacking. In 2014, we published the 2-year follow-up of our multicenter cohort of revisional LSG after failed LAGB. Evaluate the long-term follow-up (median 9.3 years) of the same cohort of patients. University and primary-care hospitals, Italy. We retrospectively examined a prospectively maintained database of the previously published multicenter cohort of 56 patients who underwent LSG after failed LAGB between 2008–2011. The control group included cross-matched non-revisional LSGs. The primary endpoint was weight loss, secondary endpoints co-morbidities, and the need for further bariatric surgery. The study group included 44 patients and the control group 56. We found %EWL 53% Vs. 67% (p = .021), %EBMIL (54 Vs. 68%, p = .018), %TWL (26 Vs. 34%, p = .002). We also found more severe GERD (gastroesophageal reflux disease) symptoms in the revisional than in the primary group (9.0 vs. 1.8% mild and 23.0 vs. 3.0% severe). Ten patients from the revisional group (22.7%) vs. eight in the primary group (13%) underwent further bariatric surgery (LRYGB). Our results showed less favorable weight loss in revisional than primary LSG after LABG, higher prevalence of GERD, and a more frequent need for further revisional surgery. Despite the study’s limitations, the present data suggest that the long-term outcomes may offset the possible reduced short-term complication rate after revisional sleeve gastrectomy for a failed LABG.

Prevalence of Gastroesophageal Reflux Disease in Asthma and Chronic Obstructive Pulmonary Disease

Background: The esophagus exposure to stomach reflexes contents (or gastric content) causes an inflammatory sensation, bitter fluid movement from the abdomen to mouth and other troublesome symptoms are generally referred to as Gastro esophageal reflux disease (GERD). Aims: The present study aimed to evaluate the prevalence of gestroesophageal reflux disease in asthma and chronic obstructive pulmonary disease. Materials and Methods: This multi-center cross-sectional study was carried out on 150 chronic obstructive pulmonary disease patients admitted at Medicine ward and OPD at Divisional Headquarters Teaching hospital Mirpur and KMU IMS, Kohat for six months duration from October 2020 to March 2021. All the patients of either gender having an age range between 16-70 years and met the inclusive criteria were enrolled. The demographic details such as age, gender, duration, and severity of chronic obstructive pulmonary disease, and Gastroesophageal reflux disease prevalence were recorded in proforma after obtaining informed consent in written form. Patients with a ratio of forced expiratory volume to forced vital capacity (&lt;70%) in one second and had no forced expiratory volume improvement after nebulization. SPSS version 20 was used for data analysis. Results: Of the total 150 chronic obstructive pulmonary disease patients, 93 (62%) were male while females were 57 (38%). The overall mean age ±SD was 54.37±16.06 years. Chronic obstructive pulmonary disease mean duration was 8.93±5.3 years. Out of 150 COPD patients, about 74 (49.3%) had Gastroesophageal reflux disease while 76 (51.7%) had no Gastroesophageal reflux disease. The GERD overall prevalence in COPD was 49.3%. Based on Gastroesophageal reflux disease symptoms, very severe, severe, moderate, and mild were 26 (17.6%), 23 (15.4%), 14 (9%), and 11 (7.3%) respectively. As per COPD severity, the prevalence of GERD was statistically insignificant (p-0.532). Conclusion: The present study concluded a significant association between chronic obstructive pulmonary diseases with gastro esophageal reflux disease. The prevalence of gastro esophageal reflux disease was reported at 49.3% among chronic obstructive pulmonary diseases patients. Keywords: Gastroesophageal reflux, chronic obstructive pulmonary disease, Asthma

The tapestry of reflux syndromes: translating new insight into clinical practice.

For decades the rationale for treatment of gastro-oesophageal reflux disease (GORD) with acid suppressors, such as proton pump inhibitors (PPIs), was that symptoms were attributable to reflux of acidic stomach contents into the oesophagus. However, recent advances in the understanding of how brain–gut interactions can modulate the perception of visceral stimuli have complicated the concept of GORD.1 It is increasingly evident that altered perception of reflux is an important underlying cause of symptoms.2 A number of syndromes related to visceral hypersensitivity and central nervous system dysregulation are now recognised as ‘functional’ gastrointestinal (GI) disorders, potentially localised to the oesophagus,3 bowel, stomach, duodenum, anorectum, gallbladder, or multiple GI sites in the same patient. These functional syndromes are common; an internet-based health survey of almost 6000 adults in the US, Canada, and the UK found that 35% had symptoms compatible with some functional GI disorder and 7% met diagnostic criteria for a functional oesophageal disorder.4 This could potentially account for a large fraction of the adults with weekly reflux symptoms in population-based assessments (global prevalence ∼13%).5 However, it being impractical to investigate all of these patients, the recognition of altered perception as a major determinant of reflux symptoms has had little impact on management in general practice. To provide guidance for the management of uninvestigated reflux symptoms in primary care, a series of sponsored (Reckitt Benckiser Healthcare Ltd, UK) workshops were held among gastroenterologists, GI surgeons, and GPs. The objective was to translate recent research findings into clinical practice strategies. Epidemiological data suggest that the prevalence of GORD has increased considerably since the mid-1990s. However, wider public awareness of the link between reflux symptoms and oesophageal cancer6 has likely contributed to the increased presentation of symptomatic patients in primary care. Additionally, the more we understand the …

Prevalence and beverage-related risk factors of gastroesophageal reflux disease: An original study in Chinese college freshmen, a systemic review and meta-analysis.

Beverage-drinking behavior could be a potential risk factor for gastroesophageal reflux disease (GERD) in young populations. However, GERD prevalence in this population has not been investigated, and beverage consumption's association with GERD remains inconclusive. This study aimed to evaluate the prevalence and beverage-related risk factors of GERD among Chinese college freshmen and in youth around the world. A cross-sectional survey was conducted in Chinese college freshmen in September 2019 using random cluster sampling method. Participants completed questionnaires on demographic information, food intake frequency, and GER symptoms. Multivariate logistic regression models were applied to assess the association between beverages and GERD. Studies were retrieved from multiple databases for systemic review. The prevalence of GERD in young populations and beverage-related risk factors were pooled using random-effect models. Based on the 3345 individuals who completed the questionnaires, GERD prevalence in Chinese college freshmen is 5.1%. Multivariate analysis showed students who drink green tea daily, and those who drink coffee regularly were more likely to develop GERD compared with those who never drink tea or coffee. The pooled prevalence of GERD in young populations is 18.0%, and frequent alcohol consumption is positively associated with GERD in general population. The prevalence of GERD in Chinese college freshmen is significantly lower than that in worldwide youth populations. Alcohol, green tea, and coffee consumption could be potential risk factors for GERD. Future large-scale epidemiological studies are warranted for reliable identification of beverage-related risk factors for GERD in young populations.

The features of GERD pharmacotherapy

The widespread prevalence of gastroesophageal reflux disease in clinical practice makes urgent the issue of therapy. This article describes the clinical manifestations, considers the recommended methods of diagnosis and therapy, including in pediatrics.

Risk Factors Associated with Oral Manifestations and Oral Health Impact of Gastro-Oesophageal Reflux Disease

Background and aim: The association of gastro esophageal reflux disease with oral health manifestations faced major challenges in terms of invasive investigative approaches to be performed on patients for necessary treatment. The current study aimed to evaluate the risk factors and impact of gastro-esophageal reflux disease on oral health. Materials and Methods: The cross-sectional study was carried out on 194 gastro-oesophageal reflux disease in Gastroenterology department of Isra University Hospital, Hyderabad for duration of six from July 2020 to December 2020. The individuals underwent duodenoscopy for oesophago–gastro–reflux disease and met the inclusive criteria were enrolled. The gastro-oesophageal reflux disease patients were categorized into two group’s namely chronic gastro-oesophageal reflux disease as a group I (97 patients), while mild GORD was group II (97). The exclusion criteria for this study was individuals with limited mouth opening and unconscious patients. Mucosa oral lesion and abnormal conditions were measured as primary and secondary outcomes. Oral Health Impact Profile-14 was utilized for assessment of life quality changes with hard and soft tissue. Results: Of the total 194 patients, 113 (58.2%) were male while 81 (41.8%) were females. The mean age was 48.32±7.56 years with an age range of 20-80 years. The socioeconomic status of the participants was as follows; urban residents 127 (65.5%) and rural 67 (34.5%). The gastro-oesophageal reflux disease prevalence was found 35.6% (n=69) out of which 34.8% (24) were dental erosion (DE). Group I and II had 97 patients each. The group I was comprised of significantly common diseases such as ulceration 52 (53.6%), Oral submucous fibrosis 59 (60.8%), and xerostomia 42 (43.3%). Chronic gastro-oesophageal reflux and dental erosion diseases were statistically significant with an unhealthy pattern of diets such as ulceration, nausea/vomiting, gingivitis, angular cheilitis, and oesophagitis. The prevalence of overall oral tobacco and smoking addiction was 59 (30.4%) and 52 (26.8%). Tea was the most prevalent consumed beverage 141(72.7%). Gastro-oesophageal reflux and dental erosion diseases were positively correlated with oral health assessment scale-14 (p-value &lt;0.05). The psychological discomfort, psychological disability, physical disability, and functional limitation were the notable impacts with their respective ranks correlation coefficient (rs) 0.29, 0.26, 0.28, and 0.19. Conclusion: Gastro-oesophageal reflux and dental erosion disease had higher severity among patients of oral manifestation compared to those with no gastro-oesophageal reflux and dental erosion disease. The systemic and oral disease severity needs to be assessed routinely with dental checkup. Keywords: Oral manifestations, Gastro-oesophageal reflux disease

Clinical, endoscopic and histopathological correlation in gastro oesophageal reflux disease

Background: Gastroesophageal reflux disease (GERD) is a common burden on health care resources in the Western world and deteriorates the health-related quality of life of those affected, but its manifestations in the general population are as yet unclear.Methods: The present prospective study was conducted on 50 patients of acid peptic disease (APD) of both gender of age 15-75 were randomly selected. APD was diagnosed clinically in patients presenting the symptoms and were subjected to upper gastrointestinal (GI) endoscopy using Pentax FG29 gastroscope. The patients who had the classical symptoms of heart burn and reflux were diagnosed as GERD clinically and were examined for erosive changes by endoscopy.Results: Out of the 16 patients diagnosed as GERD, majority of them 10 (62.5%) were vegetarian and 62.50% had symptoms from 3 to 12 months. 12 (75%) had visible erosions on endoscopy. The remaining 4 (25%) had normal endoscopic picture, the biopsy taken from whom showed inflammatory changes on histopathology.Conclusions: The most common presenting complaint in patients of GERD was heartburn followed by regurgitation of gastric contents. Prevalence of GERD was found 32% in APD. In 12 (24%) of patients oesophagitis was seen on endoscopic examination. After medical treatment for 6-8 weeks, 37.5% of subjects become asymptomatic and 50% had partial symptomatic relief.

Sleeve Gastrectomy Confers Higher Risk of Gastroesophageal Reflux Disease Than Gastric Bypass: A Randomized Controlled Trial From the Oseberg Reflux Working Group

Obesity is associated with increased intra-abdominal pressure, impaired gastric emptying, and decreased lower esophageal sphincter (LES) pressure, all factors predisposing for gastroesophageal reflux disease (GERD).1 Furthermore, autonomic neuropathy in diabetes may increase the risk of GERD because of abnormal peristalsis and reduced LES pressure. Accordingly, patients with obesity and/or type 2 diabetes have a high prevalence of GERD and esophageal motility disorders. Weight loss reduces acid reflux.

Metabolic syndrome is associated with higher rate of gastroesophageal reflux disease: a meta-analysis.

Gastroesophageal reflux disease (GERD) seriously lowers the quality of life of patients, and its prevalence has gradually increased in recent years. Some studies have showed that metabolic syndrome (MetS) is related to GERD, but the results remain controversial. This study explored the relationship between MetS and GERD through systematic retrieval and analysis of published studies. Retrieve related research from PubMed, Web of Science, and Cochrane Library. Including cohort studies that compare the prevalence of GERD between patients with MetS and patients without, and case-control studies or cross-sectional studies that compare the prevalence of MetS between patients with GERD and patients without. In addition to analyzing the relationship between MetS and GERD, individual metabolic components are also analyzed. Use a random effects model (DerSimmonian and Laird) to merge the odd ratio (OR). Cochran's Q test and Higgins' I-squared statistic were performed to assess heterogeneity. Publication bias was assessed by Egger's test. A total of 103,048 patients from 15studies were included. The combined results suggest that MetS is a risk factor of GERD (OR: 1.66, 95%CI: 1.38-1.99). Among the individual metabolic components, abdominal obesity (OR: 1.42, 95%CI: 1.22-1.64), hypertriglyceridemia (OR: 1.50, 95%CI: 1.27-1.78), hyperglycemia (OR: 1.31, 95%CI: 1.07-1.61), and hypertension (OR: 1.19, 95%CI: 1.07-1.33) are risk factors of GERD. MetS is a risk factor of GERD, and among the abnormal metabolic components that establish the diagnosis of MetS, abdominal obesity, hypertriglyceridemia, hyperglycemia, and hypertension are risk factors of GERD.

Gastro-oesophageal reflux disease.

Gastro-oesophageal reflux disease (GERD) is a common disorder in adults and children. The global prevalence of GERD is high and increasing. Non-erosive reflux disease is the most common phenotype of GERD. Heartburn and regurgitation are considered classic symptoms but GERD may present with various atypical and extra-oesophageal manifestations. The pathophysiology of GERD is multifactorial and different mechanisms may result in GERD symptoms, including gastric composition and motility, anti-reflux barrier, refluxate characteristics, clearance mechanisms, mucosal integrity and symptom perception. In clinical practice, the diagnosis of GERD is commonly established on the basis of response to anti-reflux treatment; however, a more accurate diagnosis requires testing that includes upper gastrointestinal tract endoscopy and reflux monitoring. New techniques and new reflux testing parameters help to better phenotype the condition. In children, the diagnosis of GERD is primarily based on history and physical examination and treatment vary with age. Treatment in adults includes a combination of lifestyle modifications with pharmacological, endoscopic or surgical intervention. In refractory GERD, optimization of proton-pump inhibitor treatment should be attempted before a series of diagnostic tests to assess the patient's phenotype.

Gastroesophageal Reflux Disease Diagnosis by New Consensus in Clinical Practice: The Additional Value of Mean Basal Impedance

Background: Recently, Lyon consensus and ROME IV were published as there was a need to create a more objective evaluation for gastroesophageal reflux disease (GERD) in order to better predict treatment outcomes. However, with classical pH-impedance measures, some patients would still have diagnostic uncertainty, and new metrics, such as mean nocturnal basal impedance (MNBI), have emerged to corroborate with GERD diagnosis. The aim of the present study was to describe the prevalence of GERD, functional heartburn (FH), reflux hypersensitivity (RH), and undetermined diagnosis using current consensuses and to evaluate if MNBI could be considered a supportive measure for the diagnosis of GERD. Methods: Patients who underwent pH-multichannel intraluminal impedance (MII-pH) for suspected GERD between 2013 and 2018 were included. Subjects with previous diagnosis of GERD (e.g., esophagitis grade C or D according to Los Angeles classification, Barrett’s esophagus, or peptic stricture), atypical symptoms, major esophageal motor disorder, eosinophilic esophagitis, or under proton pump inhibitor were excluded from the analysis. Results: We included 75 patients. The prevalence of GERD, FH, RH and undetermined diagnosis was 44%, 14.7%, 12%, and 29.3%, respectively. MNBI was lower in patients with GERD (GERD: 1,307.5 ± 817.9 Ω vs. FH: 3,039.6 ± 1,040.8 Ω, RH: 2,617.1 ± 1,342.2 Ω, undetermined: 2,351.9 ± 1,018.2, p < 0.001), although it was similar between patients with FH and RH (p = 0.44) or between undetermined diagnosis and FH/RH (p = 0.15). More patients with a GERD diagnosis had a MNBI under 2,292 Ω (GERD: 93.9% vs. non-GERD: 31.7%, p < 0.001). Conclusion: In our study, using MII-pH criteria, less than half of the patients had a GERD diagnosis. MNBI showed additional value as another metric for the diagnosis of GERD.

Laryngopharyngeal Reflux Disease is More Severe in Obese Patients: A Prospective Multicenter Study.

To investigate whether there is an impact of obesity and overweight on the clinical findings and therapeutic responses of patients with laryngopharyngeal reflux (LPR). Prospective uncontrolled. Patients with LPR-related symptoms and positive LPR diagnosis at the hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH) were recruited from December 2017 to December 2020. Patients were treated with a combination of diet, proton pump inhibitors, and alginate for 3 to 6 months. The following outcomes were studied according to the weight of patients: HEMII-pH, gastrointestinal endoscopy features, symptoms, findings, and therapeutic response. A total of 262 patients completed the study, accounting for 134, 85, and 43 patients with normal weight (body mass index [BMI] <25), overweight (BMI=25-29.99), and obesity (BMI >30). Obese patients reported significant higher prevalence of gastroesophageal reflux disease (GERD), acid LPR, and a more severe LPR disease regarding the number of pharyngeal reflux events, reflux symptom score (RSS), and reflux sign assessment (RSA). RSS and RSA scores significantly improved from baseline to 3-month posttreatment irrespective of the patient weight group. Symptoms and signs continued to improve from 3 to 6-month posttreatment only in patients with a normal weight. Obesity is associated with a more severe LPR disease and a higher proportion of GERD and acid LPR. Obese LPR patients may require more frequently PPI-therapy regarding the higher prevalence of GERD. 3 Laryngoscope, 131:E2742-E2748, 2021.