Prevalence Of GERD Research Articles

The Sensitivity and Specificity of GERD Score Questionnaire in Detecting the Prevalence of GERD among Children with Recurrent Secretory Otitis Media

Background: Gastroesoghageal Reflux and Otitis Media are two of the most prevalent diseases in young children. Aim: To describe the prevalence of Gastroesophageal reflux in infants and young children with recurrent secretory otitis media. Patients and Methods: This descriptive cross sectional study cross sectional included Ninety-one children of both sex aged from 3 months to 8 years were assessed with history of recurrent secretory otitis media type B Tympanometry not improved completely by medical treatment. X-ray of the nasopharynx was done. The parent or legal guardian completed the Infant Gastroesophageal Reflux Questionnaire–Revised (I-GERQ-R) symptom-based 11 points questionnaire (I-GERQ GERD). Results: this study include 61 male (67%) and 33 female (33%) and mean GERD score in patients with GER was (7.23 ± 3.1) compared to Non-GERD group (0.76 ± 0.83) (p < 0.001). The mean GERD score in patients with GER was 5.98 +/- 4.22 compared to GERD with adenoid group (3.87 ± 2.45) and Non-GERD group (0.76 ± 0.83) (p < 0.001).GERQ score ≥7 had a sensitivity of 96.2% and specificity of 98% in diagnosing GERD among our patients with overall accuracy of 97%. Conclusion:The I-GERQ-R is thus adequately sensitive to be used diagnostically to screen children for symptom burden.

Atypical and typical manifestations of the hiatal hernia

: Hiatal hernias may present in variety of ways, both typical and atypical. Manifestations are dependent on the type and size of the hernia. Gastrointestinal manifestations are the most common, predominately with GERD and associated syndromes. Typical GERD presents with heartburn and regurgitation as part of a reflux syndrome. Additionally, GERD may manifest as a typical chest pain syndrome unrelated to a cardiac etiology. Hiatal hernia associated GERD may present with esophageal mucosal injury in the form of reflux esophagitis, stricture, Barrett’s esophagus, and progress to esophageal malignancy. Atypical GERD symptoms like cough, laryngitis, asthma, and dental erosions may be may exist with hiatal hernias. GERD symptoms are more often associated with type 1 hiatal hernias. Typical gastrointestinal obstructive symptoms of hiatal hernia manifest as nausea, bloating, emesis, dysphagia, early satiety, and postprandial fullness and pain in the epigastrium and chest. Less common, atypical presentations include gastric outlet obstruction, secondary gastric volvulus, intestinal obstruction and ischemia, and bleeding. These manifestations occur more frequently with paraesophageal hernias. Bleeding, ulcerations in the form of Cameron lesions, and iron deficiency anemia are additional atypical manifestations of hiatal hernia. As hiatal hernias enlarge and move more into the thorax, non-gastrointestinal symptoms become more frequent. Typical pulmonary presentations consist of dyspnea, dyspnea on exertion, and atelectasis as a result of pulmonary compression. Similarly, compression on the left atrium may explain the higher prevalence of atrial fibrillation in patients with hiatal hernia. Pulmonary fibrosis remains an atypical presentation of hiatal hernia, likely associated with the increased prevalence of GERD in hiatal hernia.

The prevalence and risk factors of GERD in the Kingdom of Saudi Arabia and the impact of Covid-19 pandemic

The prevalence and risk factors of GERD in the Kingdom of Saudi Arabia and the impact of Covid-19 pandemic

Association Between Body Mass Index, Waist Circumference and Gerd-Q Scores: A Cross-Sectional Study

The prevalence of GERD has continued to increase in Asian countries in recent decades. The incidence of overweight and obesity continues to increase. Many studies have revealed that obesity in general or abdominal obesity causes a significant increase in the risk of GERD symptoms. The research objective was to determine the relationship between BMI and waist circumference with the incidence of GERD in the adult population of Palembang city.An analytic observational with a cross-sectional design. The population were all adults(≥20 years) of Palembang. The number of samples were 400 people. Data were taken from a self-completed questionnaire, distributed through various social media, then analyzed using logistic regression analysis.Among 400 subjects in the study, there were 81 subjects (20.3%) diagnosed with GERD, 43 subjects (10.8%) were overweight, 79 subjects (19.8%) were obese, and 160 subjects(40%) have had abdominal obesity. There was a significant relationship between obesity and diagnosis of GERD (p=0,001; OR =2,799; CI95% = 1,545-5,069). In contrast, there were no significant relationship between overweight and diagnosis of GERD. There were also no significant relationship between abdominal obesity and diagnosis of GERD. Obesity has a significant association with the diagnosis of GERD, but the absence of an association between overweight and diagnosis of GERD implies that increased BMI is not an independent risk factor in diagnosis of GERD.

Prevalence and factors associated with gastroesophageal reflux disease among primary health care attendants at Abha city, southwestern Saudi Arabia

BackgroundGastroesophageal reflux disease (GERD) is an abnormal reflux of the gastric content into the esophagus. In Saudi Arabia the GERD prevalence is not recently well studied. ObjectiveTo investigate the prevalence of gastroesophageal reflux disease and associated factors among attendants of primary health care centers (PHCCs) at Abha city, Saudi Arabia. MethodA descriptive cross- sectional study was performed using GerdQ as diagnostic tool for the GERD. The GerdQ consisted of six questions. Four questions were about the positive GERD predictors. The other two questions were about the negative GERD predictors. The scoring of GerdQ relies on the frequency of GERD symptoms during the last seven days. Using stratified random sample technique a representative sample was slected from the study PHCCs taking into conmsideration the relative catchment population in each center among adult males and females attending the selected PHCCs for any reason. ResultsThe present study included 320 persons. The study showed a prevalence of GERD of 67.8%. The prevalence of GERD with high impact on daily life (HIDL) was found to be 50%. By multiple logistic regression (enter method) only four significant independent factors associated with GERD were identified; being unmarried (aOR = 1.85, 95% CI:1.02–3.23); smoking (aOR = 2.11, 95% CI: 1.41–5.98), fast food intake (OR = 1.28, 95% CI:1.01–1.71), and subjective perception of stress (OR = 3.0, 95% CI:1.68–5.26). ConclusionsGERD is a public health problem among adults in the region. Community level awareness programs are recommended. Healthcare providers must be aware of community perceptions and practices.

Vertigo in association with gastro-esophageal reflux disease

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Gastroesophageal reflux (GERD) is a condition which develops when the reflux of stomach contents cause troublesome symptoms. Symptoms of GERD are either esophageal: heartburn and regurgitation, or extra-esophageal: chronic cough, recurrent sinusitis, and globus sensation in the throat. One of the extra-esophageal manifestations of GERD is otitis media with effusion, very common among children. The aim of our study was to find the prevalence of GERD and &lt;em&gt;Helicobacter Pylori&lt;/em&gt; (&lt;em&gt;H. Pylori&lt;/em&gt;) among patients with peripheral vertigo.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present descriptive study was conducted on randomly selected patients attending outpatient department (OPD) of in community health center, Chenani for a period of one year from August 2018 to July 2019. Patients were selected without the pathology of central nervous system for the further analysis. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 85 (75.89%) patients had gastro-esophageal reflux disease. Tendency of GERD was found higher among females (54.12%). Positive &lt;em&gt;H. pylorus&lt;/em&gt; was found for 21 patients (24.71%). 65 (74.71%) patients with vertigo positive had GERD. When acid refluxes into the upper GI system, it can affect the tubes that lead to the inner ear. When these tubes become irritated, swelling can occur, causing a loss of balance and common with GERD that occurs when lying down after a meal.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; It present data confirms the hypothesis that one of the peripheral vertigo causes could be GERD, by way of a mechanism which may include reflux of gastric acids causing inflammation or local infection. The present study found a definite prevalence of GERD and &lt;em&gt;H. Pylori&lt;/em&gt; among patients with peripheral vertigo.&lt;/p&gt;

The quality of life of comorbid patients with pathology of thyroid gland and gastroesophageal reflux disease

Introduction In Russia, the prevalence of GERD is 18-46% [Ivashkin V. T., Maev I. V., Trukhmanov A. S., 2011]. GERD leads to a significant decrease in the quality of life of patients, especially with nocturnal symptoms, extraesophageal symptoms (chest pain, persistent cough), and increases the risk of complications such as bleeding from ulcers and erosions, peptic strictures and, which causes the greatest caution, Barrett’s esophagus and esophageal adenocarcinomasObjectivesThe medical and social significance of the pathology of the thyroid gland and gastrointestinal tract problem is determined by their high prevalence regardless of age, the annual increase in morbidity and the decrease in the quality of life (QOL).MethodsPatients were divided in two groups: patients with GERD; patients with GERD and hypothyroidism. Quality of life was studied using the non-specific (general) SF 36 questionnaire.ResultsThe lowest indicators were shown by patients with GERD and hypothyroidism (PF scale - Me 75.00 and 45.00 (p=0.005470), RF scale - 75,00 and 25.00 (p=0.043046), BP scale - 74.00 and 52.00 (p=0.036493), GH scale - 58.00 and 15.00 (p=0.009959)). The second group was more disadvantaged (VT scale - IU 52.50 and 32.50 (p=0.098125), SF scale - 75 00 and 50.00 (p=0.019016), RE scale - 33.30 and 0.00 (p=0.028841), GH scale - 48.00 and 36.00 (p=0.025919).ConclusionsAccording to the results, the presence of combined pathology of the thyroid gland and gastrointestinal tract significantly affected the physical and psychological component of health in the studied patients.

Endoscopic gastric plication for the treatment of GERD and underlying class I obesity.

Endoscopic gastric plication for the treatment of GERD and underlying class I obesity.

Epidemiology of gastroesophageal reflux disease in Iran: a systematic review and meta-analysis

BackgroundGastroesophageal reflux disease (GERD), which leads to acid reflux into the esophagus, is a common gastrointestinal disorder. Several studies have shown the prevalence of GERD in Iranian population, but their evidence is contradictory. Therefore, the present study was conducted to investigate the epidemiology of GERD in Iran.MethodsThe entire steps of this systematic review and meta-analysis were based on the MOOSE protocol, and the results were reported accordance with the PRISMA guideline. This review is registered on PROSPERO (registration number: CRD42020142861). To find potentially relevant published articles, comprehensive search was done on international online databases Scopus, Science Direct, EMBASE, PubMed/Medline, CINAHL, EBSCO, Cochrane Library, Web of Science, Iranian online databases and the Google Scholar search engine in June 2019. Cochran test and I2 index were used to assess the heterogeneity of the studies. Data were analyzed using Comprehensive Meta-Analysis software ver. 2. The significance level of the test was considered to be P < 0.05.ResultsThe daily, weekly, monthly, and overall prevalence of GERD symptoms in Iranian population was 5.64% (95%CI [confidence interval]: 3.77–8.35%; N = 66,398), 12.50% (95%CI: 9.63–16.08%; N = 110,388), 18.62% (95%CI: 12.90–26.12%; N = 70,749) and 43.07% (95%CI: 35.00–51.53%; N = 73,189), respectively. The daily, weekly, monthly, and overall prevalence of heartburn in Iranian population was 2.46% (95%CI: 0.93–6.39%; N = 18,774), 9.52% (95%CI: 6.16–14.41%; N = 54,125), 8.19% (95%CI: 2.42–24.30%; N = 19,363) and 23.20% (95%CI: 13.56–36.79%; N = 26,543), respectively. The daily, weekly, monthly, and overall prevalence of regurgitation in Iranian population was 4.00% (95%CI: 1.88–8.32%; N = 18,774), 9.79% (95%CI: 5.99–15.60%; N = 41,140), 13.76% (95%CI: 6.18–44.31%; N = 19,363) and 36.53% (95%CI: 19.30–58.08%; N = 21,174), respectively. The sensitivity analysis for prevalence of all types GERD, heartburn and regurgitation symptoms by removing a study showed that the overall estimate is still robust.ConclusionThe present meta-analysis provides comprehensive and useful information on the epidemiology of GERD in Iran for policy-makers and health care providers. This study showed a high prevalence of GERD in Iran. Therefore, effective measures on GERD-related factors such as lifestyle can be among the health policies of Iran.

Impact of gastroesophageal reflux on longitudinal lung function and quantitative computed tomography in the COPDGene cohort

RationaleGastroesophageal reflux disease (GERD) is a common comorbidity in chronic obstructive pulmonary disease (COPD) and has been associated with increased risk of acute exacerbations, hospitalization, emergency room visits, costs, and quality-of-life impairment. However, it remains unclear whether GERD contributes to the progression of COPD as measured by lung function or computed tomography.ObjectiveTo determine the impact of GERD on longitudinal changes in lung function and radiographic lung disease in the COPDGene cohort.MethodsWe evaluated 5728 participants in the COPDGene cohort who completed Phase I (baseline) and Phase II (5-year follow-up) visits. GERD status was based on participant-reported physician diagnoses. We evaluated associations between GERD and annualized changes in lung function [forced expired volume in 1 s (FEV1) and forced vital capacity (FVC)] and quantitative computed tomography (QCT) metrics of airway disease and emphysema using multivariable regression models. These associations were further evaluated in the setting of GERD treatment with proton-pump inhibitors (PPI) and/or histamine-receptor 2 blockers (H2 blockers).ResultsGERD was reported by 2101 (36.7%) participants at either Phase I and/or Phase II. GERD was not associated with significant differences in slopes of FEV1 (difference of − 2.53 mL/year; 95% confidence interval (CI), − 5.43 to 0.37) or FVC (difference of − 3.05 mL/year; 95% CI, − 7.29 to 1.19), but the odds of rapid FEV1 decline of ≥40 mL/year was higher in those with GERD (adjusted odds ratio (OR) 1.20; 95%CI, 1.07 to 1.35). Participants with GERD had increased progression of QCT-measured air trapping (0.159%/year; 95% CI, 0.054 to 0.264), but not other QCT metrics such as airway wall area/thickness or emphysema. Among those with GERD, use of PPI and/or H2 blockers was associated with faster decline in FEV1 (difference of − 6.61 mL/year; 95% CI, − 11.9 to − 1.36) and FVC (difference of − 9.26 mL/year; 95% CI, − 17.2 to − 1.28).ConclusionsGERD was associated with faster COPD disease progression as measured by rapid FEV1 decline and QCT-measured air trapping, but not by slopes of lung function. The magnitude of the differences was clinically small, but given the high prevalence of GERD, further investigation is warranted to understand the potential disease-modifying role of GERD in COPD pathogenesis and progression.Clinical trials registrationNCT00608764.

Study of Gastroesophageal Reflex Disease in adult Type II Diabetes Mellitus Patients with Upper Gastrointestinal Symptoms

Gastrointestinal symptoms are relatively common in clinical practice in patients with type II diabetes mellitus. type II DM has been described as possible risk factor for the development of gastroesophageal reflux disease, in this study we aim to detect the prevalence of GRED in symptomatic patients with type II DM , also to see the accuracy of reflex disease questionnaire ( RDQ) in the diagnosis of GERD in patients with type II DM in relation to the esophagogastroduodenoscopy finding and to study the relation of autonomic neuropathy to the prevalence and stages of GERD in diabetic patients . Method: A ninety patients with upper gastrointestinal symptoms was divided in to tow groups according to whether had type II DM or not and then each group involved in a two stage process (a ) – a RDQ , ( b) – OGD . And patients in the DM group underwent another step to detect diabetic neuropathy by a bed side clinical test . Results: The prevalence of esophagitis in this study was higher in the DM group . RDQ had a statistical significance in detecting esophagitis in the DM group . There is no relation of autonomic neuropathy to the prevalence of GERD in diabetic patients . . Conclusion: The prevalence of GERD was high in patients with type II DM , RDQ is a sensitive tool for the diagnosis of GERD in diabetic pateints , Autonomic neuropathy did not increase prevalence of esophagitis in diabetic patients .

Study of Gastroesophageal Reflex Disease in adult Type II Diabetes Mellitus Patients with Upper Gastrointestinal Symptoms

Gastrointestinal symptoms are relatively common in clinical practice in patients with type II diabetes mellitus. type II DM has been described as possible risk factor for the development of gastroesophageal reflux disease, in this study we aim to detect the prevalence of GRED in symptomatic patients with type II DM , also to see the accuracy of reflex disease questionnaire ( RDQ) in the diagnosis of GERD in patients with type II DM in relation to the esophagogastroduodenoscopy finding and to study the relation of autonomic neuropathy to the prevalence and stages of GERD in diabetic patients . Methods: A ninety patients with upper gastrointestinal symptoms was divided in to tow groups according to whether had type II DM or not and then each group involved in a two stage process (a ) – a RDQ , ( b ) – OGD . And patients in the DM group underwent another step to detect diabetic neuropathy by a bed side clinical test. Results: The prevalence of esophagitis in this study was higher in the DM group. RDQ had a statistical significance in detecting esophagitis in the DM group. There is no relation of autonomic neuropathy to the prevalence of GERD in diabetic patients . Conclusion : The prevalence of GERD was high in patients with type II DM, RDQ is a sensitive tool for the diagnosis of GERD in diabetic pateints , Autonomic neuropathy did not increase prevalence of esophagitis in diabetic patients .

Study of Gastroesophageal Reflex Disease in Adult Type II Diabetes Mellitus patients with Upper Gastrointestinal Symptoms

Gastrointestinal symptoms are relatively common in clinical practice in patients with type II diabetes mellitus. type II DM has been described as possible risk factor for the development of gastroesophageal reflux disease, in this study we aim to detect the prevalence of GRED in symptomatic patients with type II DM , also to see the accuracy of reflex disease questionnaire ( RDQ) in the diagnosis of GERD in patients with type II DM in relation to the esophagogastroduodenoscopy finding and to study the relation of autonomic neuropathy to the prevalence and stages of GERD in diabetic patients . Methods: A ninety patients with upper gastrointestinal symptoms was divided in to tow groups according to whether had type II DM or not and then each group involved in a two stage process (a ) – a RDQ , ( b ) – OGD. And patients in the DM group underwent another step to detect diabetic neuropathy by a bed side clinical test . Results: The prevalence of esophagitis in this study was higher in the DM group. RDQ had a statistical significance in detecting esophagitis in the DM group. There is no relation of autonomic neuropathy to the prevalence of GERD in diabetic patients . . Conclusion : The prevalence of GERD was high in patients with type II DM , RDQ is a sensitive tool for the diagnosis of GERD in diabetic pateints , Autonomic neuropathy did not increase prevalence of esophagitis in diabetic patients .

Association between Lifestyle and Gastroesophageal Reflux Disease Questionnaire Scores: A Cross-Sectional Study of 37 442 Chinese Adults.

The aim of this study was to investigate the distribution characteristics of GerdQ results in a Chinese population and the association between lifestyle and GerdQ scores. Among the 37 442 individuals enrolled from September 2009 to March 2016, 7 449 (19.89%) had a GerdQ score of ≥8 points and 29 993 (80.11%) had a GerdQ score of <8 points. The percentage of men with suspected GERD was significantly higher than the percentage of women with suspected GERD (χ2 = 111.571, P ≤ 0.001), and the prevalence of GERD was higher in the young and middle-aged populations than in the elderly population. The prevalence of GERD increased gradually with weight gain (χ2 = 145.227, P ≤ 0.001). With regard to lifestyle, the prevalence of GERD in the subjects who smoked (χ2 = 119.361, P ≤ 0.001), consumed alcohol excessively, lacked physical activity (χ2 = 86.916, P ≤ 0.001), and had an excessive intake of oil, meat, fish, and eggs showed an ascending trend (χ2 = 105.388, P ≤ 0.001). In contrast, an adequate intake of vegetables (≥300 g/d) and fruit (≥200 g/d) was associated with a significantly lower incidence of GERD. Suspected GERD is very common in individuals undergoing health examinations. Unhealthy lifestyles are closely related to the high incidence of suspected GERD. GerdQ scores can play a role in screening for GERD.

Personal, academic and stress correlates of gastroesophageal reflux disease among college students in southwestern Saudi Arabia: A cross-section study.

BackgroundGastroesophageal reflux disease (GERD) is a worldwide prevalent gastrointestinal disorder which has negative impacts on quality of life, health and economy. The aims of this study were to assess the prevalence of GERD among college students in southwestern Saudi Arabia and to evaluate its personal, academic and stress correlates.Materials and methodsThrough a cross-sectional study design, a self-reported questionnaire was distributed between a representative sample of students in health and non-health care colleges in southwestern Saudi Arabia. The questionnaire included data for personal characteristics, academic study, and Arabic versions of GERD questionnaire (GerdQ) and Cohen's Perceived Stress Scale.ResultsOut of 2878 studied students, GERD was reported by 28.6% and 36.6% of students in health and non-health care colleges respectively with an overall prevalence rate of 33.18%. It was associated with impacts on daily life in 17.2% of students. By multivariable regression analysis, GERD was significantly higher among males (aOR = 1.44, 95% CI:117–1.65), ex-smokers (aOR = 1.87), current smokers (aOR = 1.71), non-health care students (aOR = 1.36) and those exposed to high perceived stress (aOR = 1.30).ConclusionGERD is a prevalent problem among college students in southwestern Saudi Arabia as it affects about one third of the students. Considering high prevalence of GERD, associated daily life impacts, young age of the studied subject and the risk of future complications, this condition could represent a challenging health and economic problem. The risk of GERD is higher among; males, smokers, former smokers, non-health care colleges students and subjects exposed to high perceived stress.

3106 Cirrhosis and Barrett's? WATS-3D as a Screening Tool

INTRODUCTION: Barrett's esophagus (BE) is a pre-malignant condition in patients with long-standing GERD. The gold standard for diagnosing BE is taking 4-quadrant esophageal biopsies during endoscopy followed by demonstration of intestinal metaplasia on histopathology. However, in patients with cirrhosis, taking biopsies is rendered difficult due to an increased risk of bleeding due to esophageal varices and coagulopathy. This case series reports three patients with cirrhosis that were successfully diagnosed with BE using WATS3D (Wide angle trans-epithelial sampling with computer assisted 3 dimensional tissue analysis). CASE DESCRIPTION/METHODS: Case 1: 66 year-old female with a history of cirrhosis secondary to autoimmune hepatitis, esophageal varices, GERD and previously diagnosed BE that had liver and kidney transplants 3 years prior to presentation. Case 2: 63 year-old male with a history of BE, Laennec's cirrhosis, esophageal varices and portal hypertensive gastropathy. Case 3: 62 year-old male with a history of cirrhosis due to untreated hepatitis C and alcohol abuse, known carrier for HFE gene, GERD and BE. Case 1 and 2 had WATS3D brushings and mucosal biopsies, while Case 3 had WATS3D brushings alone due to concerns of bleeding. The findings are described in Table 1. There was agreement between the WATS3D analysis and biopsy results in the 2 patients. The patient with WATS3D brushings alone had evidence of goblet cell metaplasia. There were no immediate or post-procedural complications (bleeding, infections) in any of the patients. DISCUSSION: Review of literature suggests that the prevalence of GERD and neoplastic progression in patients with cirrhosis is higher compared to patients without liver disease. However, weighing the benefits and risks of taking biopsies during EGD, many cases of BE go undetected when physicians refrain from taking biopsies and rely solely on endoscopic findings. WATS3D uses a minimally invasive brush biopsy that resects wide area tissue samples, allowing analysis of the full trans-epithelial thickness of the esophagus. It is less invasive than forceps biopsy, has a higher sampling yield, and would be safer in patients at high risk of bleeding complications in patients similar to those presented in this case report.

410 Barrett’s Esophagus and Obstructive Sleep Apnea: Is There a Link?

INTRODUCTION: Barrett’s esophagus (BE) is a precursor lesion for esophageal adenocarcinoma. While some studies suggest relationship between obstructive sleep apnea (OSA) and GERD. Studies linking BE to obstructive sleep apnea (OSA) remains limited. Here, we hypothesized that OSA is independently associated with presence of Barrett’s esophagus. METHODS: We used the Nationwide Inpatient Sample (NIS) database from the year 2016 for this study. We identified patient with obstructive sleep apnea and Barrett’s esophagus using ICD-10-CM codes. Patients less than 18 years old were excluded from the study. Clinical factors associated with Barrett’s esophagus (age &gt;50, white race, GERD, male gender, hiatal hernia, obesity and smoking) were also extracted from the database. We performed multivariate logistic regression to control for confounding factors associated with BE. All statistical analyses were performed using SAS 9.4. RESULTS: Out of 6,028,636 patients, 6.4% patients had OSA in year 2016. Prevalence of Barrett’s esophagus in OSA was 0.75%. We divided patients in two groups based on diagnosis of OSA. The mean age of the OSA population was 63.2 year, 40.8% were male, and 72% were white. Proportion of patients with age more than 50 year was high in OSA group (84.7%). Smoking and hiatal hernia were equally distributed among two groups. OSA group had higher prevalence of GERD, obesity and BE as shown in Table 1. Age more than 50, male gender, and white race were associated with almost 2-fold increase likelihood of having BE as shown in table 2. Patients with hiatal hernia are 7 times more likely to have BE (OR: 7.4, P &lt; 0.0001). For unclear reason, obesity was associated with marginally lower risk of BE (OR: 0.935, P &lt; 0.0001). Patients with OSA had 30% more chance of having BE compared to patient without OSA (OR: 1.293, 95% CI: 1.270 – 1.317, P &lt; 0.0001). AUC (Area Under Curve) for this model was 0.81. CONCLUSION: OSA is an independently associated with higher likelihood of Barrett’s esophagus even after adjusting for potential confounders. Further studies can be pursued to reinforce the finding so that OSA can be included as a factor for screening for BE.

Gastroesophageal reflux disease after peroral endoscopic myotomy: Short-term, medium-term, and long-term resultsGastroesophageal reflux disease after peroral endoscopic myotomy (POEM)

Introduction and aimsAchalasia is characterized by incomplete relaxation of the lower esophageal sphincter and esophageal aperistalsis. The efficacy of peroral endoscopic myotomy (POEM) is similar to that of the Heller myotomy, with an apparently greater prevalence of gastroesophageal reflux disease. Our aim was to determine the presence of GERD in a post-POEM cohort of Mexican patients with achalasia and follow-up of at least 12 months. Materials and methodsA retrospective cohort study was conducted on post-POEM patients with a minimum of 12 months of follow-up, within the time frame of 2012 to 2017. Pregnant patients were excluded. Serial endoscopy, pH study, and GERDQ application were performed. Univariate and bivariate data analyses were carried out and statistical significance was set at a P<0.05. ResultsSixty-eight patients had post-POEM follow-up for 12 months. Of those patients, follow-up continued to 24 months for 58, 36 months for 47, 48 months for 39, and 60 months for 25. Mean patient age was 47.8±14.3 years, 57.3% of the patients were women, 77.9% were treatment-naïve, and 54.4% had type II achalasia. The pH study, endoscopy, and questionnaire were positive in 73, 28, and 18% at 3 months; 48, 35, and 13% at 6 months, and 55, 30, and 15% at 12 months, respectively. Once the proton pump inhibitor was begun, the percentages decreased to 5, 2, and 6% at 24 months; 6, 2, and 8% at 36 months; 4,1, and 6% at 48 months; and 3, 1, and 4% at 60 months, respectively. There was no relation between the efficacy of POEM and the presence or intensity of GERD. There were no secondary complications due to gastroesophageal reflux. ConclusionsThe post-POEM prevalence of GERD was 50% in the short term (12 months), with no evidence of complications at the medium term or long term (60 months). Gastroesophageal reflux was adequately controlled through proton pump inhibitors administration in over 95% of the cases.

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

BackgroundThe implementation of high-resolution manometry (HRM) and the Lyon Consensus statement facilitate evaluation of gastroesophageal reflux disease and motility disorders in morbidly obese patients. Therefore, we aimed to investigate prevalence and phenotype of (borderline) GERD and esophageal motility disorders in this population.MethodsConsecutive morbidly obese (BMI ≥ 35 kg/m2) patients were offered evaluation by means of HRM, ambulatory 24-h pH impedance monitoring, endoscopy, and a clinical examination at our tertiary academic center. Data were collected prospectively.ResultsOut of 448 eligible individuals, 147 patients (females = 75, 51%) with a median age of 41.6 (33.4; 52.3) years and a BMI of 44 (40.9; 49.4) kg/m2 were included during the study period. The Chicago Classification revealed motility disorders in 50 (34%) patients, dominated by outflow obstruction (18.4%, n = 27) and a novel disorder (7.5%, n = 11), nicknamed jackhammer esophagus (JE). According to the Lyon Consensus, 52 (35.4%) patients had evidence of true GERD, whereas borderline GERD was noted in another 60 (40.8%). Hypersensitive esophagus was observed in 6.8% (n = 10). Sensitivity and specificity of symptoms for GERD were 53.8% and 68.4%, respectively.ConclusionsThe current gold standard of assessment revealed that the prevalence of esophageal motility disorders and (borderline) GERD is high in the morbidly obese population. Further longitudinal data are needed to delineate the natural course of novel motility disorders like JE in obesity and to identify risk factors for adverse outcomes following bariatric surgery.

Gastroesophageal reflux disease after peroral endoscopic myotomy: Short-term, medium-term, and long-term results.

Achalasia is characterized by incomplete relaxation of the lower esophageal sphincter and esophageal aperistalsis. The efficacy of peroral endoscopic myotomy (POEM) is similar to that of the Heller myotomy, with an apparently greater prevalence of gastroesophageal reflux disease. Our aim was to determine the presence of GERD in a post-POEM cohort of Mexican patients with achalasia and follow-up of at least 12 months. A retrospective cohort study was conducted on post-POEM patients with a minimum of 12 months of follow-up, within the time frame of 2012 to 2017. Pregnant patients were excluded. Serial endoscopy, pH study, and GERDQ application were performed. Univariate and bivariate data analyses were carried out and statistical significance was set at a P<0.05. Sixty-eight patients had post-POEM follow-up for 12 months. Of those patients, follow-up continued to 24 months for 58, 36 months for 47, 48 months for 39, and 60 months for 25. Mean patient age was 47.8±14.3 years, 57.3% of the patients were women, 77.9% were treatment-naïve, and 54.4% had type II achalasia. The pH study, endoscopy, and questionnaire were positive in 73, 28, and 18% at 3 months; 48, 35, and 13% at 6 months, and 55, 30, and 15% at 12 months, respectively. Once the proton pump inhibitor was begun, the percentages decreased to 5, 2, and 6% at 24 months; 6, 2, and 8% at 36 months; 4,1, and 6% at 48 months; and 3, 1, and 4% at 60 months, respectively. There was no relation between the efficacy of POEM and the presence or intensity of GERD. There were no secondary complications due to gastroesophageal reflux. The post-POEM prevalence of GERD was 50% in the short term (12 months), with no evidence of complications at the medium term or long term (60 months). Gastroesophageal reflux was adequately controlled through proton pump inhibitors administration in over 95% of the cases.