Prevalence Of Reflux Research Articles

Reference Data from the Vascular Laboratory and Application to Chronic Venous Disease Treatment

Several population studies have described the incidence and prevalence of chronic venous disease (CVD). This prospective study was designed to determine in detail the distribution of reflux and obstruction in all lower limb veins to provide reference data for the management of CVD patients. Consecutive patients presenting to a university vascular clinic and undergoing a duplex ultrasound examination were included in the study. Patients with C2 CVD class or higher regardless of symptoms or cosmetic concerns were evaluated. Every patient received a detailed history and physical examination by a vascular surgeon including all demographic information. All patients then had a bilateral lower extremity venous ultrasound examination for reflux and obstruction. The examination was performed in the standing position with the exception of iliac veins and inferior vena cava, which were assessed in the supine position. Location and extent of reflux, vein diameters, and presence of obstruction were recorded. Obstruction was characterized as partial or complete for each venous segment. History of objectively documented venous thrombosis and findings on ultrasound examination indicating previous thrombosis were noted. There were 491 patients who presented for evaluation. Excluded were 241 patients, of whom 49 had undergone previous treatment and 192 had only C0 or C1 disease bilaterally. The remaining 250 patients were 32.8% male and 67.2% female. The mean body mass index was 28.3 kg/m2 (range, 19.2-44 kg/m2); 55.2% identified as white, 11.2% as black/African American, 23.6% as Hispanic/Latino/Spanish origin, and 0.8% as American Indian/Alaska Native. Asymptomatic patients accounted for 17% of the cohort and symptomatic patients for 83%. Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) class was distributed as 43% C2, 28.8% C3, 15.2% C4, 7.6% C5, and 4.8% C6. In the superficial veins, 70.4% of patients had only unilateral disease; 29.6% had bilateral disease. Axial reflux was found in one vein 53.2% of the time; two veins, 27.6%; three veins, 4.8%; four veins, 4%; five veins, 0.8%; and six veins, 0.4%. Calculation of potential ablations was performed, excluding superficial reflux in 2.6% of limbs with small diameter, 5.6% with segmental reflux, 4.4% with tributary reflux, and 6.0% with nonsaphenous reflux that would receive adjunct procedures including microphlebectomy or ultrasound-guided foam sclerotherapy. These adjunct procedures would account for 18.6% of therapy, whereas 64.0% would be ablative therapy. Past deep venous thrombosis was found in 7.2%; 2.8% had concurrent superficial and deep venous thrombosis. From these data, we can assume that the average patient presenting with venous complaints would have symptomatic disease with great saphenous vein reflux and would require one or two ablations based on the prevalence of saphenous reflux in the population. Patients who had at least one saphenous vein with reflux would have an average of 1.6 ablations/patient.

Intrarenal reflux, an overlooked entity - retrospective analysis of 1,166 voiding cysturethrographies in children.

The significance of intrarenal reflux as a risk factor for renal scarring and hypertension has been discussed. Fluoroscopic detection of intrarenal reflux depends on the equipment, the training of the radiologists and the timing of spot film acquisition. To evaluate the prevalence of intrarenal reflux and its association with age, gender, grade of vesico-uretero-renal reflux and the renal segments affected. We retrospectively analysed 1,166 voiding cysturethrographies. Patients' ages ranged from 1day old to 19years old. Vesico-uretero-renal reflux was detected in 209 female and 164 male patients using a standardised technique with digital pulsed fluoroscopy. The point in time and grade of reflux were documented with spot films. All radiographs showing reflux were assessed for the occurrence of intrarenal reflux. Intrarenal reflux was detected in 41 of 373 (11%) patients with vesico-uretero-renal reflux. Unilateral intrarenal reflux was found in 30 patients and bilateral in 11. The left kidney was more frequently affected than the right (31 versus 21). Only patients younger than 9years of age were affected (mean age: 1.6years, median: 0.8years). Intrarenal reflux was independent of gender and was most frequently observed in grade IV reflux (59.6%) and less often in grade V (23.1%) and grade III (17.3%). Intrarenal reflux in this study was detected in 11% of patients with vesico-uretero-renal reflux, predominantly with reflux grade IV and in patients younger than 4years old.

BARIATRIC SURGERY IMPACT ON GASTROESOPHAGEAL REFLUX AND DENTAL WEAR: A SYSTEMATIC REVIEW.

ABSTRACTIntroduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective:To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.

Evaluation of the Additive Effect of Domperidone on Patients with Refractory Gastroesophageal Reflux Disease; A Randomized Double Blind Clinical Trial.

BACKGROUND Gastroesophageal reflux disease (GERD) is a common problem with annoying symptoms. It is associated with negative impact on quality of life. Prokinetic agents may be used in combination with acid suppression agents as an adjunctive in patients with GERD refractory to proton pump inhibitors (PPI) therapy, rather than as sole treatment. This study aimed to evaluate the efficacy of combination of PPI with domperidone (a prokinetic agent) compared with PPI alone in the treatment of patients with refractory GERD. METHODS This study was a double blind clinical trial on 29 patients with GERD refractory to PPI during the period of one month. By randomization, the patients were divided into two groups. Group A was treated by pantoprazole 40 mg twice daily and domperidone three times a day for a month, while group B was treated by pantoprazole 40 mg twice daily and placebo three times a day. In this study endoscopy was performed to evaluate the prevalence of erosive esophagitis, non-erosive reflux, and hiatal hernia. Manometry was conducted to study the prevalence of dysmotility. GERD symptom questionnaires including the Gastrointestinal Symptom Rating Scale (GSRS), Carlson Dennett, and the Medical Outcomes Study Short Form-36 health survey (SF36) were used before and after treatment for screening GERD and assessing treatment response. RESULTS There were 17 (58.62%) women and 12 (41.37%) men. The prevalence of erosive esophagitis and non-erosive reflux, was 10.34% and 89.66%, respectively. There was a significant difference comparing reflux symptoms before and after treatment between the two groups according to reflux and Carlson Dennett questionnaires. At the end of the study, symptoms of reflux significantly improved by treatment. Although, the quality of life questionnaire scores improved by treatment, there was no statistically significant difference in response to treatment between the two groups. CONCLUSION In this research, we showed that adding domperidone to PPI could not make any improvement in patients with refractory reflux regarding the quality of life and improving the symptoms.

Schaaf-Yang syndrome overview: Report of 78 individuals.

Schaaf‐Yang Syndrome (SYS) is a genetic disorder caused by truncating pathogenic variants in the paternal allele of the maternally imprinted, paternally expressed gene MAGEL2, located in the Prader‐Willi critical region 15q11‐15q13. SYS is a neurodevelopmental disorder that has clinical overlap with Prader‐Willi Syndrome in the initial stages of life but becomes increasingly distinct throughout childhood and adolescence. Here, we describe the phenotype of an international cohort of 78 patients with nonsense or frameshift mutations in MAGEL2. This cohort includes 43 individuals that have been reported previously, as well as 35 newly identified individuals with confirmed pathogenic genetic variants. We emphasize that intellectual disability/developmental delay, autism spectrum disorder, neonatal hypotonia, infantile feeding problems, and distal joint contractures are the most consistently shared features of patients with SYS. Our results also indicate that there is a marked prevalence of infantile respiratory distress, gastroesophageal reflux, chronic constipation, skeletal abnormalities, sleep apnea, and temperature instability. While there are many shared features, patients with SYS are characterized by a wide phenotypic spectrum, including a variable degree of intellectual disability, language development, and motor milestones. Our results indicate that the variation in phenotypic severity may depend on the specific location of the truncating mutation, suggestive of a genotype–phenotype association. This evidence may be useful in both prenatal and pediatric genetic counseling.

The predictors of Gastroesophageal Reflux Disease among University students: A cross sectional study in the western region of Saudi Arabia

Background: Gastroesophageal reflux disease (GERD) is one of the most common health problems that cause a financial burden on healthcare systems worldwide. The prevalence of GERD in Saudi Arabia is steadily increasing. There is a paucity of data regarding GERD among University students. Material and Methods: This cross-sectional observational study was conducted to assess the prevalence of GERD among male students of Taif University in the western region of Saudi Arabia in addition to determining the risk factors associated with the occurrence of GERD. Data were collected through a self-administration questionnaire. In addition, weight and height were measured to calculate the body mass index (BMI) of participating students. Results: Of 464 students who participated from different colleges of the University; More than half of the male students in Taif University (53.2%, 95% CI= 48.7% to 57.8%) suffer from GERD. There was higher prevalence among smokers, overweight and obese students, those who drink plenty of soft drinks. Students with hypertension, psychiatric diseases, diabetes mellitus, asthma or irritable bowel syndrome had higher prevalence of reflux. GERD was significantly present among students with history of psychological stress. Conclusion: Special consideration should be given to raising the awareness of about gastro esophageal reflux disease among the public and its controllable risk factors. The psychological stress among University students needs to be tackled to decrease reflux among them.

The predictors of Gastroesophageal Reflux Disease among University students: A cross sectional study in the western region of Saudi Arabia

Background: Gastroesophageal reflux disease (GERD) is one of the most common health problems that cause a financial burden on healthcare systems worldwide. The prevalence of GERD in Saudi Arabia is steadily increasing. There is a paucity of data regarding GERD among University students. Material and Methods: This cross-sectional observational study was conducted to assess the prevalence of GERD among male students of Taif University in the western region of Saudi Arabia in addition to determining the risk factors associated with the occurrence of GERD. Data were collected through a self-administration questionnaire. In addition, weight and height were measured to calculate the body mass index (BMI) of participating students. Results: Of 464 students who participated from different colleges of the University; More than half of the male students in Taif University (53.2%, 95% CI= 48.7% to 57.8%) suffer from GERD. There was higher prevalence among smokers, overweight and obese students, those who drink plenty of soft drinks. Students with hypertension, psychiatric diseases, diabetes mellitus, asthma or irritable bowel syndrome had higher prevalence of reflux. GERD was significantly present among students with history of psychological stress. Conclusion: Special consideration should be given to raising the awareness of about gastro esophageal reflux disease among the public and its controllable risk factors. The psychological stress among University students needs to be tackled to decrease reflux among them.

PS01.059: REFLUX RELATED SYMPTOMS ARE LESS COMMON IN SOUTH-EAST HUNGARIAN SUBJECTS, THAN EXPECTED ON THE BASIS OF EPIDEMIOLOGIC STUDIES OF THE WESTERN COUNTRIES

Abstract Background Most population based epidemiologic studies indicate approximately 20% prevalence of Gastroesophageal Reflux (GER) related typical symptoms appearing at least monthly. Since most of these works were carried out in the western countries, a little is known about Central-Europe, where substantial part of the population still lives outside of the larger cities. The aim of the study was to obtain population-based data on the prevalence of GER related symptoms in South-East Hungary. Methods Two thousand and two consecutive blood donor volunteers (M/F: 1156/846, mean age: 39 (17–66) years) were enrolled. Data collection was carried out by means of a questionnaire. Typical (heartburn, regurgitation) and atypical (esophageal, extraesophageal) symptoms were assessed. Results Typical symptoms of GER such as heartburn and acidic regurgitation were reported by 22% (450/2002) and 17% (333/2002) of the studied healthy subjects. The 63% and 51% of them had such symptoms less than once per month. Monthly heartburn episodes were reported by 14, and weekly by 6 percent of the cases, while acidic regurgitation occurred in 8 and 3 percent respectively. Of the atypical (esophageal and extraesophageal) symptoms upper airway symptoms were the most prevalent (19%), although only 13% had such symptom at least monthly. Globus occurred in 6%, while other atypical symptoms were reported by less than 5% of the subjects. Typical GER symptoms occurred more frequently in females, coffee drinkers and subjects with moderate obesity. Current and former smoking and alcohol-use were associated with increased GER symptom prevalence. Conclusion In contrast to the studies carried out in the western countries South-East Hungarian subjects seem to have less GER related symptoms. Disclosure All authors have declared no conflicts of interest.

The Relationship between Primary Acquired Nasolacrimal Duct Obstruction and Gastroesophageal Reflux

ABSTRACTPurpose/Aim of the study: To evaluate if there is any relationship or coincidence between gastroesophageal reflux disease (GERD) and primary acquired nasolacrimal duct obstruction (PANDO).Material and Methods: We enrolled 180 patients with PANDO, confirmed by positive regurgitation on sac squeezing or by irrigation test. In the control group, any patient with lacrimal drainage obstruction was excluded. For diagnosis of gastroesophageal reflux we used a (Gerd Q) questionnaire by R. Jones.Results: According to Gerd Q, prevalence of gastroesophageal reflux in patients with PANDO was 20% (36 out of 180 patients) and in the control group, it was 10.6% (19 out of 180 patients), which was significantly higher in the presence of PANDO (p valve = 0.013). In women, 28 patients (23.5%) in the case group versus 13 patients (10.9%) in the control group has gastroesophageal reflux (p value = 0.01), which was not significant among men (p value = 0.870). When we considered age as an independent variable, results reveled significant value only for patients over 60 years old (p value = 0.008).Conclusion: The prevalence of gastroesophageal reflux disease was significantly higher in patients with PANDO. This statistical relationship was greater among women and patients over 60 years old. In this study, we found an association between GERD and PANDO.

P167 Understanding the mechanisms for the increased prevalence of gastro-oesophageal reflux in cystic fibrosis

P167 Understanding the mechanisms for the increased prevalence of gastro-oesophageal reflux in cystic fibrosis

Iranian lifestyle factors affecting reflux disease among healthy people in Qom.

Background and aimGastroesophageal reflux disease (GERD) is one of the most common digestive system disorders. Life style factors may increase the risk of reflux disease. We aimed to determine prevalence of reflux and related life style-factors in the population living in Qom.MethodsThis cross-sectional study was conducted among 1500 residents of Qom in 2014. Individuals were selected through multi-stage sampling. They completed two questionnaires: FSSG questionnaire for diagnosis of GERD and a general questionnaire to measure demographic and lifestyle factors. Univariate and multivariate were used for analysis of data. Data were analyzed using IBM SPSS version 20.ResultsA total of 1130 individuals were analyzed in which 52.4% of them were female. Prevalence of GERD was 28%. Adjusted findings showed use of PPIs (OR: 2.2, 95% CI: 2–5), taking H2RAs (OR: 4.7, 95% CI: 2.3–9.4), the habit of quick eating (OR: 1.5, 95% CI: 1.1–2), extra salt consumption on daily meals (OR: 1.5, 95% CI: 1.05–2), lack of sleep (OR: 2.6, 95% CI: 1.5–4.8), and consumption of white bread (OR: 1.7, 95% CI: 1.05–2.7) were related to increased risk of GERD.ConclusionOur findings showed lifestyle factors such as habit of quick eating, extra salt on regular meals, lack of sleep and use of white bread were associate with increased risk of GERD. However, habit of midnight snack, having dinner just before bedtime, lack of breakfast, smoking, drinking tea and coffee were not associated with increased risk of GERD. It is recommended to carry out a cohort study among the Iranian population to evaluate the effect of life-style risk factors on GERD.

Prevalence of gastroesophageal reflux in the central province of Konya

Giriş ve Amaç: Gastroözofageal reflü hastalığı üst gastrointestinal kanalın sık rastlanılan bir hastalığıdır. Anatomik lokalizasyonu nedeniyle özofagusa komşuluğu olan organların hastalıklarını taklit edebildiği gibi; asıl hastalığın şikayetini maskeleyebilmekte hatta oluşan komplikasyonları da başka organların fonksiyonlarını bozabilmektedir. Dünyada batı tipi yaşantısı olan toplumlarda daha sık görülmektedir. Türkiye’de hastalık epidemiyolojisi ile sınırlı veri vardır. Gereç ve Yöntem: Yaşadığımız çevrenin prevalansını belirleyebilmek amaçlı yapılan çalışmada Konya İli Merkez İlçelerinde önceden belirlenmiş rastgele adreslerdeki 2000 kişi ile anket görüşmesi yapılmıştır. Bulgular: 1188 kişi ile anket tamamlanabilmiş, (%59 geri dönüş oranı), katılımcıların 581’i kadın (%48.9), 607’si erkek (%51.1), yaş ortalaması 41.34±12.8 olarak hesaplanmıştır. Aylık semptomlar göz önüne alındığında aylık %10,9 prevalans bulunmuştur. Cinsiyet, medeni hal, eğitim düzeyi, meslek ve gelir durumu reflü ile ilişkili bulunmazken yaş ve vücut kitle indeksi ile korelasyon saptanmıştır (p<0.05). Sonuç: Bulunan sonuç itibariyle Konya İli merkez ilçelerinde her üç kişiden birinin kilolu ya da obez olduğu saptanmış, reflü prevalansının batı ülkelerine yakın olduğu görülmüştür.

Gastro-oesophageal reflux - an important causative factor of severe tooth wear in Prader-Willi syndrome?

BackgroundPrader-Willi syndrome (PWS) is the most common genetic human obesity syndrome and is characterized by hypotonia, endocrine disturbances, hyperphagia, obesity and mild mental retardation. Oral abnormalities, such as decreased salivary flow rates and extreme tooth wear, have also been described. Studies have shown a significant increase in reflux symptoms in individuals with obstuctive sleep apnoea syndrome and increased BMI, both of which are typical findings in PWS. Gastro-oesophageal reflux disease (GORD) has been identified in some individuals with PWS and is a significant intrinsic factor in dental tooth wear. The aim of this study was therefore to estimate the prevalence of GORD in adults and children and to evaluate a possible correlation between GORD and tooth wear in adults with PWS. They were all registered at the TAKO-centre.ResultsTwenty-nine individuals, 17 adults with a mean age of 32.6 years (range 18–48) and 12 children with a mean age of 8.8 years (range 3–17), agreed to undergo 24-hour oesophageal pH monitoring, and 90% of those enrolled managed to complete the examination. Four children and eleven adults were diagnosed with pathological gastro-oesophageal reflux, which is defined as acid exposure (pH less than 4) more than 3.6 or 4.3 percent of the time, respectively. Manometry performed in the adult group showed a pathologically high lower oesophageal sphincter pressure in four of the five individuals who had normal oesophageal pH values (pH under 4 less than 4.3% of the time). The two groups (reflux and non-reflux) were well balanced according to BMI, genotype, tooth grinding and hyposalivation. However, twice as many individuals in the reflux group as in the non-reflux group reported high consumption of acidic foods and drinks. Increased tooth wear was significantly correlated with GORD in the two groups (reflux n=6 and non-reflux n=6).ConclusionsThe prevalence of gastro-oesophageal reflux is high in individuals with PWS. Tooth wear was strongly associated with GORD and acidic drinks, and both may be important aetiological factors underlying the extreme tooth wear in this group. Our data suggest a need for routine screening for GORD and dental wear in young individuals with Prader-Willi syndrome.

Clinical and polysomnographic predictors of laryngopharyngeal reflux in obstructive sleep apnea syndrome

IntroductionObstructive sleep apnea syndrome and laryngopharyngeal reflux are diseases with a high prevalence in the overall population; however, it remains unclear whether they are diseases with the same risk factors present in the same populations or if there is any association between them. ObjectivesTo evaluate and determine the prevalence of laryngopharyngeal reflux in patients with moderate and severe obstructive apnea syndrome and also to determine its predictive factors. MethodsHistorical cohort, cross-sectional study of patients aged 18–70 years, referred to a tertiary service Otorhinolaryngology outpatient clinic with a polysomnographic diagnosis of moderate or severe obstructive sleep apnea syndrome. The reflux symptom index questionnaire and the reflux finding score at indirect videolaryngoscopy were applied to the assessed population, considering the inclusion and exclusion criteria. ResultsFifty-six patients were evaluated, of which 64.3% had a positive laryngopharyngeal reflux (positive reflux symptom index and/or positive endolaryngeal reflux finding score). Body mass index was a predictor of reflux presence in this group of patients with moderate to severe obstructive sleep apnea syndrome. In patients with positive score for endoscopic findings and reflux symptom index (12.3%), there was a trend toward significance for a higher mean apnea–hypopnea index and a higher percentage of sleep time with oxyhemoglobin saturation below 90% (p=0.05). ConclusionThe prevalence of laryngopharyngeal reflux was higher in this group of patients with moderate to severe obstructive sleep apnea syndrome, and the body mass index was a predictor of laryngopharyngeal reflux in these patients. There was a trend toward greater oxyhemoglobin desaturation in patients with a positive score for reflux symptoms index (RSI) and reflux finding score (RFS).

Laryngopharyngeal Reflux

The prevalence of laryngopharyngeal reflux (LPR) is around 31 % in the general population. Patients with a dysphonia or other laryngeal diseases are accompanied up to 50 % by an LPR. Typical reflux associated diseases of the larynx are a chronical laryngitis and a contact granuloma. The role of LPR is still not clarified in the development of a glottic carcinoma. There still doesn't exist evidence based data for the diagnosis of a LPR. Therefore LPR is usually clinically diagnosed by a combination of typical symptoms like hoarseness, chronic coughing, relapsing throat clearing, globus pharyngis and dysphagia as well as through the laryngoscopic characteristics like mucosal erythema, mucosal hyperplasia with plication of the interarytenoid region and an edema of the vocal cords. Occasionally the LPR can be ensured with the additional method of the pharyngeal 24-hour pH-monitoring. The therapy of the LPR is a multimodal for example dietary arrangements, medication with proton pump inhibitors and where indicated a surgical intervention. The treatment of a symptomatic patient is administered by proton pump inhibitors in a close dialog with the ENT practitioner and the gastroenterologist.

A systematic review with meta-analysis of the prevalence of gastroesophageal reflux in congenital diaphragmatic hernia pediatric survivors.

Congenital diaphragmatic hernia survivors are a well-known group at risk for developing gastroesophageal reflux disease that may be particularly long-term severe. The aim of this study is to provide a systematic review of the prevalence of gastroesophageal reflux in infant and children survivors treated for congenital diaphragmatic hernia.Electronic and manual searches were performed with keywords related to congenital diaphragmatic hernia, gastroesophageal reflux disease, and epidemiology terms. Summary estimates of the prevalence were calculated. Effect model was chosen depending on heterogeneity (I2). Factors potentially related with the prevalence, including study quality or the diagnostic strategy followed, were assessed by subgroup and meta-regression analyses. Risk of publication bias was studied by funnel plot analysis and the Egger test.The search yielded 140 articles, 26 of which were included in the analyses and provided 34 estimates of prevalence: 21 in patients aged 12 months or younger, and 13 in older children. The overall prevalence of gastroesophageal reflux disease in infants was 52.7% (95% confidence interval [CI]: 43.2% to 62.1%, I2=88.7%) and, in children over 1 year old, 35.1% (95% CI: 25.4% to 45.3%, I2=73.5%). Significant clinical and statistical heterogeneity was found. The strategy chosen for gastroesophageal reflux diagnosis influenced the reported prevalence. The only estimate obtained with a systematic use of multichannel intraluminal impedance provided a higher prevalence in both age groups: 83.3% (95% CI: 67.2% to 93.6%) and 61.1% (95% CI: 43.5% to 76.9%) respectively. This last prevalence did not significantly differ from that obtained using only low risk of bias estimates.As a conclusion, gastroesophageal reflux disease is commonly observed after congenital diaphragmatic hernia repair and is almost constantly present in the first months of life. It may be underdiagnosed if systematically esophageal monitoring is not performed. This should be considered when proposing follow-up and management protocols for congenital diaphragmatic hernia survivors.

The prevalence and risk factors of non-ulcer dyspepsia in the western region of Saudi Arabia: Short form Leads dyspepsia questionnaire revisited

Background: Non-ulcer dyspepsia is one of the most common gastrointestinal (GI) problems with a worldwide incidence of 21%. Although dyspepsia is not a life threatening condition, it can significantly impact the quality of life of affected patients. Several risk factors are suggested to increase the risk of dyspepsia such as smoking and over usage of non-steroidal anti-inflammatory drug’s. Objectives: This study was conducted to assess the prevalence of dyspepsia among the population of Taif city in the western region of Saudi Arabia in addition to determining its potential risk factors. Materials and Methods: This was a cross sectional observational study. Data was collected using a self-administration questionnaire based on short form of Leads dyspepsia questionnaire. A total of 1408 participants took part in the study while only 1276 were eligible for the statistical analysis. Results: Results: Results showed that 66.1% of the participants suffer from dyspepsia. The subtypes of dyspepsia revealed 62.1% were suffering from heartburn like pain, 50.5% suffer from regurgitation, 58.0% suffer from nausea with variant frequencies. Females showed high prevalence of dyspepsia (P < 0.001) compared to males and nausea was statistically significant among females (P < 0.001). Smoking was associated with higher prevalence of reflux like variant (P = 0.017) and over usage of pain killers was also associated with higher prevalence of dyspeptic symptoms (P < 0.001). Conclusion: It is important to minimize the unnecessary prescription of pain-killers to minimize the associated risks of developing GI disorders especially among females who are at a higher risk compared to males. In addition, raising the awareness about the risks associated with smoking can have a crucial role in lowering the prevalence and intensity of non ulcer dyspepsia.

Gastro-pharyngeal reflux and total laryngectomy. Increasing knowledge about its management

PurposeInvestigate the incidence, the degree and the effect of gastro-pharyngeal reflux (GPR) in laryngectomised patients. Materials and methodsBehavioral and 24-hour pH- and impedance-monitoring data were prospectively analyzed for 25 laryngectomised patients with no previous history of GER in outpateints' setting. Reflux detected was characterized as either acid, weakly acidic or nonacid. Proximal reflux was found at 15cm above the LES. Results40% of patients presented a pathological number of reflux episodes in the upright position (p<0.0001); 9 of them presented a pathologic bolus exposure time. Bolus exposure at the proximal sphincter was one fourth-fold lower than 5cm above the LES (p=0.3593). There was a prevalence of acid reflux at both sphincters (p<0.0001); liquid reflux was prevalent at the LES (p=0.003) and mixed reflux at the UES (p=0.0001). Median REs was higher than time acid exposure (p=0.0013). ConclusionsPre- and post-surgical reflux investigation could identify preexisting reflux severity and screen potential high-risk cancer patients for postoperative complications. This might allow the early onset of acid suppressive therapy in presence of pathologic findings in high-complication risk cancer patients.

Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis

Gastro-oesophageal reflux disease (GORD) has been implicated in the development of chronic rhinosinusitis (CRS). The association of GORD with CRS is systematically assessed from the medical literature. Embase and MEDLINE were searched using a comprehensive strategy limited to English language and Human subjects. Any study with original data on the experimental, diagnostic, treatment or prognostic association of CRS with GORD was included. Studies without a control group, case reports and review articles were excluded. The search returned 958 records, with an additional 10 found from bibliographic lists; this produced 32 studies. The included studies (n=32) consisted of studies reporting pathogenic factors (n=20), epidemiological association (n=8), prognostic interactions (n=3), and a combination of these outcomes (n=1). Potential pathogenic roles for GORD in CRS were supported; CRS subjects had greater prevalence of intranasal Helicobacter pylori and acid reflux than subjects without CRS. CRS is more prevalent in GORD sufferers than those without GORD. Evidence is conflicting for GORD as a factor in CRS treatment failure. The results support a significant association of GORD with CRS. Physicians should be cognizant of the potential for acid and non-acid reflux as a driving factor in CRS.

Initial patterns of unilateral great saphenous vein reflux in women with telangiectasias and varicose veins

Telangiectasias and varicose veins have been linked to chronic venous valvular insufficiency causing great saphenous vein (GSV) reflux. GSV diameter-reflux correlations were determined in women C1 and/or C2 and unilateral GSV reflux. Subgroups were: i) bilateral C1/C1 (n=106) and ii) refluxing &lt;em&gt;GSV&lt;/em&gt; C2/contralateral nonrefluxing C1 or C2 (n=50). &lt;em&gt;GSV&lt;/em&gt; included saphenofemoral junction (SFJ), GSV, and major veins in and out of the saphenous compartment at knee and calf. Prevalence and diameters were compared by Chi-square and paired t-test. Reflux prevalence at junction, thigh and calf were 5%, 26% and 71% of 106 refluxing C1 extremities, and 18%, 44% and 72% of 50 refluxing C2 extremities (P=0.007, 0.03, 0.87). Significant diameter increase compared to contralateral nonrefluxing segment (P&amp;lt;0.05) were at: C2 junction, 7.9±1.8 &lt;em&gt;vs&lt;/em&gt; 6.6±1.5 mm, and C2 mid-thigh, junction refluxing or not, 4.8±1.1 &lt;em&gt;vs&lt;/em&gt; 3.6±1.0 or 4.1±0.8 &lt;em&gt;vs&lt;/em&gt; 3.6±0.7 mm. Calf GSV diameters averaged 2.5 to 2.7 mm if reflux was below-knee. Unilateral reflux occurred in calf veins without correlation to diameter. Enlarged diameters were noted in refluxing SFJ and thigh GSV of women with varicose veins.