Gastroesophageal Reflux Disease Symptoms Research Articles

Retrospective Cohort Study of Gastric Bypass Versus Sleeve Gastrectomy in Gastroesophageal Reflux Disease Patients: Procedure Use and Racial Disparity.

Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are common bariatric procedures, with GERD being a frequent obesity-associated disease among individuals undergoing these surgeries. RYGB is recommended for patients with GERD due to the increased control of GERD symptoms. This study examines RYGB and SG use in this population and factors influencing procedure choice. This study analyzed 2016-2022 data from the MBSAQIP database comprising patients with GERD who underwent SG or RYGB. Statistical analysis included univariate and multivariable logistic regression to identify factors associated with procedure receipt. RYGB rates are rising annually but remain lower than SG for GERD. Compared to White individuals, Hispanics are 14% less likely, and African Americans are 19% less likely, to receive RYGB. The study notes a research gap in choosing RYGB or SG for patients with GERD, despite consensus favoring RYGB. It highlights a disparity between recommendations and practice, with GERD predicting the use of RYGB but SG being more prevalent in this population overall. The analysis links race to procedure choice, showing African American and Hispanic patients are less likely to undergo RYGB, indicating potential disparities in access and decision-making.

Management of GERD Adherence to Mediterranean-Like Dietary Pattern in Association with Gastroesophageal Reflux Disease in Adolescents

Background: Gastroesophageal reflux disease (GERD) is a common esophageal disorder affecting adolescents. Recent studies have indicated that the risk of GERD may be influenced by different dietary patterns. This study aimed to examine the relationship between an adherence to Mediterranean-like dietary pattern and GERD in a large group of adolescents from central Iran. Methods: This cross-sectional study involved 5141 adolescents aged 13-14 years. Dietary intake was assessed using a food frequency method which included in a reliable and valid Global Asthma Network (GAN) core questionnaire. GERD symp­toms and the frequency of their occurrence over the last week were assessed using a validated GERD questionnaire. A binary logistic regression was used to evaluate the relationship between adherence to Mediterranean-like dietary pattern and GERD and its related symptoms. Results: The results showed that after controlling for potential confounding variables including age, sex, watching TV and computer, and BMI, the adolescents in the highest adherence to the Mediterranean style diet (MedDiet) score had lower odds of GERD [odds ratio (OR)=0.53; 95% CI 0.35-0.80, Ptrend=0.005)], sense of reflux (OR=0.45; 95% CI 0.26-0.77, Ptrend=0.01) and poor sleep (OR=0.54; 95% CI 0.31-0.96, Ptrend=0.02) compared with those in the lowest adherence. No significant association found between MedDiet and other GERD symptoms. Conclusions: This study found a negative relationship between following a MedDiet and having GERD among Iranian adolescents. Following the MedDiet may be a useful strategy to prevent GERD in adolescents.

Phenotypical Characterization of Gastroenterological and Metabolic Manifestations in Patients With Williams-Beuren Syndrome.

Gastrointestinal (GI) symptoms are common in patients with Williams-Beuren syndrome (WBS), but their prevalence and possible causes are not yet fully known. This study assessed GI symptoms' prevalence and their possible origin by performing a predefined set of tests in adult WBS patients. Laboratory tests and a questionnaire were administered to assess GI symptoms and dietary habits. All the patients underwent the urea breath test, H2-lactose and H2-glucose breath tests, and intestinal ultrasound (IUS) and vibration-controlled transient elastography for liver stiffness measurement (LSM) and controlled attenuation parameter (CAP, dB/m). Thirty-one patients were enrolled (72% of the whole cohort, 17 males, median age 32 years). Gastroesophageal reflux disease (GERD) symptoms were reported in 29% of the patients, abdominal pain in 26%, and altered bowel habits in 48%. Pathologic signs at (IUS) were present in 60% of the cases. Prevalence was 0.26 (95% CI 0.12-0.44) for Helicobacter pylori infection and 0.61 (95% CI 0.42-0.78) for lactose intolerance. LSM was > 6 kPa (in the range of a fibrosis score > F1) in three patients, and CAP values were > 268 dB/m (corresponding to a steatosis score > S2, e.g., moderate steatosis) in nine. The presence of altered bowel habits was significantly related to chronic abdominal pain (OR 13.1, p = 0.03). Increased BMI (> 28 kg/m2) (OR 10.8, p = 0.04) was associated with the presence of moderate-severe hepatic steatosis. After specific treatment and dietary counseling, most patients reported resolution/improvement of symptoms, whereas a few retained/developed symptoms during follow-up. Chronic abdominal pain, GERD symptoms, and unbalanced metabolic parameters were common in our WBS patients, together with an increased prevalence of lactose intolerance/colonic diverticula. Specific counseling and treatment improved symptoms for most patients.

Efficacy and Safety of Dual Delayed-Release Formulation of Esomeprazole in Patients with Gastroesophageal Reflux Disease: A Multicenter, Prospective, Observational Study

Gastroesophageal reflux disease (GERD) is a chronic and recurrent condition requiring constant dietary management and medication. This study evaluated the efficacy and safety of HIP1601, a dual delayed-release formulation of esomeprazole, in patients with GERD in a clinical setting. This prospective, multicenter, observational study was conducted at 309 medical institutions in Korea between June 2021 and March 2023. HIP1601 was administered at daily doses of 40 mg or 20 mg to 5,407 patients requiring treatment or prevention of erosive esophagitis. The primary outcome was the improvement rate of GERD symptoms at four weeks. GERD-related symptoms and treatment-emergent adverse events were also analyzed. This study included 5,282 patients in the safety analysis set and 5,232 in the full analysis set. At four weeks, the improvement rate of GERD symptoms was 92.1% (95% confidence interval [CI]: 91.3-92.8%). By eight weeks, the improvement rate increased to 94.6% (95% CI: 94.0-95.3%). After HIP1601 administration, the severity scores for all four GERD symptoms decreased to less than 1, with statistically significant changes in the scores (p<0.001). HIP1601 was well-tolerated, with minimal adverse events reported (0.17%), and the treatment-emergent adverse events were mild to moderate in severity. HIP1601 showed strong efficacy and safety in managing GERD symptoms, with high rates of symptom relief at four and eight weeks. Its extended action and improved symptom control make it a promising therapeutic option for GERD patients.

Effects of the Transcutaneous Electrical Stimulation System on Heartburn, Regurgitation and Esophageal Acid Exposure in GERD Patients-An Uncontrolled Feasibility Study.

Proton pump inhibitors (PPI) for gastroesophageal reflux disease (GERD) are associated with a high failure rate. Our uncontrolled feasibility study aimed determining the effect of a transcutaneous electrical stimulation system (TESS) on GERD symptoms and acid exposure time (AET). Recruited patients with heartburn and regurgitation. During the first phase (one-week, run-in period, off-PPI's), patients completed symptom diaries and demographic questionnaires. Thereafter, all patients underwent gastroscopy with subsequent placement of a wireless esophageal pH capsule, off-PPI. Based on pH analysis in the first 24 h, only those with increased AET (percent total time pH < 4 above 6%) continued to the next phase. During that phase, patients were treated for up to 3 weeks with TESS and documented their symptoms. The Primary endpoint was the magnitude of reduction in GERD-related symptoms. The secondary endpoints were the magnitude of reduction of AET and DeMeester score, as compared with their baseline values. Included 31 patients and of those, 26 patients (42% females, aged 49 ± 15 years, mean BMI 25 ± 3 kg/m2) completed the first two phases of the study. At baseline, mean number of daily heartburn and regurgitation episodes was 2.55 ± 1.79 and 1.40 ± 1.73, respectively. Following TESS, mean number of daily heartburn and regurgitation episodes dropped to 0.77 ± 0.75 and 0.36 ± 0.8, respectively (p < 0.001). At base line, mean AET and DeMeester score were 12.4 ± 5.6 and 32.1 ± 12.7, respectively. Following TESS mean AET dropped to 6.0 ± 3.5 and DeMeester score dropped to 16.2 ± 8.2 (p < 0.001). TESS is effective in reducing both symptoms and esophageal AET in GERD patients.

Poliprotect®, a Medical Device Made of Substances, Potently Protects the Human Esophageal Mucosa Challenged by Multiple Agents: Evidence from In Vitro and Ex Vivo Electrophysiological Models.

The integrity of esophageal epithelial cells in patients with gastroesophageal reflux disease (GERD) or GERD-like symptoms is the first mechanism of protection to decrease the sensitivity to gastric reflux and heartburn symptoms. We investigated the protective effects of Poliprotect® (PPRO), a CE-marked medical device, on esophageal epithelial integrity using in vitro and ex vivo models. In vitro, the protective effects of PPRO were tested on Caco-2 cells. PPRO demonstrated safety and protection against oxidative damage induced by hydrogen peroxide. It also preserved epithelial integrity by maintaining transepithelial electrical resistance (TEER) against damage from calcium removal or bile acid exposure (taurodeoxycholic acid, TDCA). Ex vivo, esophageal biopsies from patients subjected to endoscopy were mounted in Ussing chambers and exposed to damaging agents (HCl or HCl + TDCA). Untreated biopsies (control) showed significant loss of epithelial resistance (up to -33%). In contrast, low concentrations of PPRO (50-100 µg/mL) provided strong protection against these damages (p < 0.001), even after 60 min of washing. Histological analysis confirmed the barrier-enhancing effect of PPRO. Overall, PPRO effectively protected the esophageal epithelium from damage in both models, suggesting its potential role in alleviating GERD or GERD-like symptoms by strengthening mucosal barriers and reducing epithelial sensitivity to reflux.

Posterior Peroral Endoscopic Myotomy With Versus Without Sparing of the Oblique/Sling Fibers: A Meta-analysis.

Several studies have hypothesized that sparing the oblique/sling fibers during posterior peroral endoscopic myotomy (POEM) may reduce the incidence of gastroesophageal reflux disease (GERD) and reflux esophagitis without compromising the established safety and efficacy of the procedure. This study compares perioperative, postoperative motility-related, and postoperative GERD-related outcomes between posterior oblique/sling fibers-sparing POEM (OFS-POEM) and conventional posterior POEM through a pairwise meta-analysis of comparative studies. We conducted a systematic literature review following PRISMA guidelines to identify articles directly comparing posterior OFS-POEM with conventional posterior POEM. A pairwise meta-analysis was performed using a random-effects model. Effect sizes were calculated as odds ratios for dichotomous data and mean differences for continuous data. No significant differences were observed in perioperative outcomes, including mean gastric myotomy length, mean operative time, and incidence of adverse events. Similarly, no significant differences were noted in postoperative motility-related outcomes, such as mean Eckardt score and mean integrated relaxation pressure. However, a statistically significant reduction in the incidence of symptomatic GERD was observed in favor of OFS-POEM, with a number needed to treat (NNT) of 10 (95% CI: 6-49). Interestingly, no significant differences were found in the incidence of objectively diagnosed postoperative GERD, such as the number of patients with DeMeester scores >14 or the incidence of reflux esophagitis. This study suggests that OFS-POEM may reduce the incidence of symptomatic GERD following POEM, without affecting the incidence of GERD diagnosed by pH studies (DeMeester score >14) or by endoscopy (reflux esophagitis). Future studies with larger sample sizes are needed to further investigate the impact of OFS-POEM on GERD incidence as determined by pH studies and endoscopic findings. Given the limitations of this study, no definitive conclusions can be drawn. Multicenter randomized controlled trials with larger sample sizes are required to reach more reliable conclusions. Furthermore, stratifying data according to the type and class of achalasia would provide valuable information on whether there are differences in outcomes among the various types and classes of achalasia.

Koala Sleeve: innovative technique for enhanced GERD control without sacrificing weight loss.

Sleeve gastrectomy (SG) is the most frequently performed bariatric surgery worldwide, offering effective weight loss and improvement in metabolic conditions. However, one of its major complications is the exacerbation or development of gastroesophageal reflux disease (GERD), affecting over 30% of patients. While Roux-en-Y gastric bypass (RYGB) is often the preferred alternative for patients with pre-existing GERD, it may not be suitable for all patients due to contraindications or patient preference. This study introduces a novel modification to SG, combining it with horizontal gastroplasty to address GERD symptoms without compromising weight loss outcomes. The procedure involves a standard SG with complete fundus resection, followed by the creation of a horizontal valve at the gastroesophageal (GE) junction using three horizontal mattress sutures. Seven patients with preoperative GERD were selected for this technique. Post-operative outcomes were assessed, including weight loss and GERD symptom resolution. The mean operative time was 76 min, with no procedure-related complications. Three months postoperatively, the average percentage of excess weight loss (%EWL) was 68%. Importantly, none of the patients reported GERD symptoms, indicating effective reflux control. Sleeve gastrectomy with horizontal gastroplasty appears to be a promising, simple, and safe option for patients with GERD undergoing SG. This technique may offer a viable alternative to RYGB for managing GERD in bariatric patients. Further studies are needed to validate these initial findings and assess long-term outcomes.

Short-Term Outcomes of Laparoscopic Sleeve Gastrectomy for Weight Loss and Gastroesophageal Reflux Disease.

Background and objective Laparoscopic sleeve gastrectomy (LSG), a novel bariatric technique, reduces stomach capacity to promote weight loss. It is increasingly preferred due to its lower risk and improved outcomes, particularly for obesity-associated hypertension and diabetes. LSG has also demonstrated effective weight loss. This study aimed to evaluate the short-term outcomes of LSG for treating obesity and gastroesophageal reflux disease (GERD). Methodology A prospective cohort study was conducted at Lady Reading Hospital-Medical Teaching Institute (LRH-MTI), Peshawar, from March 2023 to February 2024. A total of 280 patients (aged 18-60 years) were selected using a consecutive sampling technique. Weight loss was assessed using the percentage of total body weight loss (%TBWL) and excess weight loss (%EWL). GERD symptoms were evaluated using the GerdQ score. Statistical analyses, including paired t-tests and Chi-squared tests, were performed using SPSS version 26 (IBM Inc., Armonk, New York), with significance set at p<0.05. Results LSG achieved a 100% success rate with no major complications, an average surgery duration of 45 minutes, and a mean hospital stay of 2.5 days. At the 12-month follow-up, significant reductions in hypertension (p=0.032) and diabetes (p<0.012) were observed. Substantial weight loss (p=0.001) and a decrease in comorbidities were noted, while GERD symptom improvement was not statistically significant (p=0.348). Conclusion LSG is a promising intervention for weight loss and obesity-related comorbidities. It significantly improves hypertension and diabetes, although its impact on GERD requires further research. Longer follow-ups and diverse populations are recommended for future studies.

Effectiveness of Abdominal Breathing Exercise to Control Gastroesophageal Reflux Disease, a Randomized Controlled Trial.

To determine the effect of actively training the crura of diaphragm which is a part of lower esophageal sphincter using abdominal breathing exercises to treat gastroesophageal reflux disease. With a randomized controlled study design, a total of 22 (11 in each group) clinically diagnosed patients of GERD presenting to the gastroenterology outpatient department at Holy Family Hospital in Pakistan were assessed using GERD related "quality of life index (QoLI)" questionnaire and their on-demand proton pump inhibitors (PPI) usage. Single blinding technique will be used. Patients ages 18-60 years with GERD were included. However, those with hiatal hernia > 2 cm, previous surgeries on LES and those with who could not undergo the breathing exercise training were excluded. The data was collected via interviews. The intervention group was trained to do a 5-min breathing exercise and advised to perform it 5 times a day for 4 continuous weeks. On demand PPI usage was self-recorded. The control group was also trained to perform a breathing exercise that had no effect on LES and was asked to self-record on demand PPI usage. After 4 weeks the data was collected from both groups and compared quality-of-life index and PPI usage. Data was retrieved and analyzed using SPSS version 22. Descriptive analysis was used for describing the study variables. Paired t-test was used for in group comparison before and after intervention and independent t test was used for between group comparison, p value of <0.05 was taken as significant. Mean PPI usage of the two groups was also compared. An improved QoLI and reduced PPI usage was seen in the intervention group as compared to control group. Paired t test confirmed a statistically significant difference, but the independent t test did not. Linear regression test showed that F (1,20) = 32.822, p = 0.000. Adjusted R value is 0.603. y = 13.182x +2.812. The beta value is 0.789 and p value is 0.000. The study concludes that abdominal breathing exercises can improve the GERD symptoms as assessed by QoLI score and on demand PPI usage. It advocates for an alternative treatment option for GERD patients that is more efficacious as compared to no breathing exercises and has less potential side effect as compared to continuous PPI use, enabling us to lead our way towards revolution in medicine providing more effective and less invasive treatment options to facilitate our patients.

Efficacy of the Bridge Dry Swallowing Exercise for Refractory Gastroesophageal Reflux Disease

Background Gastroesophageal reflux disease (GERD) is a condition characterized by reflux of gastric contents, leading to damage to the esophageal mucosa and/or unpleasant symptoms, with a global prevalence of 13%. Although acid-suppressive medications are currently the most effective treatments for GERD, they may be ineffective against its symptoms. We therefore investigated the efficacy of a physical exercise program for the treatment of intractable GERD symptoms. Methods Fifteen participants who underwent upper gastrointestinal endoscopy were included in this study. They received acid-suppressive drugs for more than eight weeks and had a score of ≥8 on the Frequency Scale for the Symptoms of GERD (FSSG). Participants were instructed to perform a 2-week interventional exercise program comprising drinking saliva 10 times in the bridge position (bridge dry swallowing exercise). This involved swallowing saliva without any food or drink while the hip was raised in the supine position. Changes in the FSSG scores after exercise were examined (UMIN000047829). Results Among the 15 participants, 7 were men, with a median age of 59 years old. Each participant had mild reflux esophagitis or no mucosal injuries. All participants completed the exercise program safely. Of the 15 participants, 13 demonstrated an improvement in the FSSG score after the intervention. The total FSSG score improved significantly from a median of 17 to 11 (p <0.001). Five participants discontinued acid-suppressive drugs after the intervention ended. Conclusions Bridge dry swallowing exercises can improve the intractable symptoms of GERD. However, further studies are required to verify its efficacy and safety.

Akram’s lifestyle: An effective remedy for the management of gastroesophageal reflux disease

Abstract: INTRODUCTION: The prevalence of gastroesophageal reflux disease (GERD) has generally increased worldwide. Irregular pattern of intake of meals are known to be the most prevalent cause of GERD. The intake of food on top of another meal may cause gastroesophageal reflux either by generating transient lower-esophageal sphincter relaxations (TLESRs) subsequent to distention of the upper part of the stomach or/and delayed gastric emptying due to inhibition of migrating motor complexes (MMCs) in the distal part of the stomach. Present study evaluated the effect of authors suggested regimen “Akram’s lifestyle”, taking meals twice-a-day with the liberty to consume only liquids in the intervening periods on the outcome of patients presenting with mild to moderate GERD. MATERIALS AND METHODS: Study included 60 patients with symptoms of GERD who agreed to follow “Akram’s lifestyle”, took two meals a day about 10-12 hours apart, consuming liquids in between meals for a period of two weeks. Typical GERD symptoms of heartburn, acid reflux, nausea, vomiting and dyspepsia as reported by the patients were scored on visual analog scale (VAS). Gastrointestinal and associated complaints were also evaluated by “Yes/No” response. Data obtained before and after two weeks of intervention was analyzed using SPSS version 28.0. RESULTS: Final data after 2 weeks were available for 45 patients. There was a highly significant improvement in GERD symptoms (heartburn, reflux, nausea, vomiting, and dyspepsia) within 2 weeks of dietary intervention (P &lt; 0.000). Improvement was also reflected in the significant reduction (&gt;69%) in the gastrointestinal complaints as evaluated by “Yes/No” responses after the dietary intervention. CONCLUSIONS: Adherence to “Akram’s lifestyle” for GERD for 2 weeks resulted in a significant improvement or complete relief of symptoms of patients with GERD. Reduced gastric acid secretion, TLESRs and enhanced gastric emptying could be the potential contributing factors in causing this improvement. Further investigations with larger samples are needed to confirm the findings.

Clinical and functional factors influencing the outcome of laparoscopic Nissen fundoplication.

Laparoscopic Nissen fundoplication (LNF) is the gold standard of antireflux surgery. Up to 30% of patients experience symptoms after surgery, with insufficient information available. The main objective is to evaluate epidemiological, clinical, and functional factors associated with symptoms after LNP. a retrospective case-control study including 79 operated patients (2015-2024). We assessed the relationship between epidemiological data, functional tests, and imaging study results with the occurrence of symptoms after LNF. 24 asymptomatic and 55 symptomatic patients were included. Functional and imaging tests were normal in the majority of asymptomatic patients. IRP-4s (95th percentile) in asymptomatic patients is 20.4 mmHg. Female gender (OR 4, 95%CI; 1.1-14), preoperative dysphagia (OR 8.2, 95%CI: 1.4-47.6), and IRP-4s (OR 1.2, 95%CI: 1-1.3) are independent factors for postoperative dysphagia. Type-III esophagogastric junction morphology on high-resolution manometry (OR 6.1, 95%CI: 2.1-18.1) is independently associated with GERD symptoms. AET showed a trend toward being an independent factor but did not reach statistical significance (OR 1.1, 95%CI:1-1.3). Hiatal hernia in the esophagogram was associated with reintervention (OR 5.5, 95%CI: 1.6-19.1). Asymptomatic patients mostly have normal functional tests after LNF, although IRP-4s normal value (95th percentile) is higher than proposed in the Chicago Classification. Preoperative dysphagia and female gender are independent factors for postoperative dysphagia, which should be considered in the preoperative assessment. Functional and imaging tests are essential in evaluating patients with postoperative symptoms. Dysphagia is associated with higher IRP while GERD symptoms are related to type-III-EGJ on HRM. Similarly, a hiatal hernia on the esophagogram is associated with reintervention.

The Impact of Circadian Preferences on Quality of Life in Patients With Gastroesophageal Reflux Disease: An Evaluation Using the SF-36.

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that negatively impacts individuals' quality of life. This study investigates the effect of circadian preferences on the quality of life in patients with GERD. A total of 152 participants (80 patients diagnosed with GERD and 72 healthy controls) were included in the study. Participants' circadian preferences were assessed using the morningness-eveningness questionnaire (MEQ), quality of life was evaluated with the SF-36 scale, and the severity of GERD symptoms was measured using the gastroesophageal reflux disease quality of life scale (GERD-QOL). The study's findings indicate that the quality of life and circadian preferences of GERD patients differ significantly from those of the control group. Correlation analyses revealed a positive relationship between SF-36 and MEQ, but no direct relationship was found between GERD-QOL and SF-36 or MEQ. Mediation analyses demonstrated that the effect of GERD-QOL on SF-36 is entirely mediated by circadian preferences. These results highlight the significant impact of circadian preferences on the quality of life in GERD patients, suggesting that individuals with an evening chronotype may have lower quality of life. Our study contributes to the literature as one of the first to suggest that circadian preferences should be considered in the management of GERD.

COMPARATIVE EFFICACY OF PROTON PUMP INHIBITORS VS. H2 RECEPTOR ANTAGONISTS IN THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE

Gastroesophageal reflux disease (GERD) is a common condition characterized by acid reflux into the esophagus, leading to symptoms such as heartburn and regurgitation. Objective: To compare the efficacy of Proton Pump Inhibitors (PPIs) and H2 Receptor Antagonists (H2RAs) in treating GERD in a cohort of 800 patients, assessing symptom relief, healing rates, and side effects. Methods: A total of 800 patients diagnosed with GERD were added to receive either PPIs (n=400) or H2RAs (n=400) for a treatment period of 8 weeks. The primary outcome was improved GERD symptoms, measured using a standardized GERD symptom questionnaire. Results: The study found that the PPI group demonstrated a significantly higher improvement in symptom relief, with 78% achieving complete symptom resolution compared to 54% in the H2RA group (p &lt; 0.05). Esophageal healing rates were also superior in the PPI group, with 84% showing complete healing compared to 62% in the H2RA group. Furthermore, the time to symptom relief was shorter in the PPI group (average of 5 days) compared to the H2RA group (8 days). Adverse effects were minimal and comparable between the two groups, with mild headaches (8% vs. 6%) and gastrointestinal discomfort (10% vs. 9%) being the most frequently reported. Conclusion: Proton Pump Inhibitors are more effective than H2 Receptor Antagonists in relieving symptoms, accelerating symptom resolution, and promoting esophageal healing in patients with GERD. Although both treatments are generally well-tolerated, PPIs remain the preferred choice for patients requiring more potent acid suppression due to their superior efficacy.

Gastrointestinal Efficacy of Omeprazole in Patients with Gastroesophageal Reflux Disease

Introduction: Gastroesophageal Reflux Disease (GERD) poses a significant global health burden, necessitating effective treatment strategies. Proton pump inhibitors, particularly omeprazole, are commonly prescribed for GERD management. However, comprehensive investigations into the gastrointestinal efficacy of omeprazole, considering symptom duration, frequency, severity, and quality of life improvements, are warranted. Methodology: This randomized controlled trial aimed to systematically investigate the gastrointestinal efficacy of omeprazole in individuals diagnosed with GERD. Following CONSORT guidelines, the study enrolled 180 adult participants to evaluate how omeprazole influenced the duration, frequency, and severity of symptoms, along with its impact on health-related quality of life. Adults aged 25 to 65 with GERD were randomly assigned to either the omeprazole intervention or control group. The intervention group received a standardized daily dose of 20 mg oral omeprazole over a four-week period. Baseline characteristics, including age, gender, BMI, smoking status, comorbidities, and dietary habits, were thoroughly examined. Continuous monitoring of daily vital signs and adverse events was implemented to ensure safety and tolerability. Results: The study revealed a significantly shorter mean duration of GERD symptoms in the omeprazole group (5.2 ± 1.3 days) compared to the control group (7.8 ± 1.5 days), emphasizing the rapid relief provided by omeprazole (p &lt; 0.001). Efficacy analysis demonstrated a remarkable reduction in symptom frequency (92% vs. 65%, p &lt; 0.001) and severity (p &lt; 0.001) in the omeprazole group. Health-related quality of life significantly improved in the omeprazole group, as reflected in the GERD-QOL scores (p &lt; 0.001). Conclusion: This trial provides robust evidence supporting the gastrointestinal efficacy of omeprazole in managing GERD symptoms. The rapid relief, significant reductions in symptom frequency and severity, and improvement in health-related quality of life underscore the clinical relevance of omeprazole. The study contributes valuable insights to GERD management and informs future research directions.

Effect of GERD on response to asthma treatment: A literature review

Asthma and Gastroesophageal Reflux Disease (GERD) are two conditions that are often found together, with the prevalence of GERD in asthma patients being higher than in the general population. The pathophysiological relationship between these two conditions is complex and influences each other. GERD can worsen asthma symptoms, increase the frequency of exacerbations, and reduce the effectiveness of asthma treatment. On the other hand, asthma can also worsen GERD symptoms through the mechanism of increased intra-abdominal pressure and the side effects of certain asthma medications. This literature explores pathophysiological mechanisms, the influence of GERD on asthma treatment, and management strategies that can improve asthma control. However, further research is needed to clarify the mechanism of the relationship between these two conditions and optimize treatment strategies.

The Mucosal Protection in the Treatment of Erosive Reflux Esophagitis: Mechanisms for Restoring Epithelial Permeability. A Randomized Clinical Trial.

Gastroesophageal reflux disease (GERD) is widespread in the population and is characterized by the risk of developing Barrett's esophagus and associated adenocarcinoma. Key factors in the progression of the disease are not only the frequency and duration of reflux episodes, but also the resistance of the esophageal mucosa to aggressive reflux molecules. Assessment of the state of tight junction proteins, the rate of their recovery under the influence of various treatment regimens is an urgent task for choosing optimal approaches to curing patients with GERD. The purpose of the study was to evaluate the efficacy and safety of the combination therapy with a proton pump inhibitor (PPI) and a topical mucosal protective agent (MPA) to relieve GERD symptoms and achieve a complete remission of reflux esophagitis faster. 60 patients (38 men and 22 women with an average age 41.5 years) with GERD duration of 5 years, took part in an open randomized prospective clinical study. Participants were randomized in a 1:1 ratio to be divided into the main group taking MPA and PPI and a comparison group taking a PPI only. The duration of therapy was 4 weeks. Before the treatment onset and after the end of treatment, the occurrence and severity of GERD symptoms were assessed, an endoscopic examination was performed and biopsy specimens were taken from the edge of the erosive area and the area of unchanged esophageal mucosa. The severity of histological signs of esophagitis, the expression of tight junction proteins and the proliferation marker Ki-67 were assessed. A more effective relief of GERD symptoms was documented when using combination therapy PPIs and MPAs. A more pronounced reduction in macroscopic changes was found in patients with erosive esophagitis taking PPIs and MPAs. The use of MPAs in addition to PPIs made it possible to achieve the primary and secondary endpoints more often, which suggested a high efficiency of the drug in combination with PPIs in the treatment of erosive esophagitis. An individualized approach based on the combination therapy of PPIs and MPAs can improve the effectiveness of treatment in achieving clinical, endoscopic and, more importantly, histological remission in a patient with erosive GERD.

Antral Preserving Versus Antral Resecting Laparoscopic Sleeve Gastrectomy for Patients with Severe Obesity: A Randomized Controlled Trial.

This study aimed to compare outcomes following antral preserving (AP) and antral resecting (AR) laparoscopic sleeve gastrectomy (LSG) in terms of weight loss, gastric emptying time, gastroesophageal reflux disease (GERD), resolution of associated medical problems, and complications. Patients were prospectively randomized into two groups: the AR group (resection starting 2cm from the pylorus) and the AP group (resection at 5cm from the pylorus). Follow-up evaluations included assessments of weight loss using percentage of excess weight loss (%EWL) and percentage of total weight loss (%TWL), gastric emptying, GERD symptoms, associated medical problem resolution, residual gastric volume, and complications. Upper gastrointestinal endoscopy, gastric scintigraphy, and residual sleeve volumetry were conducted at 12months. One hundred patients who met inclusion criteria were enrolled, with comparable baseline parameters such as BMI, age, and comorbidities between the groups. Ninety-five patients underwent randomization (49 in AP group and 46 in the AR group), and outcomes were compared. %EWL was higher in the AR group at 12 and 24months, although this difference was not statistically significant (AP vs. AR: 64.5 ± 20.6 vs. 72.9 ± 20.8, p = 0.1, and 66.3 ± 21.8 vs. 74 ± 22.2, p = 0.2, respectively). %TWL at 12months was significantly different between the groups (AP: 28.4 ± 6.4 vs. AR: 32 ± 8, p = 0.01), as was %TWL at 24months (AP: 29.1 ± 8.4 vs. AR: 33 ± 8.3, p = 0.01). Gastric emptying increased postoperatively in both groups, with significantly higher residual gastric volume in the AP group. Reflux symptoms decreased in both groups compared to baseline, and associated medical problem resolution and major complication rates were similar between the groups. AR-LSG leads to better weight loss without increasing reflux symptoms compared to AP-LSG. Both procedures showed similar resolution of associated medical problems and complication rates. CTRI (CTRI/2018/08/015191).

COMPARATIVE EFFECTS OF DIAPHRAGMATIC MYOFASCIAL RELEASE VERSUS DIAPHRAGMATIC BREATHING IN POST-OPERATIVE PATIENTS DIAGNOSED WITH GASTRO ESOPHAGEAL REFLUX DISEASE (GERD)

Background: GERD is a short form of “Gastro esophageal Reflux Disease”. It is a condition characterized by backflow of food particles from stomach to food pipe and associated symptoms. Objective: To determine the comparative effects of Diaphragmatic breathing exercises and diaphragm atic myofascial release in post-operative patients diagnosed with GERD. Methodology: We distributed participants through clinical trial. Postoperative patients diagnosed with GERD were studied. Sample size was 28. Patients were allocated to two treatment groups A and B by lottery method. Group A was treated with diaphragmatic myofascial release and Group B was treated with diaphragmatic breathing exercise. Reflux disease questionnaire (RDQ) was used as primary outcome measure for GERD. The secondary outcome measure was gastrointestinal symptom rating scale (GSRS) Result: A cross group analysis revealed that there was statistical significant difference in post treatment values of GSRS and RDQ, with p values of 0.001and 0.001 respectively. Conclusion: Diaphragmatic myofascial release is more effective than diaphragmatic breathing exercises in reducing the severity of GERD symptoms and improving quality of life in postoperative patients diagnosed with GERD.