scholarly journals An Unexpected Gastric Subepithelial Mass

2021 ◽  
Vol 36 (2) ◽  
pp. e252-e252
Author(s):  
Maddalena Zippi ◽  
Sirio Fiorino ◽  
Innocenzo Bertoldi ◽  
Wandong Hong ◽  
Giuseppe Occhigross
Keyword(s):  
Family History ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Clinical Examination ◽  
Reflux Disease ◽  
Digestive System ◽  
Epigastric Pain ◽  
Pharmacological Therapy ◽  
Postprandial Fullness

A63-year-old man came to our observation complaining of symptoms referable to gastroesophageal reflux disease. No epigastric pain, postprandial fullness, or vomiting were present during clinical examination. His history did not show noteworthy pathologies. The patient did not follow any pharmacological therapy, and there was no family history for neoplasia of the digestive system.

scholarly journals Differentiated approach to the examining children with chest pain

2021 ◽  
Vol 24 (1) ◽  
pp. 20-26
Author(s):  
Nataliya A. Berezneva ◽  
Olga I. Stenina ◽  
Andrey K. Uglitskikh
Keyword(s):  
Chest Pain ◽  
Gastrointestinal Tract ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Clinical Significance ◽  
Clinical Examination ◽  
Reflux Disease ◽  
Pain Syndrome ◽  
Clinical Analysis ◽  
Cardiac Pathology

The aim of this work is to determine the causes of chest pain in children with combined pathology and to develop an examination algorithm for chest pain. Materials and methods. Examined 20 children aged 7-18 years who consulted a pediatrician with pain complaints in the chest. To exclude the cardiac genesis of pain, all patients underwent electrocardiography and echocardiography; the rest of the examinations were prescribed, taking into account the anamnesis and clinical examination data. Results. According to the examination results, most patients were found to have gastrointestinal tract pathology: gastroesophageal reflux disease, chronic gastritis, biliary tract dysfunction. Against the background of adherence to a diet and taking medications prescribed by a gastroenterologist, their pain syndrome subsided, which confirmed the noncardial genesis of thoracalgia. A clinical analysis of cases of combined (cardiac and non-cardiac) pathology was carried out, an algorithm for examining children with chest pain was presented. Discussion. The causes of chest pain in children and the tactics of managing these patients are discussed, the clinical significance of the history and clinical examination data in drawing up a plan for the examination of such patients is determined.

scholarly journals Clinical Presentation of Gastroesophageal Reflux Disease: A Prospective Study on Symptom Diversity and Modification of Questionnaire Application

2019 ◽  
Vol 38 (3) ◽  
pp. 188-195 ◽  
Author(s):  
Ryan Broderick ◽  
Karl-Hermann Fuchs ◽  
Wolfram Breithaupt ◽  
Gabor Varga ◽  
Thomas Schulz ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Respiratory Symptoms ◽  
Epigastric Pain ◽  
Free Form ◽  
Thoracic Pain ◽  
Functional Studies ◽  
Symptom Profile ◽  
A Prospective Study

Introduction: Symptoms occurring in gastroesophageal reflux disease (GERD) such as heartburn, regurgitation, thoracic pain, epigastric pain, respiratory symptoms, and others can show a broad overlap with symptoms from other foregut disorders. The goal of this study is the accurate assessment of symptom presentation in GERD. Methods: Patients with foregut symptoms were investigated for symptoms as well as endoscopy and gastrointestinal-functional studies for presence of GERD and symptom evaluation by standardized questionnaire. Questionnaire included a graded evaluation of foregut symptoms documenting severity and frequency of each symptom. The three types of questionnaires include study nurse solicitated, self-reported, and free-form self-reported by the patient. Results: For this analysis, 1,031 GERD patients (572 males and 459 females) were enrolled. Heartburn was the most frequently reported chief complaint, seen in 61% of patients. Heartburn and regurgitation are the most common (82.4/58.8%, respectively) in overall symptom prevalence. With regard to modification in questionnaire technique, if patients fill in responses without prompting, there is a trend toward more frequent documentation of respiratory symptoms (up to 54.5% [p < 0.01]), fullness (up to 93.9%), and gas-related symptoms (p < 0.001). Self-reported symptoms are more diverse (e.g., throat-burning [12%], mouth-burning [9%], globus [6%], dyspnea [9%], and fatigue [7%]). Conclusions: GERD symptoms are commonly heartburn and regurgitation, but overall symptom profile for patients may change depending on the type of questionnaire.

scholarly journals Refractory gastroesophageal reflux disease

2012 ◽  
Vol 49 (4) ◽  
pp. 296-301 ◽  
Author(s):  
Joaquim Prado P. Moraes-Filho
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Reflux Disease ◽  
Skin Diseases ◽  
Pharmacological Therapy ◽  
Genotypic Differences ◽  
Esophageal Mucosa ◽  
Refractory Gerd

CONTEXT: Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Its pathophysiology, diagnosis and treatment have frequently been analyzed but it is interesting to review some aspects of the GERD refractory patients to the proton pump inhibitors treatment. The treatment encompasses behavioral measures and pharmacological therapy. The majority of the patients respond well to proton pump inhibitors treatment but 20%-42% of them may not do so well. Patients who are unresponsible to 4-8 weeks' treatment with proton pump inhibitors (omeprazole, pantoprazole, rabeprazole, lansoprazole, esomeprazole, pantoprazole-Mg) might have so-called refractory GERD. RESULTS: In some cases the patients are not real refractory because either they do not have GERD or the disease was not correctly treated, but the term refractory is still employed. Although debatable, the Brazilian GERD Consensus based upon evidences recommends as first step in the diagnosis, the upper digestive endoscopy to exclude the diagnosis of peptic ulcer and cancer and in some cases identify the presence of esophageal mucosa erosions. CONCLUSIONS: The main causes of the so-called refractory GERD are: (1) functional heartburn; (2) low levels of adherence to proton pump inhibitors treatment; (3) inadequate proton pump inhibitors dosage; (4) wrong diagnosis; (5) co-morbidities and pill-induced esophagitis; (6) genotypic differences; (7) nonacid gastroesophageal reflux; (8) autoimmune skin diseases; (9) eosinophilic esophagitis.

scholarly journals Efficacy and Safety of Esomeprazole for the Treatment of Reflux Symptoms in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Mingxing HOU ◽  
Haiqing HU ◽  
Chunlu JIN ◽  
Xuemei YU
Keyword(s):  
Clinical Trials ◽  
Placebo Group ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Epigastric Pain ◽  
Meta Analysis ◽  
Clinical Signs ◽  
Control Group ◽  
Serious Adverse Events

Background: We investigated the efficacy of esomeprazole for the treatment of gastroesophageal reflux disease (GERD) in a meta-analysis of clinical trials results. Methods: Medline, Embase, PubMed and Web of Science databases were systematically searched for suitable studies, and double-blind, randomized controlled trials (RCTs) were involved. A meta-analysis of RCTs was performed to analyze the efficacy of esomeprazole on clinical outcomes that associated with the severity of GERD. Results: A total of 8 clinical trials were selected in our meta-analysis (N=4495, patients with GERD). Esomeprazole treatment yielded a significant improvement in clinical signs and symptoms of GERD compared to placebo group. Funnel plot and Egger test showed there was no significant bias in the publication. Cochrane collaboration tool and Jadad scale were used to indicate that all 8 RCTs were of high quality. The results of Galbraith radial plot showed that no study was the major source of heterogeneity. Esomeprazole treatment significantly decreased the relapse rates more than that of placebo group (RR = 0.729; 95% CI: 0.670 to 0.794; P<0.001). It seems to be lower rates of heartburn (RR = 0.747; 95%CI: 0.665-0.839; P <0.001) and epigastric pain (RR = 0.795; 95%CI: 0.679-0.932; P =0.005) in esomeprazole-treated group compared with the placebo group. Moreover, serious adverse events was less likely to happen after esomeprazole therapy (RR = 1.406, 95% CI: 1.030-1.918; P =0.032). Conclusion: Compared with the control group, esomeprazole is a promising therapeutic agent that improves the management of patients with GERD.

scholarly journals Significance of Extra-Esophageal Symptoms in Pediatric Gastroesophageal Reflux Disease

2020 ◽  
Vol 24 (04) ◽  
pp. e472-e476
Author(s):  
Andro Košec ◽  
Orjena Žaja ◽  
Filip Matovinović ◽  
Boris Jelavić ◽  
Tomislav Baudoin
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Pediatric Patients ◽  
Epigastric Pain ◽  
Ph Monitoring ◽  
Measurement Data ◽  
Gastrointestinal Symptoms ◽  
Risk Groups ◽  
Tertiary Referral Center

Abstract Introduction Current practice guidelines in gastroesophageal reflux disease (GERD) often require invasive diagnostic testing. Objective The aim of the present study was to evaluate the significance of extra-esophageal symptoms and reliability of a screening risk score that is simple to use. Methods A longitudinal retrospective single-institution cohort study. Setting: A university clinical hospital tertiary referral center. The present study enrolled pediatric patients with symptoms suggestive of GERD: epigastric pain, occasional nausea, regurgitation, tasting acid in the oral cavity, chronic cough, hoarseness of voice, frequent throat clearing. The patients underwent 24-hour esophageal pH monitoring and fiber-optic laryngoscopy. The correlations between the local findings, anamnestic and objective measurement data were analyzed. Results The present study evaluated 89 pediatric patients. Patients with asthma presented significantly more often with adjoining gastrointestinal symptoms (p = 0.0472). Patients that were obese were linked to a higher rate of reports of gastrointestinal symptoms (p = 0.0495). After the patients had been assigned to newly developed risk groups, obesity showed to be significantly more frequent in patients placed in higher risk groups (p < 0.0001) for a positive GERD diagnosis. Conclusion Patients with leading symptoms of asthma presented significantly more often with adjoining gastrointestinal symptoms. Obesity showed to be significantly more frequent in patients placed in higher risk groups for a positive GERD diagnosis.

scholarly journals Correlation of gastroesophageal reflux disease with positive family history and headache in Shiraz city, Southern Iran

2007 ◽  
Vol 13 (4) ◽  
pp. 176
Author(s):  
Mehdi Saberi-Firoozi ◽  
MohammadA Yazdanbakhsh ◽  
Seyed-Taghi Heidari ◽  
Farnaz Khademolhosseini ◽  
Davood Mehrabani
Keyword(s):  
Family History ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Positive Family History ◽  
Southern Iran

scholarly journals The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review

2021 ◽  
Vol 12 ◽  
pp. 215013272110467
Author(s):  
Paul T. Kröner ◽  
Pedro Cortés ◽  
Frank J. Lukens
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Adverse Events ◽  
Reflux Disease ◽  
Medical Management ◽  
Kidney Injury ◽  
Pharmacological Therapy ◽  
Cochrane Library ◽  
Pharmacologic Therapy ◽  
Lifestyle Modifications

Objective The medical management of gastroesophageal reflux disease (GERD) continues to evolve. Our aim was to systematically assess the literature to provide an updated review of the evidence on lifestyle modifications and pharmacological therapy for the management of GERD. Background The cornerstones of GERD medical management consist of lifestyle modifications and pharmacologic agents. Most recently, evidence has emerged linking anti-reflux pharmacologic therapy to adverse events, such as kidney injury, metabolic bone disease, myocardial infarction, and even dementia, among others. Methods A systematic search of the databases of PubMed/MEDLINE, Embase, and Cochrane Library was performed for articles on the medical management of GERD between inception and March 1, 2021. Conclusion Although pharmacological therapy has been associated with potential adverse events, further research is needed to determine if this association exists. For this reason, lifestyle modifications should be considered first-line, while pharmacologic therapy can be considered in patients in whom lifestyle modifications have proven to be ineffective in controlling their symptoms or cannot institute them. Naturally, extra-esophageal causes for GERD-like symptoms must be considered on suspected high-risk patients and excluded before considering treatment for GERD.

scholarly journals Association of hepatobiliary pathology and gastroesophageal reflux disease

2021 ◽  
Vol 5 (6) ◽  
pp. 404-412
Author(s):  
A.N. Kazyulin ◽  
◽  
A.Yu. Goncharenko ◽  
I.E. Kalyagin ◽  
◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Ursodeoxycholic Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Reflux Disease ◽  
Digestive System ◽  
Biliary Dyskinesia ◽  
Esophageal Mucosa ◽  
Duodenogastroesophageal Reflux

The problem of comorbidity with a high risk of polypragmasia is relevant in a large group of patients with diseases in the digestive system. Currently, the problem of comorbidity in patients with gastroesophageal reflux disease (GERD) attracts the attention of specialists due to the high disease prevalence and data indicating its association with other digestive system diseases, primarily of the hepatobiliary system. The article presents the results of clinical and experimental studies revealing the pathogenetic connections of GERD and hepatobiliary pathology accompanied by biliary dyskinesia, factors leading to an impairment of the duodenal propulsive activity. It is noted that the most important components of the esophageal mucosa lesion in duodenogastroesophageal reflux are bile acids, lysolecithin and pancreatic enzymes. The relevance of prescribing drugs that can affect the course of pathogenetically related diseases, which can significantly reduce the risk of polypragmasia, is justified. Such drugs include ursodeoxycholic acid, which, in the conditions of the GERD and hepatobiliary pathology association, contributes to the functional state normalization of the liver and biliary tract, reduces biliary dyskinesia, the severity of duodenal hypertension and duodenogastroesophageal reflux. The next example is the rebamipide cytoprotector, which has a multilateral protective effect against the mucous membrane of the GIT, including the esophagus, gastroduodenal zone, small intestine, as well as liver. The expediency of prescribing rebamipide to patients who are refractory to therapy with proton pump inhibitors is justified. KEYWORDS: comorbidity, hepatobiliary pathology, gastroesophageal reflux disease, ursodeoxycholic acid, rebamipid, proton pump inhibitors. FOR CITATION: Kazyulin A.N., Goncharenko A.Yu., Kalyagin I.E. Association of hepatobiliary pathology and gastroesophageal reflux disease. Russian Medical Inquiry. 2021;5(6):404–412 (in Russ.). DOI: 10.32364/2587-6821-2021-5-6-404-412.

Sign in / Sign up

Export Citation Format

Share Document