scholarly journals Endoscopic cardial constriction with band ligation in the treatment of refractory gastroesophageal reflux disease: a preliminary feasibility study

2021 ◽  
Author(s):  
Zhi-Tong Li ◽  
Feng Ji ◽  
Xin-Wei Han ◽  
Rui Zhang ◽  
Li-Dong Chen ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Symptom Relief ◽  
Final Analysis ◽  
Band Ligation ◽  
Post Surgery ◽  
Esophageal Ph ◽  
Symptom Scores ◽  
Invasive Method

Abstract Background Gastroesophageal reflux disease (GERD) is a common digestive disease, could cause extra-esophageal symptoms. Peroral endoscopic cardial constriction with band ligation (PECC-b) is a minimally invasive method for the treatment of GERD in recent years. The goals of this study were to evaluate the clinical efficacy of PECC-b to treat gastroesophageal reflux-related symptoms. Methods A retrospective study of patients undergoing PECC-b between January 2017 and December 2018 at a single institution was conducted. All patients confirmed GERD by endoscopy, esophageal PH-impedance monitoring, esophageal manometry and symptom questionnaires. The outcome measures included reflux-related scores, patients’ satisfaction and drug independence after 12 months following surgery. Results A total of 68 patients, with follow-up of 12 months post surgery, were included in the final analysis. The symptom scores were all significantly decreased as compared with preoperation (P < 0.05). The esophageal symptom scores showed a better improvement than extra-esophageal symptoms (P < 0.001). Fifty-three (77.9%) patients achieved complete drug therapy independence and 52 (76.5%) patients were completely or partially satisfied with the symptom relief following surgery. Conclusions The PECC-b is a safe, effective and recommended approach for the control of GERD-related symptoms. Further multicenter prospective studies are required to confirm these outcomes.

scholarly journals Food patterns in Russian patients with gastroesophageal reflux disease: the results of pilot comparative study

2020 ◽  
Vol 92 (8) ◽  
pp. 66-72
Author(s):  
V. S. Kropochev ◽  
S. V. Morozov ◽  
M. A. Lantseva ◽  
A. N. Sasunova ◽  
V. I. Pilipenko ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Healthy Eating ◽  
Reflux Disease ◽  
Final Analysis ◽  
Control Group ◽  
Esophageal Ph ◽  
Symptom Evaluation ◽  
Source Data ◽  
Acid Exposure Time

Aim. To evaluate nutritional patterns in patients with gastroesophageal reflux disease (GERD) compared to the control group without GERD. Materials and methods. The data of complex examination of patients referred to perform esophageal pH-impedance recording and who gave written informed consent to participate in the study served as a source data. All the participants underwent complex examination, including clinical data (presence of heartburn and acid regurgitation), symptom evaluation (GERD-Q questionnaire), esophagogastroscopy, esophageal pH-impedance recordings and food frequency questionnaire. Diagnosis of GERD was based on GERD-Q score 8, acid exposure time 6%, number of gastroesophageal refluxes 80/day by 24-hrs esophageal pH-impedance recordings. Nutritional patterns were assessed with the use of healthy eating pyramid principles. Results. Overall 165 patients were enrolled and the data of 150 of them (34 with confirmed GERD and 116 of the control group) were available for the final analysis. The patients of the both groups consumed lower compared to the recommended amounts of dairy and higher amounts of meat. Those with GERD consumed larger amounts of fruits (0.910.68 compared to the values of healthy eating pyramid vs 0.520.57 in the control group, p=0.001), and fats (0.690.55 vs 0.490.55, p=0.001). Compared to the controls, patients with GERD consumed lower amounts of vegetables (0.860.46 of the healthy eating pyramid vs 0.940.63 in the control group, р=0.004) and sugars confectionaries (0.380.39 vs 1.930.98, p=0.0001). Conclusion. Nutritional patterns of patients with gastroesophageal reflux disease significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

Medical Image Analysis Based on Endoscopic Radiofrequency Ablation Catheter System on the Treatment of Gastroesophageal Reflux Disease Related Extra-Esophageal Symptoms

2019 ◽  
Vol 9 (8) ◽  
pp. 1765-1769
Author(s):  
Wei-Tao Liang ◽  
Tao Li ◽  
Ji-Min Wu ◽  
Zhi-Wei Hu ◽  
Chao Yan ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Statistical Significance ◽  
Medical Image Analysis ◽  
Final Analysis ◽  
Symptom Scores ◽  
Endoscopic Radiofrequency Ablation

Objective: Gastroesophageal reflux disease is easily missed on X-ray or even computer tomography. This study was to evaluate the endoscopic imaging for the radiofrequency ablation (RA) on the diagnosis and management of gastroesophageal reflux disease related extra-esophageal symptoms. Methods: From January 2011, to January 2012, we allocated 51 patients to LTF and 47 to RA procedure. Primary outcome measures, including symptom scores of globus hysterics, chest pain, belching, hiccup, cough and asthma as well as proton pump inhibitors (PPIs) use, were analyzed after 5-year follow-up. Results: There were 90 patients following RA procedure (N = 40) or LTF (N = 50) that completed the designated 5-year follow-up and were included in the final analysis. At the end of 5-year follow-up, the symptom scores were all significantly decreased as compared with the corresponding values before the two procedures in both groups (p < 0.05). Moreover, the improvement in symptom scores between the two groups did not achieve statistical significance. After RA procedure and LTF, 18 (45%) and 32 (64%) patients in each group achieved complete PPIs therapy independence (p = 0.071). Comparing with LTF, however, the RA procedure had a higher risk of reoperation (17.5% vs. 0, p = 0.002). Conclusion: Comparing with LTF in controlling GERD-related extra-esophageal symptoms, RA procedure can offer equivalent relief on symptoms and PPIs independence. However, it has a higher risk of reoperation during the 5 years follow-up.

Medical Image Analysis Based on Endoscopic Radiofrequency Ablation Catheter System on the Treatment of Gastroesophageal Reflux Disease

2019 ◽  
Vol 9 (2) ◽  
pp. 395-399
Author(s):  
Wei-Tao Liang ◽  
Tao Li ◽  
Zhong-Gao Wang ◽  
Ji-Min Wu ◽  
Zhi-Wei Hu ◽  
...  
Keyword(s):  
Chest Pain ◽  
Radiofrequency Ablation ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Medical Image Analysis ◽  
Final Analysis ◽  
Ablation Procedure ◽  
Atypical Symptoms ◽  
Symptom Scores

Objective: Gastroesophagel reflux disease is not readily diagnosed using X-ray or even computer tomography. This study was to evaluate the endoscopic imaging for the radiofrequency ablation (RA) on the diagnosis and management of gastroesophageal reflux disease. Methods: We allocated 85 to mechanical RA and 80 patients to LTF. Primary outcome measures, including symptom scores of heartburn, regurgitation, chest pain, belching, hiccup, cough and asthma as well as proton pump inhibitors (PPIs) use, were analyzed. Results: There were 125 patients following mechanical radiofrequency ablation procedure (N = 60) or LTF (N = 65) included in the final analysis. The symptom scores were all significantly decreased as compared with the corresponding values before the two procedures in both groups (p < 0.05). After mechanical RA procedure and LTF, 30 (50%) and 45 (69.2%) patients in each group achieved complete PPIs therapy independence (p = 0.028). Comparing with LTF, the mechanical RA procedure had less effect on improving typical symptoms of heartburn and chest pain and the rate of reoperation (13% vs. 0, p = 0.003). Conclusions: Comparing with LTF in controlling GERD symptoms, the mechanical radiofrequency ablation procedure can offer equivalent relief on atypical symptoms. However, it has less effect on improving PPIs independence and avoiding reoperation.

scholarly journals Gastroesophageal Reflux and Wheezing in Pediatry pH-metry studies

2019 ◽  
Vol 70 (7) ◽  
pp. 2668-2670
Author(s):  
Alina Mihaela Elisei ◽  
Dana Tutunaru ◽  
Camelia Ana Grigore ◽  
Ciprian Adrian Dinu ◽  
Laura Florescu ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Pediatric Practice ◽  
First Semester ◽  
Esophageal Ph ◽  
Esophageal Sphincter ◽  
Specific Symptoms ◽  
Acidity Level ◽  
Ph Metry

Analysis of esophageal pH is useful and recommended by specialists when the gastroesophageal reflux disease does not show specific symptoms such as chest pain or burnings, but a form of asthma and chronic cough. The investigation is performed after a mild anesthesia, inserting a thin and flexible catheter in the patient�s nostril; it reaches the esophagus, particularly the esophageal sphincter that connects the stomach to the esophagus. The catheter has a sensor that monitors the acidity level, the number of reflux episodes, their duration and the part of the esophagus reached by the acid in the stomach. Gastroesophageal reflux disease is frequently met in pediatric practice, rooting in the intrauterine life, a physiologic phenomenon in infants during the first semester of life.

scholarly journals A novel endoscopic assessment of the gastroesophageal junction for the prediction of gastroesophageal reflux disease: a pilot study

2019 ◽  
Vol 07 (11) ◽  
pp. E1468-E1473 ◽  
Author(s):  
Haruhiro Inoue ◽  
Yusuke Fujiyoshi ◽  
Mary Raina Angeli Abad ◽  
Enrique Rodriguez de Santiago ◽  
Kazuya Sumi ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Gastroesophageal Junction ◽  
Optimal Cutoff ◽  
Esophageal Ph ◽  
Impedance Monitoring ◽  
Acid Exposure Time ◽  
Sensitivity Specificity ◽  
Endoscopic Assessment

Abstract Background and aim Hiatal hernia and lower esophageal sphincter (LES) dysfunction play major roles in gastroesophageal reflux disease (GERD) pathogenesis. We developed a novel endoscopic assessment to evaluate the gastroesophageal junction (GEJ). This study aims to evaluate the feasibility of this method for the diagnostic prediction of GERD. Methods A retrospective analysis of patients with GERD symptoms who underwent gastroscopy and esophageal pH-impedance monitoring was conducted. The novel assessment evaluated the following in retroflex view: 1) Cardiac Opening (CO): diameter of the opening of the cardia, 2) Sliding Hernia (SH): length from the diaphragmatic crus to the squamocolumnar junction, 3) Scope Holding Time% (SHT%): the percentage of time that the Scope Holding Sign (SHS) was observed out of 30 seconds. The SHS is defined as the lower esophagus holding the endoscope under excessive insufflation. The results of this assessment and that of pH-impedance monitoring were compared. Results In total, 61 patients (mean age ± SD, 54.1 ± 16.4 years, 32 males) were enrolled. CO and SH were significantly correlated with acid exposure time (AET) (ρ = 0.36, P = 0.005, and ρ = 0.36, P = 0.004). The optimal cutoff of CO for AET > 6 % was 3 cm (Sensitivity = 72.4 %, Specificity = 46.9 %, AUC = 0.64) and that of SH was 2 cm (Sensitivity = 55.2 %, Specificity = 75.0 %, AUC = 0.70). When the population was stratified according to this cutoff, patients with CO > 3 cm and those with SH > 2 cm presented higher AET (15.1 vs 4.1 %, P = 0.037, and 23.0 vs 3.6 %, P = 0.026). Optimal cutoff of SHT% for the number of all reflux episodes > 80 was 75 % (Sensitivity = 81.8 %, Specificity = 54.6%, AUC = 0.67). Patients with SHT% < 75 % presented a higher number of all reflux episodes (88 vs 65, P = 0.014). Sensitivity, specificity, and accuracy of SHT% < 75 % for all reflux episodes > 80 were 81.8 % (95 %CI: 67.7 – 91.8), 54.5% (95 %CI: 40.4 – 64.5), and 68.2 % (95 %CI: 54.0 – 78.1). Conclusion This novel endoscopic assessment of GEJ significantly predicted the presence of GERD and merits further testing in future studies.

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