Gastroesophageal Reflux Type and Number Correlate with Nutritional Patterns (P06-066-19)

Abstract Objectives The correlation of nutritional patterns with number and types of gastroesophageal refluxes is poorly studied yet. Aim: To assess the effect of actual nutrition of GERD patients on the number and type of gastroesophageal reflux detected with 24-hours esophageal pH-impedance. Methods One hundred twenty-four GERD patients (54 men, age (M ± m): 46 ± 17.7 y.o., BMI 28.5 ± 0.6 kg/m2) and 41 healthy controls (8 men, age 42 ± 12.4 y.o., BMI 28.3 ± 1.3 kg/m2) were examined with the use of language-specific food frequency questionnaire and 24-hours esophageal pH-impedance (Ohmega, MMS; 2 pH, 6 impedance catheters, Unisensor). The correlation analysis between macro- and micronutrient consumption and the number of gastroesophageal refluxes (GER), their acidity and duration was performed (Statistica 10, StatSoft) Results Direct medium-strength correlation was found between esophageal acid exposure time and the energy value of the ration (Spearman rank R = 0.19, p < 0.05), and the amount of consumed fat (R = 0.2, p < 0.05). There was a direct correlation of the total number of GERs with the energy value of the ration (R = 0.35, p < 0.05), protein (R = 0.3, p < 0.05), fat (R = 0.33, p < 0.05), and alcohol consumption (R = 0.28, p < 0.05) and the inverse one with the dietary fiber consumption (R = −0.22). Significant direct correlation was found between the number of acid GERs and total energy value of the ration (R = 0.35, p < 0.05), consumption of fat (R = 0.32, p < 0.05), protein (R = 0.25, p < 0.05), carbohydrates (R = 0.24, p < 0.05) and alcohol (R = 0.24, p < 0.05). Number of weak-acid GERs showed direct correlation with the calories intake (R = 0.22, p < 0.05), fat (R = 0.21, p < 0.05), protein (R = 0.22, p < 0.05), alcohol (R = 0.23, p < 0.05) consumption, and the inverse one with the amount of dietary fiber intake (R = −0.24, p < 0.05). Number of high GERs correlated directly with the amount of fat (R = 0.3, p < 0.05), protein (R = 0.22, p < 0.05), alcohol (R = 0.25, p < 0.05) consumed, and inversely with the amount of dietary fiber (R = −0.25, p < 0.05) in the ration. Paired comparison of the correlation coefficients was performed, but didn't reveal any difference. Conclusions High energy value, consumption of fat and alcohol showed direct medium-strength correlation with esophageal acid exposure and number of GERs. Dietary fiber consumption correlated inversely with total number, weak acid and high GERs. Funding Sources Federal research Center of Nutrition and Biotechnology, Russian science foundation.

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572 NUTRITIONAL PATTERNS MAY AFFECT ESOPHAGEAL ACID EXPOSURE, AND THE NUMBER AND TYPE OF GASTROESOPHAGEAL REFLUXES

Diseases of the Esophagus ◽

10.1093/dote/doaa087.150 ◽

2020 ◽

Vol 33 (Supplement_1) ◽

Author(s):

S Morozov ◽

V Kropochev ◽

V Isakov

Keyword(s):

Dietary Fibre ◽

Inverse Correlation ◽

High Energy ◽

Weak Acid ◽

Esophageal Acid Exposure ◽

Acid Exposure ◽

Published Data ◽

Esophageal Function ◽

Energy Value ◽

Food Structure

Abstract The role of nutritional patterns on esophageal function testing parameters is not widely studied. Earlier published data focused on symptoms of GERD and their association with the food structure. Aim of the study was to assess the influence of nutritional patterns on esophageal acid exposure and types and number of gastroesophageal refluxes Methods The data of complete examination of 165 participants served as a source data for the study. Diagnosis of GERD was based on clinical data (heartburn and acid regurgitation at least once a week for not less than 6 month, actual during last 3 month, history of effective PPI treatment), GERD-Q questionnaire (≥8 points), endoscopic evaluation (Excera II, Olympus, Japan) and 24-hours esophageal pH-impedance studies (Ohmega, MMS, the Netherlands; 2 pH, 6 impedance catheters, UnisensorAG, USA). Food frequency questionnaire was used to analyse food structure. StatSoft (USA) software was used for correlation analysis. The work has been performed within RSF 19–76-30014. Results We enrolled 124 GERD patients and 41 controls. Significant (P < 0.05) correlation of AET was with energy value of the ration (Spearman rank R = 0.19), amount of fat (R = 0.2). Significant correlation of number of GERs was with energy values (R = 0.35), protein (R = 0.3), fat (R = 0.33), alcohol (R = 0.28) and dietary fibre (R = -0.22) consumption. Number of acid GERs correlated with calorie (R = 0.35), fat (R = 0.32), protein (R = 0.25), carbohydrates (R = 0.24) and alcohol (R = 0.24) consumption. Number of weak-acid GERs correlated with calories (R = 0.22), fat (R = 0.21), protein (R = 0.22), alcohol (R = 0.23) and dietary fibre (R = -0.24) consumption. High GERs correlated with fat (R = 0.3), protein (R = 0.22), alcohol (R = 0.25) and fibre (R = -0.25). Conclusion High energy value, consumption of fat and alcohol showed direct medium-strength correlation with esophageal acid exposure and the total number gastroesophageal refluxes. The total number of gastroesophageal refluxes, number of weak acid and high gastroesophageal refluxes had inverse correlation with the amount of dietary fibre consumed. Found trends are used to establish nutritional patterns for reflux events in GERD patients.

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Gastroesophageal Reflux Characteristics and Patterns in Patients with Idiopathic Subglottic Stenosis

Gastroenterology Research and Practice ◽

10.1155/2018/8563697 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hongfei Fang ◽

Don C. Codipilly ◽

Karthik Ravi ◽

Dale C. Ekbom ◽

Jan L. Kasperbauer ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Proton Pump Inhibitor Therapy ◽

Esophageal Acid Exposure ◽

Acid Exposure ◽

Subglottic Stenosis ◽

Tertiary Referral Center ◽

Esophageal Ph ◽

Impedance Testing

Introduction. Idiopathic subglottic stenosis represents a spectrum of subglottic disease without a clear underlying cause. Prior studies have implicated a pathogenic role of gastroesophageal reflux disease in idiopathic subglottic stenosis. The aim of this study was to examine the presence and pattern of gastroesophageal reflux in a large cohort of patients with idiopathic subglottic stenosis at a tertiary referral center. Methods. We performed a retrospective review of patients with idiopathic subglottic stenosis from January 2010 to December 2016 who had undergone combined pH impedance testing. Patients with prior gastric or esophageal surgery were excluded. Data obtained included esophageal acid exposure times, number of reflux events, patient position during reflux events (defined as upright, supine, or mixed), body mass index, and the presence of proton pump inhibitor therapy. Results. 159 patients with the idiopathic subglottic stenosis were identified, of whom 41 had undergone esophageal pH impedance testing. 40 (97.6%) were women, with a mean age of 54.8 (range 31–79) years and BMI of 31.0 (range 17–55). Overall, 19 (46.3%) patients were found to reflux as confirmed by abnormal esophageal acid exposure or abnormal number of reflux events. 15 of the 19 patients with reflux had predominantly upright gastroesophageal reflux disease, whereas 2 had supine and 2 mixed reflux. Discussion. In patients with idiopathic subglottic stenosis who underwent evaluation by combined pH impedance, close to half were found to have gastroesophageal reflux disease. The majority of gastroesophageal reflux occurred while the patients were in the upright position.

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Impact of prolonged 48-h wireless capsule esophageal pH monitoring on diagnosis of gastroesophageal reflux disease and evaluation of the relationship between symptoms and reflux episodes

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032011000100006 ◽

2011 ◽

Vol 48 (1) ◽

pp. 24-29 ◽

Cited By ~ 7

Author(s):

Gerson Ricardo de Souza Domingues ◽

Joaquim Prado P. Moraes-Filho ◽

Aline Gonçalves Leite Domingues

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Diagnostic Yield ◽

Ph Monitoring ◽

Esophageal Acid Exposure ◽

Acid Exposure ◽

Esophageal Ph ◽

Symptom Association Probability ◽

Wireless Capsule

CONTEXT: Gastroesophageal reflux disease is one of the most common digestive diseases and an important cause of distress to patients. Diagnosis of this condition can require ambulatory pH monitoring. OBJECTIVES: To determine the diagnostic yield of a wireless ambulatory pH monitoring system of 48-hours, recording to diagnose daily variability of abnormal esophageal acid exposure and its symptom association. METHODS: A total of 100 consecutive patients with persistent reflux symptoms underwent wireless pH capsule placement from 2004 to 2009. The wireless pH capsule was deployed 5 cm proximal to the squamocolumnar junction after lower esophageal sphincter was manometrically determined. The pH recordings over 48-h were obtained after uploading data to a computer from the receiver that recorded pH signals from the wireless pH capsule. The following parameters were analyzed: (1) percentual time of distal esophageal acid exposure; (2) symptom association probability related to acid reflux. The results between the first and the second day were compared, and the diagnostic yield reached when the second day monitoring was included. RESULTS: Successful pH data over 48-h was obtained in 95% of patients. Nearly one quarter of patients experienced symptoms ranging from a foreign body sensation to chest pain. Forty-eight hours pH data analysis was statistically significant when compared to isolated analysis of day 1 and day 2. Study on day 2 identified seven patients (30.4%) that would be missed if only day 1 was analyzed. Three patients (18.7%) out of 16 patients with normal esophageal acid exposure on both days, showed positive symptom association probability, which generated an increase in diagnostic yield of 43.4%. CONCLUSION: Esophageal pH monitoring with wireless capsule is safe, well tolerated, does not require sedation. The extended 48-h period of study poses an increased yield to diagnose gastroesophageal reflux disease patients.

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