SEVERITY OF GASTROESOPHAGEAL REFLUX DISEASE (GERD) SYMPTOMS AND EROSIVE ESOPHAGITIS (EE) AS A FUNCTION OF AGE

2003 ◽  
Vol 98 ◽  
pp. S6-S7
Author(s):  
Malcolm Robinson ◽  
Lian Mao ◽  
Luella Engelhart ◽  
Reshmi Siddique ◽  
Leonard Jokubaitis
2020 ◽  
Author(s):  
R. Thomas Finn III ◽  
Walter W Chan

Gastroesophageal reflux disease (GERD) is the most common gastrointestinal diagnosis made in outpatient clinics, responsible for over 5 million annual outpatient visits and likely hundreds of thousands of inpatient stays for noncardiac chest pain. GERD’s current definition, based on international consensus, is a “condition which develops when the reflux of stomach contents causes troublesome symptoms (i.e., at least two heartburn episodes per week) and/or complications.” Also defining GERD is the presence of erosive esophagitis on upper endoscopy (esophagogastroduodenoscopy [EGD]) with or without the presence of troublesome symptoms or the presence of troublesome symptoms without endoscopic evidence of erosive esophagitis (also known as nonerosive reflux disease). This review looks at GERD in detail, including its epidemiology and risk factors, genetics, pathogenesis and etiologic factors, clinical presentation and symptoms, differentials, diagnosis, and complications. Figures presented are an EGD image showing signs of erosive esophagitis, Barrett esophagus, and hiatal hernia and sample recordings from a 24-hour combined multichannel intraluminal impedance and pH testing. Tables list differential diagnoses for GERD, indications for performing EGD in patients with GERD symptoms, and a summary of GERD therapies. This review contains ­2 figures, 4 tables, and 74 references. 


2020 ◽  
Vol 101 (5) ◽  
pp. 661-668
Author(s):  
A A Zhilina ◽  
N V Lareva ◽  
E V Luzina

Aim. To study the prevalence of gastroesophageal reflux disease (GERD) symptoms and lesions of the esophageal mucosa in residents of Zabaikalsky krai, taking into account ethnicity. Methods. The first stage: 371 residents of Zabaikalsky krai over 18 years old, were door-to-door interviewed by using the GERD questionnaire (GerdQ). The respondents with 8 or more points were classified as having GERD symptoms. Additionally, we collected passport data, smoking status, alcohol and coffee consumption, anthropometric data and social status. The second stage: we analyzed 2130 upper gastrointestinal (GI) endoscopy reports from Regional Clinical Hospital in Chita. Results. 48 (12.9%) of 371 respondents had GERD symptoms. 135 (36.4%) respondents were Buryats, and 236 (63.6%) were non-Buryats, with the latter more often had GerdQ total score of 8 or more [38 (16.1%) non-Buryats and 10 (7.4%) Buryats, p=0.009]. The average age of non-Buryats respondents with GERD symptoms was 53.417.47 years and exceeded that in the group without symptoms (46.219.2 years), p=0.035. The age of Buryats with and without GERD symptoms did not differ (42.6711.52 and 37.8915.54 years, respectively, р=0.087). The prevalence of obesity, smoking, alcohol and coffee consumption of respondents with and without GERD symptoms, both among Buryats and non-Buryats was the same. Of the 2130 patients who underwent endoscopy, 164 (7.8%) had morphological changes in the esophagus, 105 (4.9%) had erosive esophagitis (EE). Catarrhal and erosive changes in the esophagus were detected in 156 non-Buryats (91 men and 66 women) (7.7%), while EE was diagnosed in 97 (4.8%) patients. 6.5% (5 women and 3 men) Buryats had the esophagus pathology, which caused by erosion. It was found that in non-Buryats group EE develop more often in male respondents (p=0.0019). Only non-Buryats had catarrhal changes in the esophagus (37.8%, 59 people), p=0.0312. At the same time, the incidence of complicated disease course in groups with EE was the same (p=0.8934). Conclusion. About 13% of residents of Zabaikalsky krai have weekly symptoms of GERD, male of a non-Buryat ethnic group are more likely to develop erosive esophagitis than women; the incidence of complications of esophagitis is the same in Buryats and non-Buryats respondents groups.


2021 ◽  
Vol 9 ◽  
pp. 232470962110512
Author(s):  
Priyadarshini Loganathan ◽  
Mahesh Gajendran ◽  
Brian Davis ◽  
Richard McCallum

Systemic sclerosis (SSc) is a disease that affects the gastrointestinal tract resulting in its atrophy and fibrosis of smooth muscles. Approximately 80% of SSc patients develop both gastroesophageal reflux disease (GERD) and dysphagia. The nocturnal GERD can cause regurgitation and aspiration, which can further aggravate the pulmonary fibrosis from SSc. Also, their dysphagia is further worsened by performing standard Nissen fundoplication. Therefore, we aimed to investigate whether Dor fundoplication (a 180° anterior wrap) can reduce nocturnal heartburn and regurgitation without worsening dysphagia in patients with SSc and severe GERD. Five SSc patients with drug-refractory severe GERD underwent a Dor fundoplication procedure with a median follow-up of 2 years (range: 1-5 years). In all 5 patients, the preoperative high-resolution manometry showed significant impairment of esophageal motility. Patients were interviewed postoperatively to assess for nocturnal and diurnal GERD symptoms, treatment response, the status of dysphagia, and adverse effects of surgery. The average age of 5 patients was 50 years and all were females. Four of the 5 patients (80%) reported 90% improvement in both diurnal and nocturnal GERD symptoms since surgery, with no nocturnal reflux, heartburn, or regurgitation, and reports to sleep at night without requiring any more pillows or wedges. About 50% of patients reported a decrease in their proton pump inhibitor dosage after surgery compared to before surgery. No surgical complication was reported and specifically, no worsening of dysphagia. The Dor fundoplication performed for refractory GERD in SSc patients substantially decreases heartburn and regurgitation, primarily nocturnal, without affecting dysphagia, thus improving the quality of life.


2009 ◽  
Vol 1 ◽  
pp. CMT.S2538
Author(s):  
Keith M. Olsen ◽  
Margaret L. Hitzeman

Dexlansoprazole MR, an enantiomer of lansoprazole, is a unique proton pump inhibitor with a duel release mechanism. This release mechanism produces two distinct peak concentrations that result in a prolonged mean residence time with increased duration of plasma concentrations and a greater percent time the pH is maintained above 4. The prolonged residence time allows dexlansoprazole MR to be administered throughout the day without regards to meals or the timing before a meal. In two trials of patients with erosive esophagitis, dexlansoprazole MR 60 mg and 90 mg demonstrated comparable healing rates to lansoprazole 30 mg. In patients with healed EE, dexlansoprazole MR 30 mg (75%) and 60 mg (83%) were superior to placebo (27%; p < 0.0025) in maintenance of healing. Dexlansoprazole MR 30 mg and 60 mg had a greater pecentage of heartburn-free days (91%-96%) and heartburn-free nights (96%-99%) than placebo (29%-72%) over the 6-month maintenance trial. Dexlansorpazole MR appears to be well tolerated with the safety profile being similar to lansoprazole with gastrointestinal adverse events being the most common. Dexlansoprazole MR provides a new treatment option for gastroesophageal reflux disease due to the flexible dosing, the unique release mechanisms and prologned pharmacodynamic effect.


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