Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid

2020 ◽  
Author(s):  
Priya Sharma ◽  
Rena Yadlapati
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Treatment Options

scholarly journals Surgical Management of Pediatric Gastroesophageal Reflux Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Hope T. Jackson ◽  
Timothy D. Kane
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Surgical Management ◽  
Reflux Disease ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Treatment Options ◽  
Failure To Thrive ◽  
Solid Diet ◽  
Esophageal Sphincter

Gastroesophageal reflux (GER) is common in the pediatric population. Most cases represent physiologic GER and as the lower esophageal sphincter (LES) matures and a solid diet is introduced, many of these patients (>65%) experience spontaneous resolution of symptoms by two years of age. Those who continue to have symptoms and develop complications such as failure to thrive, secondary respiratory disease, and others are classified as having gastroesophageal reflux disease (GERD). Goals of GERD treatment include the resolution of symptoms and prevention of complications. Treatment options to achieve these goals include dietary or behavioral modifications, pharmacologic intervention, and surgical therapy. This paper will review the clinical presentation of GERD and discuss options for surgical management and outcomes in these patients.

scholarly journals Treatment Options for Non-Erosive Gastroesophageal Reflux Disease Patients Refractory to Frequent Dose Rabeprazole Therapy

2011 ◽  
Vol 140 (5) ◽  
pp. S-249
Author(s):  
Mitsushige Sugimoto ◽  
Masafumi Nishino ◽  
Chise Kodaira ◽  
Mihoko Yamade ◽  
Takahiro Uotani ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Treatment Options ◽  
Frequent Dose

scholarly journals Maintenance Treatment of Gastroesophageal Reflux Disease: An Evaluation of Continuous and On-Demand Therapy with Rabeprazole 20 mg

2007 ◽  
Vol 21 (12) ◽  
pp. 820-826 ◽  
Author(s):  
David G Morgan ◽  
Michael FJ O’Mahony ◽  
William F O’Mahony ◽  
Jean Roy ◽  
Fernando Camacho ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Treatment Options ◽  
Open Label ◽  
Open Label Study ◽  
On Demand ◽  
History Of ◽  
The Mean ◽  
Symptom Recurrence

OBJECTIVE: To evaluate continuous therapy (COT) and on-demand therapy (ODT) with rabeprazole 20 mg for maintenance in uninvestigated gastroesophageal reflux disease (GERD).METHODS: This randomized, open-label study enrolled 331 GERD (heartburn-predominant) patients with a pre-existing proton pump inhibitor history of one month or longer, to an acute four-week trial with 20 mg rabeprazole daily for heartburn management. Patients who achieved satisfactory heartburn control during the acute phase (three days or less of heartburn, with no more than one episode rated as moderate, and heartburn rated satisfactorily or completely controlled with minimal rescue antacid use in the seven days preceding randomization) were randomly assigned to six months of rabeprazole 20 mg given as either daily COT or daily ODT, which was initiated upon symptom recurrence and stopped upon symptom resolution. Rescue antacid usage was permitted and tracked. Primary efficacy was measured as the proportion of heartburn-free days over six months.RESULTS: For the 268 patients, the mean percentage of heartburn-free days for the COT group and for the ODT group were 90.3%±14.8% and 64.8%±22.3%, respectively (P<0.0001). COT was associated with an increased number of medication intake days (154±40.2) versus ODT (68±46.1), with less heartburn episodes observed with COT versus ODT, respectively (n=7, n=26, P<0.0001). Ninety-two per cent of COT patients and 79% of ODT patients were either ‘satisfied’ or ‘very satisfied’ with treatment. The mean usage of antacids was low and similar in both groups. COT and ODT regimens were safe and well-tolerated, with a similar incidence of adverse events.CONCLUSION: Results based on symptom assessments favour COT with rabeprazole 20 mg for maintenance therapy in patients with uninvestigated GERD; however, both therapy types are safe and acceptable treatment options for selected patients.

scholarly journals REFRACTORY FORM OF GASTROESOPHAGEAL REFLUX DISEASE: EVOLUTION OF CONCEPTS

2017 ◽  
Vol 2 (1) ◽  
pp. 24-30
Author(s):  
IL L Davydkin ◽  
AM M Osadchuk ◽  
TA A Gritsenko ◽  
IV V Kurtov
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Complete Response ◽  
Response To Treatment ◽  
Disease Evolution ◽  
New Methods ◽  
Gerd Symptoms

Aim of the review - to illuminate the problem of proton pump inhibitor(PPI)-refractory form of gastroesophageal reflux disease (RFGERD) at a modern scientific level. It is shown that PPI remain the standard and the most effective therapy for GERD. Patients, whose GERD symptoms are refractory to PPI, should be further examined to exclude other diseases. It is possible to use different treatment options: medication, endoscopic or surgical treatment. The response to IPP therapy can be complete (no symptoms), partial or absent. In patients with complete response to treatment with PPI no other therapy is provided. Currently, new methods of RFGERD treatment are being actively developed. Patients with partial response may require endoscopic or surgical intervention.

scholarly journals The Effect of Endoscopic Bariatric and Metabolic Therapies on Gastroesophageal Reflux Disease

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 737
Author(s):  
Su-Young Kim
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Lifestyle Modification ◽  
Treatment Options ◽  
Future Research ◽  
Research Directions ◽  
Future Research Directions ◽  
Sleeve Gastroplasty ◽  
The Relationship

Obesity is a chronic disease that is becoming increasingly more prevalent and is associated with many health problems, such as metabolic syndrome. The treatment options for obese patients include lifestyle modification, medications, endoscopic bariatric and metabolic therapies (EBMTs), and surgery. In particular, EBMTs have an excellent therapeutic effect and are less invasive than bariatric surgery. Although it is clear that EBMTs are relatively safe procedures, they can result in several adverse events. Among them, the relationship between EBMTs and gastroesophageal reflux disease (GERD) is unclear. Several studies have demonstrated that an intragastric balloon (IGB) may worsen GERD. There are a few studies on the effects of endoscopic sleeve gastroplasty (ESG) on GERD, but the linking evidence is insufficient. However, the conclusion is not simple. Because obesity is an important cause of GERD, and GERD naturally improves with weight loss after EBMTs, it is not easy to evaluate accurately the effect of EBMTs on GERD. This review aimed to discuss the effect of EBMTs on GERD and suggest future research directions.

scholarly journals Study on The Symptoms and Esophageal Motility Characteristics of Gastroesophageal Reflux Disease Patients with Obesity

2020 ◽  
Author(s):  
Yifan Yang ◽  
Attique Ur Rehman ◽  
Lixia Wang ◽  
Dong Yang ◽  
Zhifeng Zhang ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Esophageal Motility ◽  
Treatment Options ◽  
Separation Distance ◽  
High Resolution Manometry ◽  
Reflux Symptoms ◽  
Stomach Pain ◽  
Resting Pressure

Abstract Background: Previous studies have shown that obesity affects the occurrence and development of GERD, GERD is also one of the many complications of obesity. However, few prior studies have evaluated the symptoms and esophageal motility characteristics of GERD patients with obesity. The purpose of this study was to assess the symptoms and esophageal motility characteristics of gastroesophageal reflux disease (GERD) patients with obesity and the relationship between symptoms and esophageal motility results. Methods: We conducted a retrospective study. Patients were divided into four groups according to whether diagnosed with GERD and obesity: obese GERD group (N=25), obese non-GERD group (N=21), non-obese GERD group (N=29), non-obese non-GERD group (N=22). High resolution manometry (HRM) was performed to assess esophageal motility. Gastroesophageal reflux symptoms were in accordance with the GERD questionnaire (GerdQ). Results: a) The main symptoms of obese GERD group were: reflux, upper stomach pain, nausea; in the non-obese GERD group were: reflux, heartburn and taking additional medication. b) The LES resting pressure in obese GERD group was lower than in non-obese non-GERD group, non-obese GERD group and obese non-GERD group ( P <0.05); The EGJ separation distance in obese GERD group was larger compared with non-obese non-GERD group, non-obese GERD group and obese non-GERD group ( P <0.05); The length of the esophagus in obese GERD group was shorter than in non-obese non-GERD group, non-obese GERD group and obese non-GERD group ( P <0.05); The DCI in obese GERD group was lower than in obese non-GERD group ( P <0.05). c) In obese GERD group, patients with reduced LES resting pressure or increased EGJ separation distance are more likely to have "reflux" symptoms. Conclusions: Comparing with GERD patients without obesity, the symptoms, esophageal motility, esophageal motility mechanism related to the symptoms of GERD patients with obesity got different characteristics. This result provides a reference for treatment options of GERD patients with obesity.

Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Best Practice ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Diagnostic Tools ◽  
Swallowing Function ◽  
Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

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